title: Prognostic significance of high-risk human papillomavirus and p16(INK4A) in patients with esophageal squamous cell carcinoma.
abstract: The prognostic value of the HPV status in ESCC is much controversial, this study aimed to determine the prognostic importance of high-risk HPV and p16 in patients with ESCC. A total of 105 consecutive patients who underwent esophagectomy in 2008 were included in this study. All specimens with ESCC were tested by in situ hybridization for HPV16/18 and immunohistochemistry for p16 expression. Kappa values were calculated using Cohen's kappa test. The 5-year overall survival (OS) and progression-free survival (PFS) were calculated in relation to the two markers and the Cox proportional hazards model was used to determine the hazard ratio (HR) of variables. Thirty-nine (37.1%) of 105 were p16-positive, and HPV was detected in 29 of the 105 patients (27.6%) with ESCC. P16 was detected in 25 of the 29 patients (86.2%) who were HPV-positive, and only 14 of 76 patients (18.4%) who were HPV-negative (P < 0.001). Cohen's kappa coefficient revealed an agreement in two researchers (kappa = 0.61). The 5-year OS rate and PFS rate in the p16-positive group were 64.1% and 58.7%, respectively, and the rates in the p16-negative group were 45.5%, 37.9%, respectively. The difference of survival rate between the two groups remained statistically significant. P16-positive patients had better 5-year rates of OS and PFS than p16-negative group (P = 0.02 and P = 0.007 by the Log-rank test, respectively). Using HPV status as a stratification factor, we found differences in OS and PFS that were consistent with those based on p16 expression. P16 is a very good marker of HPV infection for ESCC. HPV-positive or p16-positive ESCC is a distinct entity with a favorable prognosis compared with HPV-negative or p16-negative ESCC.
authors.affiliation: Department of Radiation Oncology, Qilu Hospital of Shandong University 107#, Wenhua Xi Road, Jinan, China ; Department of Oncology, Liaocheng People's Hospital Liaocheng, China.
authors.forename: Fangli
authors.initials: F
authors.lastname: Cao
authors.affiliation: Department of Oncology, Liaocheng People's Hospital Liaocheng, China.
authors.forename: Weihong
authors.initials: W
authors.lastname: Zhang
authors.affiliation: Department of Oncology, The First Hospital of Zibo Zibo, China.
authors.forename: Fang
authors.initials: F
authors.lastname: Zhang
authors.affiliation: Department of Oncology, Liaocheng People's Hospital Liaocheng, China.
authors.forename: Hui
authors.initials: H
authors.lastname: Han
authors.affiliation: Department of Pathology, Liaocheng People's Hospital Liaocheng, China.
authors.forename: Junlong
authors.initials: J
authors.lastname: Xu
authors.affiliation: Department of Radiation Oncology, Qilu Hospital of Shandong University 107#, Wenhua Xi Road, Jinan, China.
authors.forename: Yufeng
authors.initials: Y
authors.lastname: Cheng
keywords: Human papillomavirus; esophageal cancer; p16INK4A; prognosis; squamous cell carcinoma