A Research Of The Chemoradiosensitivity And Prognosis Of Human Papillomavirus(HPV)-associated Esophageal Squamous Cell Carcinoma And Its Malignant

Objective A retrospective study was carried out to analyze the affection of HPV infection in esophageal squamous cell carcinoma(ESCC). Methods 192 specimens from patients with locally advanced ESCC were tested by immunohistochemistry(IHC) for HPV 16/18-E6 and P53 protein, and quantitative real time-PCR for p53 gene mutation. We analyzed the relationships between the chemoradiation response and overall survival(OS) rate with the above aforementioned markers. Results HPV16/18-E6 was positive in 33.9%(65/192) of the patients with ESCC. HPV16/18-E6 positive patients showed higher radiosensitivity(p<0.05) and better 3-year OS(log-rank p=0.026) than the negative group without consideration for the mutational status of p53 gene. The incident of p53 mutation tested by RT-PCR happened about 53.5%(104/192). p53 mutant patients with HPV infected had higher sensitivity to chemoradiation(CR+PR 90.3% vs. 72.6% p<0.05) and better 3-year rates of OS(log-rank p<0.05) than HPV-negative tumors. No significant difference in p53 wild type cases. The sensitivity of IHC for p53 mutation is only 94%, and the positive predictive value was only 89.6%. Conclusion HPV infection may contribute to higher treatment sensitivity and better prognosis of ESCC. The status of the p53 protein by IHC should not be equated with wild-type or mutant genotype.