Wen-Lun Wang1, Yu-Chi Wang2, Chi-Yang Chang1, Jo-Lin Lo3, Yao-Hung Kuo4, Tzer-Zen Hwang5, Chih-Chun Wang5, Lein-Ray Mo1, Jaw-Town Lin1,6,7, Ching-Tai Lee1. 1. Department of Internal Medicine, E-Da Hospital/I-Shou University, Kaohsiung. 2. Department of Biological Science and Technology, E-Da Hospital/I-Shou University, Kaohsiung. 3. Department of Oncology, E-Da Hospital/I-Shou University, Kaohsiung. 4. Department of Radiation Oncology, E-Da Hospital/I-Shou University, Kaohsiung. 5. Department of Otolaryngology, E-Da Hospital/I-Shou University, Kaohsiung. 6. Department of Internal Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan. 7. School of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan.
Abstract
OBJECTIVES/HYPOTHESIS: 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. STUDY DESIGN: A case control study. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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. LEVELS OF EVIDENCE: NA. Laryngoscope, 126:1097-1102, 2016.
OBJECTIVES/HYPOTHESIS: 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. STUDY DESIGN: A case control study. METHODS: 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. RESULTS: 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. CONCLUSIONS: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. LEVELS OF EVIDENCE: NA. Laryngoscope, 126:1097-1102, 2016.
Authors: Graciele Almeida de Oliveira; Robert Y S Cheng; Lisa A Ridnour; Debashree Basudhar; Veena Somasundaram; Daniel W McVicar; Hugo Pequeno Monteiro; David A Wink Journal: Antioxid Redox Signal Date: 2016-10-31 Impact factor: 8.401