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. 2017 Oct 13:12:54.
doi: 10.1186/s13027-017-0163-4. eCollection 2017.

HPV infection and p53 and p16 expression in esophageal cancer: are they prognostic factors?

Allini Mafra da Costa  1   2 , José Humberto Tavares Guerreiro Fregnani  1 , Paula Roberta Aguiar Pastrez  1   3 , Vânia Sammartino Mariano  1   3 , Estela Maria Silva  1   3 , Cristovam Scapulatempo Neto  1 , Denise Peixoto Guimarães  3   4 , Luisa Lina Villa  5   6 , Laura Sichero  5 , Kari Juhani Syrjanen  1   3   7 , Adhemar Longatto-Filho  1   3   8   9   10
Affiliations

HPV infection and p53 and p16 expression in esophageal cancer: are they prognostic factors?

Allini Mafra da Costa et al. Infect Agent Cancer. .

Abstract

Background: Esophageal squamous cell carcinoma (ESCC) is a highly lethal malignant tumor. Currently, Human papillomavirus (HPV) is suggested as a potential risk factor for esophageal cancer (EC) in addition to the classic risk factors, alcohol and tobacco, but this hypothesis still remains contradictory. We sought to investigate wether HPV and well-known biomarkers (p16 and p53) and patient-related factors that may have impact on survival of ESCC.

Methods: We conducted a prospective cohort study. By using multiplex PCR, we determined the prevalence of high risk HPV in ESCC, and evaluated the immunohistochemical expression of p16 and p53, molecular markers related to esophageal carcinogenesis in order to verify the potential influence of these variables in patients's survival. Survival rates were estimated using Kaplan-Meier methods. A multivariate confirmatory model was performed using Cox proportional hazards regression.

Results: Twelve (13.8%) of 87 patients were HPV-DNA positive. Positive reactions of p16 and p53 were 10.7% and 68.6%, respectively. Kaplan-Meier analysis indicated that men (p = 0.025) had poor specific-cancer survival and a shorter progression-free survival (p = 0.050) as compared to women; III or IV clinical stage (p < 0.019) had poor specific-cancer survival and a shorter progression-free survival (p < 0.001) compared to I and II clinical stage; not submitted to surgery (<0.001) and not submitted to chemoradiotherapy (p = 0.039) had a poor specific-cancer survival, as well. The multivariate analysis showed that HPV, p16 and p53 status are not predictive parameters of progression-free and specific-cancer survival.

Conclusion: HPV infection and p53 and p16 expression are not prognostic factors in ESCC.

Keywords: Esophageal cancer; Human Papillomavirus; Survival.

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Conflict of interest statement

Ethics approval and consent to participate

This study was approved by the local Ethics Committee under registration number 134471. All patients with limited understanding of research objectives during the consent, with unfavorable clinical conditions for sampling biopsies during endoscopy, previous history of any malignant neoplasia, and inadequate quality of sample were excluded. Patients were referred to a private room and informed about the purpose of the study, procedures for biological sampling and the necessary information requested on the data collection instrument. All patients included on study signed the Informed Consent form.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Kaplan Meier curves for specific-cancer survival according HPV, p53 and p16 status
See this image and copyright information in PMC

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