Prevalence of Human Papillomavirus in Esophageal Squamous Papilloma: A Polymerase Chain Reaction Study
DC Phan, RC Chan, WS Nichols, P Manna, S Kerley, OTM Chan, E Himmelfarb, D Dhall, HL Wang. Cedars-Sinai Medical Center, Los Angeles, CA; Physicians Reference Laboratory, Overland Park, KS
Background: Human papillomavirus (HPV) has been implicated in the etiopathogenesis of a variety of benign and malignant squamous lesions, including squamous papilloma and squamous cell carcinoma of the upper aerodigestive tract. However, the role of HPV in the development of esophageal squamous papilloma is poorly understood. Studies over the past two decades have generated highly controversial results, which may be due to differences in the techniques used to detect viral antigens or DNA and/or geographic variations. We aimed to reinvestigate this question using advanced polymerase chain reaction (PCR) technique for the detection of both low and high risk HPV DNA.
Design: Forty-five cases of esophageal squamous papilloma were included in this study. DNA was extracted from formalin-fixed, paraffin-embedded esophageal biopsies. The detection of HPV DNA was performed using MY11/MY09 and GP5+/GP6+ primers in a nested PCR assay, which is capable of amplifying a 455-bp fragment within the conserved L1 region common to different HPV types. Positive cases were further characterized employing type-specific PCR. The quality of sample DNA was evaluated by amplification of a 289-bp fragment of the housekeeping gene b-actin.
Results: The patients included 22 males and 23 females with a mean age of 50 years (range: 17-84 years). HPV DNA was detected in only 2 (4%) cases. Further typing of these 2 cases demonstrated HPV subtype 59 in 1 case but was indeterminate in the other. Interestingly, both patients with positive HPV detection were immunocompromised and the one with subtype 59 also had a history of anal squamous cell carcinoma in situ (HPV testing was not performed on this lesion). None of the 45 patients developed squamous cell carcinoma in the esophagus.
Conclusions: Unlike other squamous lesions in the upper aerodigestive tract, squamous papilloma of the esophagus is infrequently associated with HPV infection and carries an insignificant risk to evolve into squamous cell carcinoma.
Monday, March 22, 2010 1:00 PM
Poster Session II # 71, Monday Afternoon