title: Human papillomavirus infection and esophageal squamous cell carcinoma: a case-control study.
abstract: BACKGROUND
  The risk factors for esophageal squamous cell carcinoma (ESCC) in the high-incidence areas of China remain unclear.
  
  
  METHODS
  A total of 300 patients with ESCC and 900 controls matched for age and sex were enrolled in Anyang (China), a high-risk area for ESCC in China. In tumor tissue of the cases and in esophageal biopsies of controls, the presence of human papillomavirus (HPV) DNA was assessed by an SPF1/GP6(+)-mediated PCR followed by sequencing. The presence of serum antibody against the HPV-16 E7 oncoprotein was assessed by use of the ELISA. ORs with 95% confidence intervals (CI) were calculated via unconditional logistic regression models.
  
  
  RESULTS
  The presence of HPV in the esophagus (OR, 6.4; 95% CI, 4.4-9.2) was associated with increased risk of ESCC. Moreover, infection with "oncogenic" types of HPV (OR, 10.3; 95% CI, 6.3-16.8) was more strongly associated with ESCC than other types of HPV (OR, 2.4; 95% CI, 1.4-4.2). The presence of HPV-16 (OR, 12.8; 95% CI, 7.6-21.7) was particularly strongly associated with ESCC. In addition, a higher proportion of cases than controls had serum antibodies against HPV-16 E7 (OR, 6.1; 95% CI, 3.7-10.0).
  
  
  CONCLUSIONS
  This study provides the strongest epidemiologic evidence to date in support of the important role of HPV in the development of ESCC in high-incidence areas of China.
authors.affiliation: Key laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital & Institute, Beijing 100042, PR China.
authors.forename: Fangcen
authors.initials: F
authors.lastname: Guo
authors.forename: Ying
authors.initials: Y
authors.lastname: Liu
authors.forename: Xueqian
authors.initials: X
authors.lastname: Wang
authors.forename: Zhonghu
authors.initials: Z
authors.lastname: He
authors.forename: Noel S
authors.initials: NS
authors.lastname: Weiss
authors.forename: Margaret M
authors.initials: MM
authors.lastname: Madeleine
authors.forename: Fangfang
authors.initials: F
authors.lastname: Liu
authors.forename: Xiuyun
authors.initials: X
authors.lastname: Tian
authors.forename: Yuqin
authors.initials: Y
authors.lastname: Song
authors.forename: Yaqi
authors.initials: Y
authors.lastname: Pan
authors.forename: Tao
authors.initials: T
authors.lastname: Ning
authors.forename: Haijun
authors.initials: H
authors.lastname: Yang
authors.forename: Xiaotian
authors.initials: X
authors.lastname: Shi
authors.forename: Changdong
authors.initials: C
authors.lastname: Lu
authors.forename: Hong
authors.initials: H
authors.lastname: Cai
authors.forename: Yang
authors.initials: Y
authors.lastname: Ke
mesh_terms: D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D015331:Cohort Studies; D004938:Esophageal Neoplasms / Q000453:epidemiology* / Q000473:pathology / Q000821:virology*; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D030361:Papillomavirus Infections / Q000453:epidemiology* / Q000473:pathology* / Q000821:virology; D012307:Risk Factors