Prognostic significance of human papillomavirus genomes (type-16, -18) and aberrant expression of p53 protein in human esophageal cancer.

The presence and distribution of human papillomavirus (HPV) DNA or of increased expression of the p53 protein were determined in 71 patients with esophageal squamous-cell carcinoma (SCC) by in situ hybridization with biotinylated DNA probes for HPV-16, -18, -31 and -33, and immunohistochemical techniques using antibody to p53 protein. Of 71 patients from Kochi prefecture, 24 (Group I) were positive for HPV DNA, including 10 for HPV type-16 and 14 for HPV type-18; in contrast, none were positive for HPV-31 or -33. Of the remaining 47 patients, 24 (Group II) showed positive nuclear staining in cancer cells with p53 antibody. The group of 23 patients with neither HPV nor p53 expression (Group III) had a significantly better survival rate than Group I or II. These results suggest that HPV-16 and -18 may play a role in the pathogenesis of esophageal SCC, particularly with regard to its striking geographical distribution; that esophageal cancers do occur in the absence of HPV infection when over-expression of p53 is present; and that the presence of HPV infection and over-expression of p53 may each be a factor indicating a relatively poor prognosis.