Human papillomavirus-related esophageal cancer survival

Guo, Lanwei; Liu, Shuzheng; Zhang, Shaokai; Chen, Qiong; Zhang, Meng; Quan, Peiliang; Sun, Xin

doi:10.1097/md.0000000000005318

Cited by 26 publications

(22 citation statements)

References 34 publications

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“…We observed that HPV status does not in uence patient's survival, although HPV positive individuals have a longer survival in relation to HPV negative individuals. These results are in line with previous reports on esophageal cancer, that shown that HPV infection is not associated with improved survival, suggesting that the presence of HPV may not be useful for a possible prognostic assessment related to fact or that contribute to cancer of the esophagus 58,59 .…”

Section: Discussionsupporting

confidence: 92%

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Frequency of HPV detection in chagasic megaesophagus associated or not with esophageal squamous cell carcinoma

Munari

Sichero

Cruvinel-Carloni

et al. 2020

Preprint

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Abstract Background: Chagasic megaesophagus (clinical manifestation of chagasic disease) has been reported as an etiological factor for squamous cell carcinoma of the esophagus, as well as the presence of human papillomavirus (HPV). Objective: We accessed the prevalence of HPV DNA in a series of squamous cell carcinomas of the esophagus associated or not with the chagasic megaesophagus, and within samples of chagasic megaesophagus without cancer. Data obtained was further correlated to the pathological clinical data of affected individuals. Methods: Retrospective study that used a total 92 samples tissue/biopsy specimens of formalin fixed and paraffin embedded tissues were retrospectively collected from the southeast region of Brazil from patients treated in three hospitals: Barretos Cancer Hospital, Barretos, São Paulo; Federal University of Triângulo Mineiro (UFTM), Uberaba, Minas Gerais; and São Paulo State University (UNESP), Botucatu, São Paulo. Cases were divided in three groups: i) 24 patients with chagasic megaesophagus associated with esophageal ESCC (CM/ESCC); ii) 37 patients with esophageal ESCC without chagasic megaesophagus (ESCC); iii) 31 patients with chagasic megaesophagus without esophageal ESCC (CM). Results: We detected a higher prevalence of high-risk HPVs in patients from both CM (12/31, 38.8%) and CM/ESCC groups (8/24, 33.3%), as compared to individuals of the ESCC group (6/37, 16.3%), although data was not statistically significant. We further observed that HPV-16 was more prevalent in patients of the ESCC (4/9, 44.5%) and CM/ESCC groups (2/8, 25.0%). In addition, some of these samples presented infection by multiple HPV types. High-risk HPVs detected were HPV-31, 45, 51, 53, 56, 66, and 73, of which the majority was identified in patients from the CM group. Furthermore, low-risk HPV-11 and HPV70 were identified in individuals from both ESCC and CM groups. Conclusion: This is the first report regarding the presence of HPV DNA in megaesophagus associated with esophageal squamous cell carcinoma. In the present study, HPV infection appears to be directly related to the development of esophageal squamous cell carcinoma in patients with chagasic megaesophagus. Further studies are warrantee to confirm and better understand the role of oncogenic HPV persistent infection in these patients.

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Section: Discussionsupporting

confidence: 92%

“…11, 70; 6 probably high risk: HPV-26, 53, 66, 68, 73, 82; and 11 high risk: HPV-16,18,31,33,35,39,45,52,56,58,59 …”

mentioning

confidence: 99%

Frequency of HPV detection in chagasic megaesophagus associated or not with esophageal squamous cell carcinoma

Munari

Sichero

Cruvinel-Carloni

et al. 2020

Preprint

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“…Unlike the high prevalence of HPV in cancer of the cervix, the detection rate in ESCC is highly variable even within high-risk areas, averaging 19.8% in Africa and 27.7% worldwide. The major oncogenic strain, HPV16, has only been detected in 11.4% of ESCC cases (93,94). HPV viral genomes per cell are very low, if present at all, and the sequencing of viral-cellular DNA junctions has not been validated (93).…”

Section: Other Potentially Harmful Factorsmentioning

confidence: 99%

“…HPV viral genomes per cell are very low, if present at all, and the sequencing of viral-cellular DNA junctions has not been validated (93). Several other squamous cell cancers have a positive prognosis if found to be HPV-positive; however, this is not the case with ESCC (94,95). It is currently accepted by the majority, that a role for HPV, if any, remains elusive.…”

Section: Other Potentially Harmful Factorsmentioning

confidence: 99%

Esophageal squamous cell cancer susceptibility: Environmental and nutritional associations reveal a universally applicable pathogenesis scenario (Review)

Rensburg¹,

Rensburg

2019

Wrld Acd Sci

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Some epidemiological features, such as marked variations of incidence between geographical regions, are unique to esophageal squamous cell carcinoma (ESCC). The objective of this evaluation of only ESCC was to collate those factors that have quantitative and biological credibility, enabling the deduction of an etiological hypothesis to explain this, based on facts. Worldwide, 80% of new cases arise in less developed regions and are generally not associated with alcohol or tobacco use. Abstinence was also usual in some European localities where a high incidence occurred in certain remote regions, as well as in patients with malabsorption syndromes. All had multiple micronutrient deficiencies, resulting in atrophy and chronic esophagitis that preceded clinical carcinomas. The esophagus has an extraordinarily high cell replication rate requiring higher micronutrient nutrition than other epithelia. Stable communities worldwide, whose staple diet was maize (corn) or wheat were invariably at high risk, whereas the use of nutritious food sources resulted in an unusually low risk. The susceptibility of animals fed such diets mirrored the human situation exactly. Pertinent deficiencies identified thus far are riboflavin, nicotinamide, molybdenum (Mo), magnesium (Mg), manganese (Mn), selenium (Se) and zinc (Zn). Subclinical deficiencies of these have been shown to enhance the susceptibility of rats to ESCC. Extraordinary carcinogen exposure has only been shown in rural epidemic regions. Geologically determined poor soils yield plants vulnerable to fungal pathogens, some of which are carcinogenic to the rat esophagus. Tobacco exerts its synergistic effects on the nutritionally impaired esophagus. Nitrosamine exposure is not unusual; however, regenerative stress such as that caused by constrictions and hot drinks increase the risk. The common underlying determinant of susceptibility worldwide is chronic deficiencies of multiple micronutrients that normally maintain the integrity of the esophagus and are necessary for a number of anti-carcinogenic mechanisms. Micronutrient fortification of staple foods appears to markedly reduce the risk. Contents 1. Introduction 2. Populations studied 3. Environmental similarities in ESCC epidemic regions 4. Nutrition studies 5. Esophageal epithelial pathology possibly related to nutrition 6. Mycotoxin contamination of food 7. Other potentially harmful factors 8. Discussion and conclusions

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“…The prognostic value of HPV status has previously been investigated in patients with ESCC [ 19 – 21 ]. The first meta-analysis investigating overall survival in HPV-related esophageal cancer was published in 2016, and showed no significant association between HPV infection and survival [ 22 ]. The controversial results of the included studies are in contrast to oropharyngeal lesions, where HPV-positivity has been consistently shown to be a strong positive prognostic factor in patient outcomes [ 23 , 24 ].…”

Section: Discussionmentioning

confidence: 99%

Prognostic role of HPV infection in esophageal squamous cell carcinoma

Bognár

Hegedűs

Bellyei

et al. 2018

Infect Agents Cancer

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BackgroundThe aims of this study were to evaluate whether HPV infection has a prognostic role in patients with esophageal squamous cell carcinoma who underwent oncological treatment and also to compare the heat shock proteins (Hsp) 90, 27 and 16.2 and growth hormone-releasing hormone receptor (GHRH-R) expression patterns of the pre-treatment tumor biopsies with the HPV status and with the oncological response.MethodsPre-treatment tumor biopsies of 74 patients with locally advanced esophageal squamous cell carcinoma were processed retrospectively. The presence of HPV was detected by chromogenic in situ hybridization. Hsp and GHRH-R expressions were determined using immunohistochemistry. Following neoadjuvant or definitive radiochemotherapy, the patients were restaged according to the Response Evaluation Criteria in Solid Tumors. The correlation between the HPV status, response to treatment and Hsp and GHRH-R expressions were evaluated.ResultsFourteen (19%) patients were HPV-positive. These patients were more likely to respond poorly to multimodal therapy (71.4% were non-responders vs. 28.6% responders) and had shorter survival compared to HPV-negative patients (mean survival of 8 months vs. 11 months), although the difference was not significant. A significantly higher number of HPV-positive patients expressed Hsp 90 and 16.2 at high levels (93 and 79%, respectively) than at low levels (Chi-Square p = 0.019 and p = 0.031). Higher levels of Hsp expressions were associated with poorer response to therapy and worse overall survival. No correlation was found between GHRH-R expression and the HPV status, nor between GHRH-R expression and the treatment response of the examined samples.ConclusionsWe found that HPV infection was associated with poor response to oncological treatment and decreased overall survival, and therefore proved to be a negative prognostic factor in patients with esophageal squamous cell carcinoma. There was a linear correlation between levels of Hsp 90 and 16.2 expression and HPV positivity.

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Human papillomavirus-related esophageal cancer survival

Abstract: Supplemental Digital Content is available in the text

Cited by 26 publications

References 34 publications

Frequency of HPV detection in chagasic megaesophagus associated or not with esophageal squamous cell carcinoma

Frequency of HPV detection in chagasic megaesophagus associated or not with esophageal squamous cell carcinoma

Esophageal squamous cell cancer susceptibility: Environmental and nutritional associations reveal a universally applicable pathogenesis scenario (Review)

Prognostic role of HPV infection in esophageal squamous cell carcinoma

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