Human papillomavirus infection on initiating synchronous esophageal neoplasia in patients with head and neck cancer.
Human papillomavirus (HPV) is a risk factor for head and neck squamous cell carcinoma (HNSCC) as well as esophageal squamous cell carcinoma (ESCC). We aimed to investigate whether HPV infection underlies the field cancerization phenomenon over upper aerodigestive tract to develop synchronous multiple cancers.



A case control study.



The presence and subtype of HPV-DNA sequence in cancers were examined by polymerase chain reaction and sequencing in a prospective cohort with 100 HNSCCs, 50 of which had synchronous ESCCs. The clinicopathologic characteristics were further analyzed according to the presence of HPV.



Twelve patients were HPV-positive, of which 11 were positive for HPV-16. The prevalence of HPV infection were not different between the synchronous and HNSCC alone groups (P = 0.357). Testing for HPV in paired HNSCC and ESCC tissues from the same patient revealed that none were concomitantly HPV-positive. Multivariate logistic regression showed drinking alcohol (odds ratio [OR], 18.75; P = 0.030), alcohol flushing (OR, 2.53; P = 0.041), and body mass index (OR, 0.77; P = 0.001) but not HPV infection were independent risk factors for synchronous phenotype. The patients with synchronous ESCCs had significantly poorer survival than those with HNSCC alone (5-year overall survival: 30% vs. 70%; log-rank P < 0.001). However, patients with HPV-positive HNSCC tend to have favorable outcome than those with HPV-negative HNSCC.



HPV infection plays little role in field cancerization phenomenon to initiate synchronous SCC. The synchronous HNSCC and ESCC from the same patients had no clonal relationship. Routine endoscopic examination of the esophagus should be recommended for patients with risk factors identified.



NA. Laryngoscope, 126:1097-1102, 2016.
Department of Internal Medicine, E-Da Hospital/I-Shou University, Kaohsiung.
Wen-Lun
WL
Wang
Department of Biological Science and Technology, E-Da Hospital/I-Shou University, Kaohsiung.
Yu-Chi
YC
Wang
Department of Internal Medicine, E-Da Hospital/I-Shou University, Kaohsiung.
Chi-Yang
CY
Chang
Department of Oncology, E-Da Hospital/I-Shou University, Kaohsiung.
Jo-Lin
JL
Lo
Department of Radiation Oncology, E-Da Hospital/I-Shou University, Kaohsiung.
Yao-Hung
YH
Kuo
Department of Otolaryngology, E-Da Hospital/I-Shou University, Kaohsiung.
Tzer-Zen
TZ
Hwang
Department of Otolaryngology, E-Da Hospital/I-Shou University, Kaohsiung.
Chih-Chun
CC
Wang
Department of Internal Medicine, E-Da Hospital/I-Shou University, Kaohsiung.
Lein-Ray
LR
Mo
Department of Internal Medicine, E-Da Hospital/I-Shou University, Kaohsiung.|Department of Internal Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan.|School of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan.
Jaw-Town
JT
Lin
Department of Internal Medicine, E-Da Hospital/I-Shou University, Kaohsiung.
Ching-Tai
CT
Lee
D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000821:virology*; D016022:Case-Control Studies; D004279:DNA, Viral / Q000032:analysis; D004938:Esophageal Neoplasms / Q000821:virology*; D000077277:Esophageal Squamous Cell Carcinoma; D005260:Female; D006258:Head and Neck Neoplasms / Q000821:virology*; D052162:Human papillomavirus 16; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009378:Neoplasms, Multiple Primary / Q000821:virology*; D016017:Odds Ratio; D027383:Papillomaviridae; D030361:Papillomavirus Infections / Q000150:complications* / Q000821:virology; D016133:Polymerase Chain Reaction; D011446:Prospective Studies; D012307:Risk Factors; D000077195:Squamous Cell Carcinoma of Head and Neck
D004279:DNA, Viral
Human papillomavirus; esophageal cancer; field cancerization; head and neck cancer; synchronous cancer