High-risk human papillomavirus in esophageal squamous cell carcinoma.
BACKGROUND
Although most cases of esophageal squamous cell carcinoma (ESCC) in western populations have been attributed to high levels of exposure to tobacco and alcohol, infectious agents have been postulated as possible causes, particularly human papillomavirus (HPV).


METHODS
To explore this issue, we analyzed HPV DNA prevalence and HPV types together with lifestyle factors, in relation to tumor stage and survival in a low-incidence population. Archived tumor samples from a nationwide cohort of 222 ESCC patients were tested for the presence of HPV DNA by PCR; positive samples were sequenced to determine HPV type, and p16(INK4a) status was assessed by immunohistochemistry.


RESULTS
Of 222 ESCC patients, 8 tested HPV positive (prevalence, 3.6%; 95% confidence interval, 1.1-6.1%), of which 6 were HPV-16 positive and 2 were HPV-35 positive. Four of the eight HPV-positive tumors overexpressed p16(INK4a). None of 55 normal esophageal tissue samples from healthy participants had any detectable HPV. Although the numbers were low, it seemed that patients with HPV-positive ESCC tumors were younger than those with HPV-negative tumors (mean age, 60.8 versus 65.3 years, P = 0.18) and had higher body mass index (BMI) throughout life (mean current BMI of 25.1 for HPV positive, 22.2 for HPV negative, P = 0.08; mean BMI at 20 years of 25.8 for HPV positive, 22.1 for HPV negative, P = 0.003). We found no difference between patients with HPV-positive and HPV-negative tumors with respect to other lifestyle factors.


CONCLUSIONS
These findings suggest a very low prevalence of HPV DNA in human ESCC.


CONCLUSIONS
HPV is very unlikely to be a common cause of ESCC in Australia.
Antonsson
Annika
A
Queensland Institute of Medical Research, 300 Herston Road, Herston, QLD 4029, Australia.
Nancarrow
Derek J
DJ
Brown
Ian S
IS
Green
Adele C
AC
Drew
Paul A
PA
Watson
David I
DI
Hayward
Nicholas K
NK
Whiteman
David C
DC
D000328:Adult; D000367:Age Factors; D000368:Aged; D001315:Australia / Q000453:epidemiology; D015992:Body Mass Index; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology / Q000821:virology*; D016022:Case-Control Studies; D004279:DNA, Viral / Q000032:analysis*; D004938:Esophageal Neoplasms / Q000401:mortality / Q000473:pathology / Q000821:virology*; D005260:Female; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D027383:Papillomaviridae / Q000145:classification*; D030361:Papillomavirus Infections / Q000150:complications*; D012307:Risk Factors; D016019:Survival Analysis
D004279:DNA, Viral