Early esophageal squamous cell carcinoma in a western series is not associated with active HPV infection
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ORIGINAL ARTICLE
Early esophageal squamous cell carcinoma in a western series is not associated with active HPV infection Christina Kanaan 1 & Diane Lorenzo 2 & Maximilien Barret 2 & Anne Audebourg 1 & Sarah Leblanc 2 & Stanislas Chaussade 2 & Frédéric Prat 2 & Benoît Terris 1 Received: 16 April 2020 / Revised: 26 May 2020 / Accepted: 28 May 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Few data are available concerning human papillomavirus (HPV) in early esophageal squamous cell carcinoma (ESCC) in Western population. Our study intended to determine the prevalence of HPV infection and the histological characteristics in such early tumors. A monocentric and retrospective study was conducted including 86 patients with early ESCC treated by endoscopic resection or esophagectomy, from 2012 to 2018. Histopathological prognostic criteria were evaluated. Immunohistochemistry for p16 and p53 and an HPV mRNA in situ hybridization were performed. The tumors were composed of 25 (29%) in situ carcinomas, 21 (24%) intramucosal carcinomas, and 40 (47%) submucosal carcinomas, of which 34 had a deep infiltration (> 200 μm). Emboli, present in 12 cases, were associated with deep infiltration. P16-positive ESCC accounted for 21% of the patients. It was not correlated with active HPV infection as no cases were found to be positive in RISH analysis for RNA detection of this virus. However, there was a correlation between p16 expression and alcohol or tobacco consumption. The only histopathological criterion correlated with p16 positivity was marked inflammatory infiltrate. Local or distant neoplastic recurrence occurred in 25% of patients. Overall survival was 95.8% and local or metastatic recurrence-free survival was 75%. There was a correlation between positive resection margins and tumor recurrence. In contrast to oropharynx carcinoma, our study showed that ESCC were not associated with an active HPV infection, highlighting the negligible role of this virus in early ESCC carcinogenesis in the Western world. Keywords Squamous cell carcinoma . Esophagus . HPV . p16-positive
Abbreviations HPV Human papillomavirus ESCC Esophageal squamous cell carcinoma HNSCC Head and neck squamous cell carcinoma RISH HPV mRNA in situ hybridization
* Christina Kanaan [email protected] 1
Department of Pathology, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Paris Centre, Hôpital Cochin, Université de Paris, Paris, France
2
Department of Gastroenterology, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Paris Centre, Hôpital Cochin, Université de Paris, Paris, France
Introduction Esophageal cancer is the eighth most common cause of cancer deaths worldwide [1]. It is endemic in the third-world countries, where it is the fourth most common cause of cancer deaths [1]. Incidence rates vary greatly with more than 10fold differences between countries [2]. The areas of northern Iran, some areas of southern Russia, and northern China called the “esophageal cancer belt”
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