Esophageal cancer (EC) is the eighth most common type of cancer worldwide frequently found with esophageal squamous cell carcinoma (ESCC) differentiation. The main risk factors related to ESCC development are smoking, alcohol consumption, chagasic megaesophagus (CME) (common digestive chronic manifestation of Chagas Disease), and likely HPV, although the role of HPV in ESCC carcinogenesis is still disputable. Therefore, the present study aimed to detect high-risk HPV DNA in patients with chagasic megaesophagus with and without cancer and to correlate these findings with clinicopathological data.
Samples tissue/biopsy specimens fixed paraffin were retrospectively collected from the southeast region of Brazil obtained from patients treated in two hospitals: Universidade Federal do Triangulo Mineiro e Barretos Cancer Hospital. Cases were divided in two groups: CME (n=30) and ESCC/CME (n=21). The detection, and typing of high-risk HPV were performed by multiplex PCR (Luminex)
Overall, the prevalence of HPV was higher in the CME group (n=15/30, 50%) when compared to the ESCC/CME group (n=8/21, 38%). Among the HPV types detected, HPV-16 and HPV-73 (13.3% and 6.7%, respectively) were detected with similar frequency in both groups. On the other, HPV-45, HPV-51 and HPV-56 (6.7%, 10% and 6.7%, respectively) were found only in the CME group, as well low-risk HPV-6 and HPV-11 (3.3% and 3.3%, respectively). In addition, HPV-positive patients (38.1%) had I/II (non-advanced) grade megaesophagus, whereas HPV-negative patients (61.9%) had grade III/IV (advanced), staging T3/T4 (91.7%), N0/N1 (91.7%) and M0 (75%). Regarding the pathological features of the ESCC/CME group, the most frequent type reported was moderately differentiated, which was more frequently associated with HPV-negative status, yet not reaching statistical significance.
Despite the high frequency of HPV DNA detected in patients with chagasic megaesophagus with and without cancer, a statistically significant association was not found, thus further studies are important in order to understand the role of HPV in esophageal cancer in patients with megaesophagus.