Human Papillomavirus Infection and Esophageal Squamous Cell Carcinoma: A Case-Control Study
Menée en Chine, cette étude (300 cas et 900 témoins) évalue l'association entre une infection par le papillomavirus humain et le risque de carcinome épidermoïde de l'œsophage
Background: The risk factors for esophageal squamous cell carcinoma (ESCC) in the high incidence areas of China remain unclear Methods: A total of 300 ESCC patients and 900 controls matched for age and sex were enrolled in Anyang, a high risk area for ESCC in China. In tumor tissue of the cases and in esophageal biopsies of controls, the presence of HPV DNA was assessed by an SPF1/GP6+ mediated polymerase chain reaction (PCR) followed by sequencing. The presence of serum antibody against the HPV-16 E7 oncoprotein was assessed by use of the enzyme-linked immunosorbent assay (ELISA). Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated via unconditional logistic regression models. Results: The presence of HPV in the esophagus (OR=6.4, 95%CI: 4.4-9.2) was associated with increased risk of ESCC. Moreover, infection with "oncogenic" types of HPV (OR= 10.3, 95%CI: 6.3-16.8) was more strongly associated with ESCC than other types of HPV (OR=2.4, 95%CI: 1.4-4.2). The presence of HPV-16 (OR=12.8, 95%CI: 7.6-21.7) was particularly strongly associated with ESCC. In addition, a higher proportion of cases than controls had serum antibodies against HPV-16 E7 (OR=6.1, 95%CI: 3.7-10.0). Conclusion and impact: This study provides the strongest epidemiologic evidence to date in support of the important role of HPV in the development of ESCC in high-incidence areas of China.