Introduction

High-risk human papillomavirus (hr-HPV) has been suggested as a risk factor for oesophageal adenocarcinoma (OAC).^1-3 In HPV driven cancers (eg cervical malignancy), associated lymph nodes with a detectable viral load denote metastatic involvement.⁴ To date, there have been no reported studies regarding HPV involvement in lymph nodes of metastatic OAC.⁵

Aims & Methods

Formalin fixed surgically resected specimens were utilised in this study. Eight primary OAC and 16 associated metastatic lymph nodes were analysed for hr-HPV using droplet digital polymerase chain reaction (ddPCR). Viral load was determined and clinical data collected. Utmost care was undertaken to prevent cross-contamination.

Results

The mean age of the patients was 68.6 years. All patients had Siewert Class I or II tumours [T3N1-3,M0 (n=6), T4N3M0 (n=1), T1bN2M0 (n=1)]. 6/8 tumours were positive for hr-HPV DNA. All were genotype 18. There were no other hr-HPV genotypes detected in the primary cancer. The viral load ranged from 1 to 34 copy numbers per 10,000 cells in the primary tumour. 3/16 corresponding lymph nodes obtained from these 8 tumours were positive for hr-HPV; genotype 16 (n=1) and genotype 18 (n=2). These 3 hr-HPV DNA positive lymph nodes corresponded to 2 hr-HPV genotype 18 positive primary OAC. Viral load was measured to be 1 to 2 copy numbers per 10,000 cells in the metastatic lymph nodes.

Conclusion

This is the first time that hr-HPV has been detected in both the primary OAC and associated nodal metastases giving credence to the role of this pathogen in this malignancy.

References

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