No role for infection with human papillomavirus in upper aerodisgestive tract cancers in smokers and alcoholics.

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e14597 Background: The highest rates of esophageal cancer in Brazil occur in Rio Grande do Sul (18/100,000/year for men and 6/100,000/year for women). Furthermore, the incidence of head and neck squamous cell carcinoma (HNSCC) is significant in this region (11/100,000/year for cancer of the oral cavity and 10/100,000/year for laryngeal cancer in men). Tobacco smoking and alcohol consumption are the major risk factors for esophageal squamous cell carcinoma (ESCC) and HNSCC. The role of HPV in the development of ESCC remains controversial. Otherwise, there are some evidence that HPV-related HNSCC is a distinct entity compared with HNSCC associated with smoking and alcohol consumption. Methods: In order to investigate the association of HPV infection with ESCC and HNSCC in smokers/alcoholics in southern Brazil, we evaluated, prospectively, samples from three groups. Group 1 was formed by patients with ESCC where we evaluated esophageal samples from tumor and from non-tumoral areas. Group 2 was formed by HNSCC patients. We assessed biopsies from primary tumor and esophageal biopsies from either iodine negative or positive areas. Group 3 was formed by dyspeptic patients, no smokers/non alcoholics, with normal appearing esophageal mucosa in Upper GI Endoscopy. Biopsies were taken from middle esophagus. With extreme care to prevent DNA contamination, we used nested PCR with the general primer sets MY09/11 and GP5/GP6 for HPV L1 in formalin fixed paraffin-embedded tissue. We planned to genotype the final PCR product for 73 HPV types. Results: Group 1 included 48 samples from ESCC and 48 samples of esophageal non-tumoral areas. In Group 2, there were 37 patients with 35 biopsies taken from primary tumor, 32 from iodine positive esophageal areas and 17 from unstained esophageal areas (15 normal and 2 esophagitis). In this group, 1 patient had synchronous tumors of HNSCC and ESCC. Group 3 included 37 patients, 35 with normal esophageal mucosa and 2 with mild esophagitis. HPV DNA was negative in all samples. Therefore, we did not carry out the genotyping. Conclusions: In smokers/alcoholics patients from Southern Brazil, there is no evidence that HPV is involved in upper aerodigestive carcinogenesis.