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Br J Cancer. 1997; 75(5): 722–728.
PMCID: PMC2063341

Renal allograft recipients with high susceptibility to cutaneous malignancy have an increased prevalence of human papillomavirus DNA in skin tumours and a greater risk of anogenital malignancy.


Renal allograft recipients (RARs) have a well-documented increased incidence of viral warts and cutaneous neoplasia, particularly those with long graft life and high sun exposure. A clinicopathological survey of 69 RARs in south-east Scotland, with follow-up periods of up to 28 years after transplantation, revealed marked variation in patient susceptibility to cutaneous malignancy with concomitant variation in HPV prevalence. Skin cancers were found in 34 patients. Eight patients showed high susceptibility [defined as more than four intraepidermal carcinomas (IECs) or invasive squamous cell carcinomas (SCCs)] 42 had intermediate susceptibility (1-3 IECs or SCCs, or >3 keratoses) and 18 had low susceptibility (< or = 3 keratoses and no cancers). SCCs, IECs and keratoses from the high-susceptibility group were found to have greater prevalences of human papillomavirus (HPV) DNA (56%, 45% and 50% respectively), than SCCs (0%) and IECs (33%) from intermediate-susceptibility RARs and keratoses (36%) from the combined intermediate- and low-susceptibility groups and compared with a group of immunocompetent controls (27%, 20% and 15% respectively). No differences in p53 protein accumulation, determined immunohistochemically, were observed in tumours from the three groups. Categorization of RARs by susceptibility to cutaneous malignancy provides clinically useful information, as significantly more high-susceptibility patients (38%) developed aggressive, potentially lethal anogenital or cutaneous squamous cell cancers than did patients in the intermediate group (5%, P=0.005) or the low-susceptibility group (0%).

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  • Alloub MI, Barr BB, McLaren KM, Smith IW, Bunney MH, Smart GE. Human papillomavirus infection and cervical intraepithelial neoplasia in women with renal allografts. BMJ. 1989 Jan 21;298(6667):153–156. [PMC free article] [PubMed]
  • Arends MJ, Wyllie AH, Bird CC. Papillomaviruses and human cancer. Hum Pathol. 1990 Jul;21(7):686–698. [PubMed]
  • Arends MJ, Donaldson YK, Duvall E, Wyllie AH, Bird CC. HPV in full thickness cervical biopsies: high prevalence in CIN 2 and CIN 3 detected by a sensitive PCR method. J Pathol. 1991 Dec;165(4):301–309. [PubMed]
  • Arends MJ, Donaldson YK, Duvall E, Wyllie AH, Bird CC. Human papillomavirus type 18 associates with more advanced cervical neoplasia than human papillomavirus type 16. Hum Pathol. 1993 Apr;24(4):432–437. [PubMed]
  • Arends MJ, Wyllie AH, Bird CC. Human papillomavirus type 18 is associated with less apoptosis in fibroblast tumours than human papillomavirus type 16. Br J Cancer. 1995 Sep;72(3):646–649. [PMC free article] [PubMed]
  • Banks L, Matlashewski G, Crawford L. Isolation of human-p53-specific monoclonal antibodies and their use in the studies of human p53 expression. Eur J Biochem. 1986 Sep 15;159(3):529–534. [PubMed]
  • Barr BB, Benton EC, McLaren K, Bunney MH, Smith IW, Blessing K, Hunter JA. Human papilloma virus infection and skin cancer in renal allograft recipients. Lancet. 1989 Jan 21;1(8630):124–129. [PubMed]
  • Berkhout RJ, Tieben LM, Smits HL, Bavinck JN, Vermeer BJ, ter Schegget J. Nested PCR approach for detection and typing of epidermodysplasia verruciformis-associated human papillomavirus types in cutaneous cancers from renal transplant recipients. J Clin Microbiol. 1995 Mar;33(3):690–695. [PMC free article] [PubMed]
  • Blessing K, McLaren KM, Benton EC, Barr BB, Bunney MH, Smith IW, Beveridge GW. Histopathology of skin lesions in renal allograft recipients--an assessment of viral features and dysplasia. Histopathology. 1989 Feb;14(2):129–139. [PubMed]
  • Blessing K, McLaren KM, Morris R, Barr BB, Benton EC, Alloub M, Bunney MH, Smith IW, Smart GE, Bird CC. Detection of human papillomavirus in skin and genital lesions of renal allograft recipients by in situ hybridization. Histopathology. 1990 Feb;16(2):181–185. [PubMed]
  • Bavinck JN, Gissmann L, Claas FH, Van der Woude FJ, Persijn GG, Ter Schegget J, Vermeer BJ, Jochmus I, Müller M, Steger G, et al. Relation between skin cancer, humoral responses to human papillomaviruses, and HLA class II molecules in renal transplant recipients. J Immunol. 1993 Aug 1;151(3):1579–1586. [PubMed]
  • Eliezri YD, Silverstein SJ, Nuovo GJ. Occurrence of human papillomavirus type 16 DNA in cutaneous squamous and basal cell neoplasms. J Am Acad Dermatol. 1990 Nov;23(5 Pt 1):836–842. [PubMed]
  • Ellis JR, Keating PJ, Baird J, Hounsell EF, Renouf DV, Rowe M, Hopkins D, Duggan-Keen MF, Bartholomew JS, Young LS, et al. The association of an HPV16 oncogene variant with HLA-B7 has implications for vaccine design in cervical cancer. Nat Med. 1995 May;1(5):464–470. [PubMed]
  • Euvrard S, Chardonnet Y, Dureau G, Hermier C, Thivolet J. Human papillomavirus type 1-associated squamous cell carcinoma in a heart transplant recipient. Arch Dermatol. 1991 Apr;127(4):559–564. [PubMed]
  • Leigh IM, Glover MT. Cutaneous warts and tumours in immunosuppressed patients. J R Soc Med. 1995 Feb;88(2):61–62. [PMC free article] [PubMed]
  • London NJ, Farmery SM, Will EJ, Davison AM, Lodge JP. Risk of neoplasia in renal transplant patients. Lancet. 1995 Aug 12;346(8972):403–406. [PubMed]
  • Lutzner M, Croissant O, Ducasse MF, Kreis H, Crosnier J, Orth G. A potentially oncogenic human papillomavirus (HPV-5) found in two renal allograft recipients. J Invest Dermatol. 1980 Oct;75(4):353–356. [PubMed]
  • Lutzner MA, Orth G, Dutronquay V, Ducasse MF, Kreis H, Crosnier J. Detection of human papillomavirus type 5 DNA in skin cancers of an immunosuppressed renal allograft recipient. Lancet. 1983 Aug 20;2(8347):422–424. [PubMed]
  • McGregor JM, Farthing A, Crook T, Yu CC, Dublin EA, Levison DA, MacDonald DM. Posttransplant skin cancer: a possible role for p53 gene mutation but not for oncogenic human papillomaviruses. J Am Acad Dermatol. 1994 May;30(5 Pt 1):701–706. [PubMed]
  • Müller M, Kelly G, Fiedler M, Gissmann L. Human papillomavirus type 48. J Virol. 1989 Nov;63(11):4907–4908. [PMC free article] [PubMed]
  • Ogunbiyi OA, Scholefield JH, Raftery AT, Smith JH, Duffy S, Sharp F, Rogers K. Prevalence of anal human papillomavirus infection and intraepithelial neoplasia in renal allograft recipients. Br J Surg. 1994 Mar;81(3):365–367. [PubMed]
  • Purdie CA, O'Grady J, Piris J, Wyllie AH, Bird CC. p53 expression in colorectal tumors. Am J Pathol. 1991 Apr;138(4):807–813. [PubMed]
  • Rüdlinger R, Grob R. Papillomavirus infection and skin cancer in renal allograft recipients. Lancet. 1989 May 20;1(8647):1132–1133. [PubMed]
  • Shamanin V, Glover M, Rausch C, Proby C, Leigh IM, zur Hausen H, de Villiers EM. Specific types of human papillomavirus found in benign proliferations and carcinomas of the skin in immunosuppressed patients. Cancer Res. 1994 Sep 1;54(17):4610–4613. [PubMed]
  • Shamanin V, zur Hausen H, Lavergne D, Proby CM, Leigh IM, Neumann C, Hamm H, Goos M, Haustein UF, Jung EG, et al. Human papillomavirus infections in nonmelanoma skin cancers from renal transplant recipients and nonimmunosuppressed patients. J Natl Cancer Inst. 1996 Jun 19;88(12):802–811. [PubMed]
  • Smith SE, Davis IC, Leshin B, Fleischer AB, Jr, White WL, Feldman SR. Absence of human papillomavirus in squamous cell carcinomas of nongenital skin from immunocompromised renal transplant patients. Arch Dermatol. 1993 Dec;129(12):1585–1588. [PubMed]
  • Soler C, Chardonnet Y, Euvrard S, Chignol MC, Thivolet J. Evaluation of human papillomavirus type 5 on frozen sections of multiple lesions from transplant recipients with in situ hybridization and non-isotopic probes. Dermatology. 1992;184(4):248–253. [PubMed]
  • Tieben LM, Berkhout RJ, Smits HL, Bouwes Bavinck JN, Vermeer BJ, Bruijn JA, Van der Woude FJ, Ter Schegget J. Detection of epidermodysplasia verruciformis-like human papillomavirus types in malignant and premalignant skin lesions of renal transplant recipients. Br J Dermatol. 1994 Aug;131(2):226–230. [PubMed]
  • de Jong-Tieben LM, Berkhout RJ, Smits HL, Bouwes Bavinck JN, Vermeer BJ, van der Woude FJ, ter Schegget J. High frequency of detection of epidermodysplasia verruciformis-associated human papillomavirus DNA in biopsies from malignant and premalignant skin lesions from renal transplant recipients. J Invest Dermatol. 1995 Sep;105(3):367–371. [PubMed]
  • Van der Leest RJ, Zachow KR, Ostrow RS, Bender M, Pass F, Faras AJ. Human papillomavirus heterogeneity in 36 renal transplant recipients. Arch Dermatol. 1987 Mar;123(3):354–357. [PubMed]
  • Vojtesek B, Bártek J, Midgley CA, Lane DP. An immunochemical analysis of the human nuclear phosphoprotein p53. New monoclonal antibodies and epitope mapping using recombinant p53. J Immunol Methods. 1992 Jul 6;151(1-2):237–244. [PubMed]
  • Yoshikawa T, Rae V, Bruins-Slot W, Van den Berg JW, Taylor JR, Streilein JW. Susceptibility to effects of UVB radiation on induction of contact hypersensitivity as a risk factor for skin cancer in humans. J Invest Dermatol. 1990 Nov;95(5):530–536. [PubMed]
  • zur Hausen H. Human genital cancer: synergism between two virus infections or synergism between a virus infection and initiating events? Lancet. 1982 Dec 18;2(8312):1370–1372. [PubMed]
  • zur Hausen H. Molecular pathogenesis of cancer of the cervix and its causation by specific human papillomavirus types. Curr Top Microbiol Immunol. 1994;186:131–156. [PubMed]
  • zur Hausen H. Disrupted dichotomous intracellular control of human papillomavirus infection in cancer of the cervix. Lancet. 1994 Apr 16;343(8903):955–957. [PubMed]

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