HIGH PREVALENCE OF HUMAN PAPILLOMAVIRUS IN SQUAMOUS-CELL CARCINOMA AND MATCHED NORMAL ESOPHAGEAL MUCOSA - ASSESSMENT BY POLYMERASE CHAIN REACTION

Background. Studies using DNA technology have reported the presence of human papillomavirus (HPV) DNA in esophageal carcinomas, suggesting t hat it could play a role in the pathogenesis of this tumor. In the pre sent study, in addition to DNA from neoplasms, normal mucosa was scree ned for viral DNA, assuming that this would increase HPV detection sub stantially. Methods. Seventeen patients with esophageal carcinoma and 10 control subjects were studied. In 8 of the patients, normal mucosa was also available. Polymerase chain reaction (PCR) was performed usin g primers for the E6 region of HPV-16 and HPV-18. Koilocytosis, a comm only accepted histopathologic marker of viral infection, was studied, and results were correlated with PCR findings. Results. DNA from neopl astic lesions was positive for HPV-16 and HPV-18 in 8 of 16(50%) and i n 3 of 16 (18.8%), respectively. When tumor tissue and normal mucosa w ere available, PCR results were 3 of 8 (37.5%), 5 of 8 (62.5%), and 8 of 8 (100%) for HPV-16, in tumor, normal mucosa, and both. For HPV-18, results were 0 of 8 (0%), 5 of 8 (62.5%), and 5 of 8 (62.5%), respect ively. In comparison with tumor samples, positivity in normal mucosa w as increased for HPV-18 and for both viral genotypes (P = 0.01). No am plification was obtained in the control group. Koilocytosis was presen t in 33% of the cases. Conclusions. These results suggested a high pre valence of HPV in esophageal carcinoma. The detection rate is signific antly higher in normal mucosa specimens, suggesting that infection pro bably antedates tumor development. Koilocytosis was substantially less sensitive than PCR.