Silvia de Sanjosé

IDIBELL Bellvitge Biomedical Research Institute, Barcino, Catalonia, Spain

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Publications (335)1946.76 Total impact

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    ABSTRACT: Background:Incidence rates of lymphoma are usually higher in men than in women, and oestrogens may protect against lymphoma.Methods:We evaluated occupational exposure to endocrine disrupting chemicals (EDCs) among 2457 controls and 2178 incident lymphoma cases and subtypes from the European Epilymph study.Results:Over 30 years of exposure to EDCs compared to no exposure was associated with a 24% increased risk of mature B-cell neoplasms (P-trend=0.02). Associations were observed among men, but not women.Conclusions:Prolonged occupational exposure to endocrine disruptors seems to be moderately associated with some lymphoma subtypes.British Journal of Cancer advance online publication, 5 March 2015; doi:10.1038/bjc.2015.83
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    ABSTRACT: Analysis of the cervical cancer screening activity in the National Health System of Catalonia has identified a cytological coverage at 3 years of 40.8%, an interval of 2.4 years between Pap smears and a loss to follow-up of 50% at 3 years in women aged 25-65 years old. The introduction of human papillomavirus testing in the management of women with cytological results of atypical squamous cell of undetermined significance and as an adjunct to cytology in women with a history of inadequate screening has facilitated the management and detection of women at risk of developing cervical intraepithelial neoplasia grade 2 or worse (CIN2 + ).
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    ABSTRACT: Recently the International Agency for Research on Cancer (IARC) Programme for the Evaluation of Carcinogenic Risks to Humans has been criticized for several of its evaluations, and also the approach used to perform these evaluations. Some critics have claimed that IARC Working Groups' failures to recognize study weaknesses and biases of Working Group members have led to inappropriate classification of a number of agents as carcinogenic to humans. The authors of this paper are scientists from various disciplines relevant to the identification and hazard evaluation of human carcinogens. We have examined here criticisms of the IARC classification process to determine the validity of these concerns. We review the history of IARC evaluations and describe how the IARC evaluations are performed. We conclude that these recent criticisms are unconvincing. The procedures employed by IARC to assemble Working Groups of scientists from the various discipline and the techniques followed to review the literature and perform hazard assessment of various agents provide a balanced evaluation and an appropriate indication of the weight of the evidence. Some disagreement by individual scientists to some evaluations is not evidence of process failure. The review process has been modified over time and will undoubtedly be altered in the future to improve the process. Any process can in theory be improved, and we would support continued review and improvement of the IARC processes. This does not mean, however, that the current procedures are flawed. The IARC Monographs have made, and continue to make, major contributions to the scientific underpinning for societal actions to improve the public's health.
    Environmental Health Perspectives 02/2015; DOI:10.1289/ehp.1409149 · 7.26 Impact Factor
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    ABSTRACT: Autoimmune conditions and immune system-related genetic variations are associated with risk of non-Hodgkin lymphoma (NHL). In a pooled analysis of 8,692 NHL cases and 9,260 controls from 14 studies (1988-2007) within the International Lymphoma Epidemiology Consortium, we evaluated the interaction between immune system genetic variants and autoimmune conditions in NHL risk. We evaluated the immunity-related single nucleotide polymorphisms rs1800629 (tumor necrosis factor gene (TNF) G308A), rs1800890 (interleukin-10 gene (IL10) T3575A), rs6457327 (human leukocyte antigen gene (HLA) class I), rs10484561 (HLA class II), and rs2647012 (HLA class II)) and categorized autoimmune conditions as primarily mediated by B-cell or T-cell responses. We constructed unconditional logistic regression models to measure associations between autoimmune conditions and NHL with stratification by genotype. Autoimmune conditions mediated by B-cell responses were associated with increased NHL risk, specifically diffuse large B-cell lymphoma (odds ratio (OR) = 3.11, 95% confidence interval (CI): 2.25, 4.30) and marginal zone lymphoma (OR = 5.80, 95% CI: 3.82, 8.80); those mediated by T-cell responses were associated with peripheral T-cell lymphoma (OR = 2.14, 95% CI: 1.35, 3.38). In the presence of the rs1800629 AG/AA genotype, B-cell-mediated autoimmune conditions increased NHL risk (OR = 3.27, 95% CI: 2.07, 5.16; P-interaction = 0.03) in comparison with the GG genotype (OR = 1.82, 95% CI: 1.31, 2.53). This interaction was consistent across major B-cell NHL subtypes, including marginal zone lymphoma (P-interaction = 0.02) and follicular lymphoma (P-interaction = 0.04). © The Author 2015. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail:
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    ABSTRACT: Anal condylomata are common in HIV-positive individuals and among men who have sex with men (MSM). Generally attributable to infection by low-risk human papillomaviruses (HPVs), condylomata are considered benign low-grade Squamous Intraepithelial Lesions (SILs). However, anal condylomata have occasionally been linked to high-grade SIL and to oncogenic, high-risk HPVs. Here we describe the range of intraepithelial lesions and of the associated HPVs in heterosexual men/women and MSM. Perianal and anal condylomata were collected from 243 patients (56 heterosexual women, 61 heterosexual men and 126 MSM, including 41 HIV-positive MSM). We assessed lesion histology and HPV genotype. Prevalence estimates and Poisson models were used. Irrespective of HIV-infection status, MSM showed higher proportion of condylomata as high-grade SILs compared with heterosexual men/women. High-grade SILs were also more prevalent in anal than in perianal lesions in all patient groups. HIV-positive MSM exhibited increased prevalence ratio [4.6; 95% CI: 2.1-10.0] of perianal low-grade SILs containing only high-risk HPVs compared with HIV-negative MSM. In addition, more than 64% of anal SILs with a high-grade component, regardless of HIV infection, were exclusively associated with low-risk HPVs. In anal condylomata, both high-grade and low-grade SILs can be associated with high-risk and/or low-risk HPVs. Particularly, low-grade perianal SILs associated with high-risk HPVs were common in HIV-positive MSM, while presence of only low-risk HPVs in high-grade SILs were common in both MSM groups. Our findings sound a note of caution for the common clinical practice for the treatment of anal condylomata as benign lesions in MSM and HIV+ patients.
    Clinical Microbiology and Infection 02/2015; in press. DOI:10.1016/j.cmi.2015.02.009 · 5.20 Impact Factor
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    ABSTRACT: Great controversy exists about the association between Human Papillomavirus (HPV) and breast tumors. The aim of this study was to explore the presence of HPV DNA in a large set of breast cancer cases. Techniques used followed the standards for an international retrospective survey of HPV-DNA genotyping, coordinated by our own group and the DDL Laboratories in Rijswijk, the Netherlands. Paraffin-embedded samples were used. SPF-10 broad-spectrum primers were applied, followed by deoxyribonucleic acid enzyme immunoassay and genotyping by reverse-line probe assay. A total of 78 samples were included in the study, 2 of benign conditions and 76 carcinomas, including different histological subtypes. HPV was not present in any of the specimens studied irrespective of histology, hormonal status and stage of disease. Our data do not support the involvement of HPV in breast carcinogenesis as no evidence of its presence was found. Copyright© 2015 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.
    Anticancer research 02/2015; 35(2):851-6. · 1.87 Impact Factor
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    ABSTRACT: We present the protocol of a large population-based case-control study of 5 common tumors in Spain (MCC-Spain) that evaluates environmental exposures and genetic factors. Between 2008-2013, 10,183 persons aged 20-85 years were enrolled in 23 hospitals and primary care centres in 12 Spanish provinces including 1,115 cases of a new diagnosis of prostate cancer, 1,750 of breast cancer, 2,171 of colorectal cancer, 492 of gastro-oesophageal cancer, 554 cases of chronic lymphocytic leukaemia (CLL) and 4,101 population-based controls matched by frequency to cases by age, sex and region of residence. Participation rates ranged from 57% (stomach cancer) to 87% (CLL cases) and from 30% to 77% in controls. Participants completed a face-to-face computerized interview on sociodemographic factors, environmental exposures, occupation, medication, lifestyle, and personal and family medical history. In addition, participants completed a self-administered food-frequency questionnaire and telephone interviews. Blood samples were collected from 76% of participants while saliva samples were collected in CLL cases and participants refusing blood extractions. Clinical information was recorded for cases and paraffin blocks and/or fresh tumor samples are available in most collaborating hospitals. Genotyping was done through an exome array enriched with genetic markers in specific pathways. Multiple analyses are planned to assess the association of environmental, personal and genetic risk factors for each tumor and to identify pleiotropic effects. This study, conducted within the Spanish Consortium for Biomedical Research in Epidemiology & Public Health (CIBERESP), is a unique initiative to evaluate etiological factors for common cancers and will promote cancer research and prevention in Spain. Copyright © 2014 SESPAS. Published by Elsevier Espana. All rights reserved.
    Gaceta Sanitaria 01/2015; DOI:10.1016/j.gaceta.2014.12.003 · 1.25 Impact Factor
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    ABSTRACT: Marginal zone lymphoma (MZL) is the third most common subtype of B-cell non-Hodgkin lymphoma. Here we perform a two-stage GWAS of 1,281 MZL cases and 7,127 controls of European ancestry and identify two independent loci near BTNL2 (rs9461741, P=3.95 × 10(-15)) and HLA-B (rs2922994, P=2.43 × 10(-9)) in the HLA region significantly associated with MZL risk. This is the first evidence that genetic variation in the major histocompatibility complex influences MZL susceptibility.
    Nature Communications 01/2015; 6:5751. DOI:10.1038/ncomms6751 · 10.74 Impact Factor
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    ABSTRACT: Background:CLL is a chronic disease that often progresses slowly from a precursor stage, monoclonal B-cell lymphocytosis (MBL), and that can remain undiagnosed for a long time. Methods:Within the European EPIC cohort, we measured pre-diagnostic plasma sCD23 for 179 individuals who eventually were diagnosed with CLL and an equal number of matched control subjects who remained free of cancer. Results: In a very large proportion of CLL patients plasma sCD23 was clearly elevated 7 or more years before diagnosis. Considering sCD23 as a disease predictor, the area under the ROC curve (AUROC) was 0.95 [95% CI (0.90, 1.00)] for CLL diagnosed within 0.1-2.7 years after blood measurement, 0.90 [0.86-0.95] for diagnosis within 2.8-7.3 years, and 0.76 [0.65-0.86] for CLL diagnosed between 7.4 and 12.5 years. Even at a 7.4-year and longer time interval, elevated plasma sCD23 could predict a later clinical diagnosis of CLL with 100% specificity at >45% sensitivity. Conclusions:Our findings provide unique documentation for the very long latency times during which measurable B-cell lympho-proliferative disorder exists prior to the clinical manifestation of CLL. Impact:Our findings have relevance for the interpretation of prospective epidemiologic studies on the causes of CLL in terms of reverse causation bias. The lag-times indicate a time frame within which an early detection of CLL would be theoretically possible. Copyright © 2014, American Association for Cancer Research.
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    ABSTRACT: Background: Past investigations of cigarette smoking and multiple myeloma have been underpowered to detect moderate associations, particularly within subgroups. To clarify this association we conducted a pooled analysis of nine case-control studies in the International Multiple Myeloma Consortium, with individual-level questionnaire data on cigarette smoking history and other covariates. Methods: Using a pooled population of 2,670 cases and 11,913 controls, we computed odds ratios (ORs) and 95% confidence intervals (CIs) relating smoking to multiple myeloma risk using unconditional logistic regression adjusting for gender, age group, race, education, body mass index, alcohol consumption, and study center. Results: Neither ever smokers (OR=0.95, 95% CI 0.87-1.05), current smokers (OR=0.82, 95% CI 0.73-0.93), nor former smokers (OR=1.03, 95% CI 0.92-1.14) had increased risks of multiple myeloma compared to never smokers. Analyses of smoking frequency, pack-years, and duration did not reveal significant or consistent patterns, and there was no significant effect modification by subgroups. Conclusion: Findings from this large pooled analysis do not support the hypothesis of cigarette smoking as a causal factor for multiple myeloma. Impact: Cigarette smoking is one of the most important risk factors for cancer, but the association with multiple myeloma was inconclusive. This study had excellent power to detect modest associations, and had individual-level data to evaluate confounding and effect modification by potentially important factors that were not evaluated in previous studies. Our findings confirm that smoking is not a risk factor for multiple myeloma. Copyright © 2014, American Association for Cancer Research.
  • Laura Costas, Silvia de Sanjosé, Claire Infante-Rivard
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    ABSTRACT: Considerable efforts have been made to elucidate non-Hodgkin lymphoma's (NHL) etiology during the last decades. Some evidence points to an association with reproductive factors, as incidence rates for most NHL subtypes are usually higher in men than in women, and several subtypes express hormonal receptors. Although the evidence is not compelling, some studies show an inverse association with gravidity. Associations with postmenopausal hormone therapy are usually derived from unopposed estrogen use, rather than for the combination of estrogen with progestin, but these findings vary by study design. Inconsistencies in the results are likely due to the complex relationship between reproductive, biological, and sociodemographic factors, as well as to study limitations. Elucidating the role of hormonal factors should provide clues for therapeutic options and public health decisions. We provide an overview of the available evidence on reproductive factors in NHL etiology, underscoring potential sources of discrepancies and bias.
    Critical Reviews in Oncology/Hematology 12/2014; 92(3). DOI:10.1016/j.critrevonc.2014.07.004 · 4.05 Impact Factor
  • Revista Española de Salud Pública 12/2014; 88(6):735-743. DOI:10.4321/S1135-57272014000600006 · 0.71 Impact Factor
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    ABSTRACT: We aimed to provide updated information about the global estimates of attributable fraction and type distribution of human papillomavirus (HPV) in head and neck squamous cell carcinomas by doing a systematic review and meta-analysis. We did a literature search on PubMed to identify studies that used PCR for detection of HPV DNA in head and neck squamous cell carcinomas with information about HPV genotype distribution. We included studies that tested 20 or more biopsies per cancer site and were published between July 15, 1990, and Feb 29, 2012. We collected information about sex, risk factors, HPV detection methods, and biomarkers of potentially HPV-induced carcinogenesis (E6/E7 mRNA and p16(INK4a)). If it was not possible to abstract the required information directly from the paper, we contacted the authors. We did a meta-analysis to produce pooled prevalence estimates including a meta-regression to explore sources of heterogeneity. 148 studies were included, contributing data for 12 163 cases of head and neck squamous cell carcinoma from 44 countries. HPV DNA was detected in 3837 cases. HPV16 accounted for 82·2% (95% CI 77·7-86·4) of all HPV DNA positive cases. By cancer site, pooled HPV DNA prevalence estimates were 45·8% (95% CI 38·9-52·9) for oropharynx, 22·1% (16·4-28·3) for larynx (including hypopharynx), and 24·2% (18·7-30·2) for oral cavity. The percent positivity of p16(INK4a) positive cases in HPV-positive oropharyngeal cancer cases was 86·7% (95% CI 79·2-92·9) and of E6/E7 mRNA positive cases was 86·9% (73·2-96·8). The estimate of HPV attributable fraction in oropharyngeal cancer defined by expression of positive cases of E6/E7 mRNA was 39·8% and of p16(INK4a) was 39·7%. Of subsites, tonsils (53·9%, 95% CI 46·4-61·3) had the highest HPV DNA prevalence. HPV DNA prevalence varied significantly by anatomical site, geographic region, but not by sex or tobacco or alcohol consumption. The contribution of HPV prevalence in head and neck squamous cell carcinoma and in particular that of HPV16 in the oropharynx shows the potential benefit of prophylactic vaccines. European Commission. Copyright © 2014 Elsevier Ltd. All rights reserved.
    The Lancet Oncology 11/2014; 15(12):1319-31. DOI:10.1016/S1470-2045(14)70471-1 · 25.12 Impact Factor
  • Silvia de Sanjosé, Laia Bruni, Laia Alemany
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    ABSTRACT: Human papillomavirus (HPV) infection has been firmly established as a central and necessary cause of invasive cervical cancer and it has been etiologically linked to other anogenital (vulva, vagina, anus and penis) and head and neck cancers, particularly oropharyngeal. Although being rare, the incidence of some of these cancers in some countries has increased in the last decades. HPV-related anogenital tumors share many risk factors with cervical cancer. The HPV aetiological contribution differs in each anatomical location reflecting differences in the natural history and viral tissue tropism. The highest prevalence of HPV DNA in cancers other than cervix has been described for anal, followed by vagina, penile and vulvar cancers. HPV16 has been described as the most common type detected in all cancer sites with different contributions being the highest in anal carcinoma (around 80% of HPV DNA positive anal cancers) and the lowest in vaginal cancers with a contribution similar to that found in cervical cancers (around 60%). Current HPV vaccines have already demonstrated their efficacy in preventing anogenital pre-neoplastic lesions caused by vaccine HPV types. HPV-based prevention tools like HPV vaccination and to a lesser extend screening (e.g. for anal cancer) can be useful measures for reducing the burden of these anogenital cancers.
    La Presse Médicale 10/2014; DOI:10.1016/j.lpm.2014.10.001 · 1.17 Impact Factor
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    ABSTRACT: Secondary prevention of breast cancer, cervix and colon is performed by screening. Spain in the last decade has presented a major wave of migration; it is known that immigrants have more inequalities in access to health services compared to the native population. The objective is to review the published studies and identify gaps in research on cancer prevention among immigrants living in Spain. We have conducted a scoping review. The sources of information were the databases Medline (Pubmed) and MEDES - medicine in Spanish (1998-2012). We used three thematic filters: concerning to Cancer, immigration and geographic. Inclusion criteria were studies of cancer prevention and health of immigrants from Latin America, Africa, Asia and Eastern Europe and developed in Spain. We developed an ad hoc data collection protocol. We included five studies of 237 reviewed. The included studies are written in English and published in journals with impact factor. Most studies have used country of origin as the immigration variable 80 % of the studies conducted cross-sectional surveys. Immigrant population had a lower participation of early detection of breast and cervical cancer. Women reported to be sex workers were more likely to be human papillomavirus positive for high risk types. There is little information on cancer prevention through screening programs in the immigrant population. It is important to evaluate and improve the screening circuits and registries to implement programs to better identify the most vulnerable population groups.
    Revista Española de Salud Pública 10/2014; 88(6):735-743.. · 0.71 Impact Factor
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    ABSTRACT: Background We estimated the potential impact of an investigational 9-valent human papillomavirus (HPV) vaccine (HPVs 6/11/16/18/31/33/45/52/58) in HPV-related cervical disease in Brazil, Mexico, India and China, to help to formulate recommendations on cervical cancer prevention and control. Methods Estimations for invasive cervical cancer (ICC) were based on an international study including 1356 HPV-positive cases for the four countries altogether, and estimations for precancerous cervical lesions were extracted from a published meta-analysis including 6 025 HPV-positive women from the four mentioned countries. Globocan 2012 and 2012 World Population Prospects were used to estimate current and future projections of new ICC cases. Results Combined proportions of the 9 HPV types in ICC were 88.6% (95%CI: 85.2–91.3) in Brazil, 85.7% (82.3–88.8) in Mexico, 92.2% (87.9–95.3) in India and 97.3% (93.9–99.1) in China. The additional HPV 31/33/45/52/58 proportions were 18.8% (15.3–22.7) in Brazil, 17.6% (14.2–21.2) in Mexico, 11.3% (7.5–16.1) in India and 11.9% (7.5–17.2) in China. HPV6 and 11 single types were not identified in any of the samples. Proportion of the individual 7 high risk HPV types included in the vaccine varied by cytological and histological grades of HPV-positive precancerous cervical lesions. HPV 16 was the dominant type in all lesions, with contributions in low grade lesions ranging from 16.6%(14.3–19.2) in Mexico to 39.8% (30.0–50.2) in India, and contributions in high grade lesions ranging from 43.8% (36.3–51.4) in Mexico to 64.1% (60.6–67.5) in Brazil. After HPV 16, variations in other majors HPV types were observed by country, with an under representation of HPV 18 and 45 compared to ICC. Conclusion The addition of HPVs 31/33/45/52/58 to HPV types included in current vaccines could increase the ICC preventable fraction in a range of 12 to 19% across the four countries, accounting the 9-types altogether 90% of ICC cases. Assuming the same degree of efficacy of current vaccines, the implementation of the 9-valent HPV vaccine in Brazil, Mexico, India and China would substantially impact on the reduction of the world cervical cancer burden.
    Cancer Epidemiology 10/2014; DOI:10.1016/j.canep.2014.09.003 · 2.56 Impact Factor
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    ABSTRACT: Genome-wide association studies (GWASs) of follicular lymphoma (FL) have previously identified human leukocyte antigen (HLA) gene variants. To identify additional FL susceptibility loci, we conducted a large-scale two-stage GWAS in 4,523 case subjects and 13,344 control subjects of European ancestry. Five non-HLA loci were associated with FL risk: 11q23.3 (rs4938573, p = 5.79 × 10(-20)) near CXCR5; 11q24.3 (rs4937362, p = 6.76 × 10(-11)) near ETS1; 3q28 (rs6444305, p = 1.10 × 10(-10)) in LPP; 18q21.33 (rs17749561, p = 8.28 × 10(-10)) near BCL2; and 8q24.21 (rs13254990, p = 1.06 × 10(-8)) near PVT1. In an analysis of the HLA region, we identified four linked HLA-DRβ1 multiallelic amino acids at positions 11, 13, 28, and 30 that were associated with FL risk (pomnibus = 4.20 × 10(-67) to 2.67 × 10(-70)). Additional independent signals included rs17203612 in HLA class II (odds ratio [ORper-allele] = 1.44; p = 4.59 × 10(-16)) and rs3130437 in HLA class I (ORper-allele = 1.23; p = 8.23 × 10(-9)). Our findings further expand the number of loci associated with FL and provide evidence that multiple common variants outside the HLA region make a significant contribution to FL risk.
    The American Journal of Human Genetics 10/2014; 95(4):462-71. DOI:10.1016/j.ajhg.2014.09.004 · 10.99 Impact Factor
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    ABSTRACT: Diffuse large B cell lymphoma (DLBCL) is the most common lymphoma subtype and is clinically aggressive. To identify genetic susceptibility loci for DLBCL, we conducted a meta-analysis of 3 new genome-wide association studies (GWAS) and 1 previous scan, totaling 3,857 cases and 7,666 controls of European ancestry, with additional genotyping of 9 promising SNPs in 1,359 cases and 4,557 controls. In our multi-stage analysis, five independent SNPs in four loci achieved genome-wide significance marked by rs116446171 at 6p25.3 (EXOC2; P = 2.33 × 10(-21)), rs2523607 at 6p21.33 (HLA-B; P = 2.40 × 10(-10)), rs79480871 at 2p23.3 (NCOA1; P = 4.23 × 10(-8)) and two independent SNPs, rs13255292 and rs4733601, at 8q24.21 (PVT1; P = 9.98 × 10(-13) and 3.63 × 10(-11), respectively). These data provide substantial new evidence for genetic susceptibility to this B cell malignancy and point to pathways involved in immune recognition and immune function in the pathogenesis of DLBCL.
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    ABSTRACT: HPV infection is a necessary cause for cervical cancer, and it is also causally linked with a range of different attributable fractions to other anogenital and head and neck cancers. The highest HPV DNA involvement in cancers other than cervix has been described in anal cancer (88.3%), followed by vaginal cancers (74.3%), peneal (33.0%) and vulvar (28.6). In high grade pre-neoplastic lesions from vulvar, vaginal, peneal and anal sites a very high HPV DNA detection rate is observed (over 85%). Agreement with biomarkers measuring the viral transforming activity is not 100%. The contribution of these additional markers is not well established when global estimates of HPV-attributable fractions (AF) in human cancer are provided. Objectives To evaluate the contribution of HPV type specific DNA, p16INK4a and type specific mRNA E6*I in anogenital cancers derived from a large repository of parafin-embedded specimens. Methods HPV DNA (SPF-10/LiPA25), p16INK4a and type specific mRNA E6*I are being evaluated in cancer and precancerous lesions of the vulva, vagina, anus and penis. The HPV contribution is estimated by considering different scenarios of biomarkers positivity and correcting for sensitivity drops. Preliminary results p16INK4a positivity among HPV DNA positive cases was 98% in cervical cancer; 95% in anal cancer; 87% in cancer of the vagina; 83% in cancer of the vulva; and 70% in peneal cancer. The HPV contribution varies depending on the markers used e.g. in vulva cancer contribution would range from 29.4% if considering a positive staining with p16INK4a, 27% with HPV DNA or 22% both combined. The meaning of discrepant results between biomarkers is still subject of discussion. Comprehensive analyses on HPV DNA, p16INK4a and mRNA E6*I in anogenital locations will be provided. Discussion The best approach to estimate HPV contribution in a given tumor has relied mainly on the viral DNA detection. A better understanding of the additional information obtained by other markers like p16INK4a or mRNA may refine our estimates of HPV contribution in related cancers at the population level.
    Revue Francophone des Laboratoires 09/2014; 2014(465):12–13. DOI:10.1016/S1773-035X(14)72669-3
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    ABSTRACT: Aim: This work describes the human papillomavirus (HPV) prevalence and the HPV type distribution in a large series of vaginal intraepithelial neoplasia (VAIN) grades 2/3 and vaginal cancer worldwide. Methods: We analysed 189 VAIN 2/3 and 408 invasive vaginal cancer cases collected from 31 countries from 1986 to 2011. After histopathological evaluation of sectioned formalin-fixed paraffin-embedded samples, HPV DNA detection and typing was performed using the SPF-10/DNA enzyme immunoassay (DEIA)/LiPA 25 system (version 1). A subset of 146 vag-inal cancers was tested for p16 INK4a expression, a cellular surrogate marker for HPV transfor-mation. Prevalence ratios were estimated using multivariate Poisson regression with robust variance. Results: HPV DNA was detected in 74% (95% confidence interval (CI): 70–78%) of invasive cancers and in 96% (95% CI: 92–98%) of VAIN 2/3. Among cancers, the highest detection rates were observed in warty-basaloid subtype of squamous cell carcinomas, and in younger ages. Concerning the type-specific distribution, HPV16 was the most frequently type detected in both precancerous and cancerous lesions (59%). p16 INK4a overexpression was found in 87% of HPV DNA positive vaginal cancer cases. Conclusions: HPV was identified in a large proportion of invasive vaginal cancers and in almost all VAIN 2/3. HPV16 was the most common type detected. A large impact in the reduction of the burden of vaginal neoplastic lesions is expected among vaccinated cohorts.
    European Journal of Cancer 08/2014; DOI:10.1016/j.ejca.2014.07.018 · 4.82 Impact Factor

Publication Stats

16k Citations
1,946.76 Total Impact Points


  • 2006–2015
    • IDIBELL Bellvitge Biomedical Research Institute
      Barcino, Catalonia, Spain
    • National Institutes of Health
      • Division of Cancer Epidemiology and Genetics
      Bethesda, MD, United States
    • VU University Amsterdam
      Amsterdamo, North Holland, Netherlands
  • 2001–2015
    • Catalan Institute of Oncology
      • • Infections and Cancer Unit
      • • Cancer Epidemiology Research Programme (PREC)
      Badalona, Catalonia, Spain
  • 2014
    • National Cancer Institute (USA)
      • Radiation Epidemiology
      베서스다, Maryland, United States
    • Mayo Clinic - Rochester
      • Department of Health Science Research
      Рочестер, Minnesota, United States
  • 2011–2014
    • Institut Marqués, Spain, Barcelona
      Barcino, Catalonia, Spain
    • Queen Mary, University of London
      • Centre for Cancer Prevention
      London, ENG, United Kingdom
  • 1996–2014
    • Institut Català d'Oncologia
      Barcino, Catalonia, Spain
    • Clinica Girona
      Girona, Catalonia, Spain
  • 2013
    • Hospital Italiano de Buenos Aires
      Buenos Aires, Buenos Aires F.D., Argentina
    • Madrid Salud
      Madrid, Madrid, Spain
    • London School of Hygiene and Tropical Medicine
      • Faculty of Infectious and Tropical Diseases
      London, ENG, United Kingdom
  • 2012
    • Harvard University
      • Center for Health Decision Science
      Boston, MA, United States
    • Vall d’Hebron Institute of Oncology
      Barcino, Catalonia, Spain
    • Universitätsklinikum Freiburg
      • Center for Chronic Immunodeficiency (CCI)
      Freiburg, Lower Saxony, Germany
    • Universidad Nacional de Asunción
      San Lorenzo del Campo Grande, Central, Paraguay
  • 2011–2012
    • DDL Diagnostic Laboratory
      Rijswijk, South Holland, Netherlands
  • 2010–2012
    • Università degli studi di Cagliari
      • Department of Public Health, Clinical and Molecular Medicine
      Cagliari, Sardinia, Italy
    • University of California, Berkeley
      • School of Public Health
      Berkeley, California, United States
  • 2007–2011
    • German Cancer Research Center
      • Division of Cancer Epidemiology
      Heidelberg, Baden-Wuerttemberg, Germany
    • University of Crete
      Retimo, Crete, Greece
    • Hospital Universitario Ramón y Cajal
      Madrid, Madrid, Spain
  • 2008–2010
    • University of Barcelona
      Barcino, Catalonia, Spain
    • Makerere University
      • Department of Pathology
      Kampala, Kampala District, Uganda
    • IDIBGI Girona Biomedical Research Institute
      Girona, Catalonia, Spain
    • Moffitt Cancer Center
      Tampa, Florida, United States
    • Hospital Universitari de Girona Dr. Josep Trueta
      Girona, Catalonia, Spain
  • 1991–2007
    • International Agency for Research on Cancer
      • Section of Cancer Information
      Lyons, Rhône-Alpes, France
  • 1998–2006
    • Molecular Biology Institute of Barcelona
      Barcino, Catalonia, Spain
  • 2005
    • Yale University
      New Haven, Connecticut, United States
  • 2004
    • Aristotle University of Thessaloniki
      • Department of Obstetrics and Gynecology IV
      Thessaloníki, Kentriki Makedonia, Greece
    • Hospital Sant Joan de Déu
      Barcino, Catalonia, Spain
  • 2002–2004
    • Hospital Monte Aranco
      Oviedo, Asturias, Spain
    • Johns Hopkins University
      Baltimore, Maryland, United States