Molecular Detection of Epstein-Barr virus in Biopsy Samples of Patients Suffering from Bladder Cancer in Bushehr Province, Iran

Bladder cancer is the sixth most common cancer in men and the tenth most common cancer in women. The role of viral infections in the development of urinary bladder cancer has been discussed a lot in recent years. The role of Epstein-Barr Virus (EBV) as a cocarcinogen has been proven in some human cancers. Therefore, the aim of this research is the molecular investigation of EBV in bladder masses in Bushehr province.

The current research is a descriptive-analytical study. The study population includes bladder tissue biopsies of people diagnosed with bladder cancer referred to Persian Gulf Martyrs Hospital in Bushehr. The paraffin-embedded bladder biopsy tissue of 181 patients with bladder cancer with an average age of 64.52±13.78 as well as 30 non-cancerous bladder tissue samples as the control group were examined for molecular tests after deparaffinization and nucleic acid purification. In order to ensure the absence of PCR inhibitors, human beta globin gene was first detected as an internal control, and then the BKRF1 gene of EBV was detected by nested PCR method. Finally, SPSS software version 26 was used to analyze the data and perform statistical tests.

Out of 181 bladder carcinoma samples, 7 cases (3.9%) were infected with EBV, but no statistically significant relationship was found for age, sex, and stage and grade of tumor with EBV positive samples (P>0.05). In addition, EBV was not detected in any of the non-cancerous control samples; however, the difference in the prevalence of EBV between the bladder cancer patients' group and the control group was not statistically significant (P=0.33). In addition, the sequencing of the nested PCR products of the BKRF1 gene and the phylogenetic analysis indicate the presence of EBV type 1 in the positive samples.

Based on the findings of the present study and despite the fact that the percentage of EBV infection in cancerous samples was higher than in non-cancerous samples, it is unlikely that EBV is an effective factor in causing bladder cancer in Bushehr province, and other risk factors are probably involved in the etiology of bladder tumors in our study population, such as increasing air pollution in this region of the country, high-risk occupations, smoking, and other carcinogenic viral factors.