The Relationship between Human Papillomavirus and Oesophageal Squamous Cell Carcinoma in China—A Review of the Evidence

Surabhi S. Liyanage, Qian Li, Yang Zheng, Holly Seale, Philip J. Crowe, Anthony T. Newall, Bayzidur Rahman, Eva Segelov, Chenxu Qu, Fanghui Zhao, Junfeng Liu, Zhanhai Gao, Weixian Shi, Peng Yang, Aye Moa, Chandini Raina MacIntyre

Centre for Disease Control and Prevention, Beijing, China.
Department of Cancer Epidemiology, Cancer Institute, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China.
Department of Medicine, St. Vincent’s Hospital Clinical School, The University of New South Wales, Sydney, Australia.
Department of Surgery, Fourth Hospital, Shijiazhuang, China.
Department of Surgery, Prince of Wales Hospital Clinical School, The University of New South Wales, Sydney, Australia.
School of Public Health and Community Medicine, The University of New South Wales Medicine, The University of New South Wales, Sydney, Australia.

DOI: 10.4236/aid.2013.31003                

Abstract

Background: China has one of the highest incidence rates of oesophageal cancer in the world. The role of human papillomavirus (HPV) has been extensively researched in oesophageal squamous cell carcinoma (OSCC) with indeterminate results. The majority of these studies have been conducted in the Chinese population. Evidence for a definitive HPV-OSCC association could potentially support prophylactic vaccination in target populations, highlighting the need for ongoing investigation. The aim of this review is to summarise the findings of HPV DNA in OSCC tissue in Chinese subjects, with a view to informing further research in this area. Methods: A systematic literature search of the Chinese National Knowledge Infrastructure (CNKI) database, Medline, Embase and PubMed was conducted for all studies in English and Chinese language, examining OSCC tissue for HPV DNA in China. Reference lists of retrieved articles were reviewed and hand searches of relevant, key journals were conducted, to source articles which were not electronically indexed. Sixty-four studies met our selection criteria. Data from case-control and cross-sectional studies were analysed separately for any HPV-OSCC association, using the Epi Info^TM 3.5.3 software program. Results: From all studies conducted in the Chinese population, 2166/5953 (36%) of all OSCC tissue and 478/1684 (28%) of healthy control tissue, tested positive for HPV. We found that 11/16 case-control and cross-sectional studies had a statistically significant crude odds ratio, which supported a potential HPV-OSCC association. The largest study, carried out in the high incidence County of Anyang in Henan Province, reported 207/265 (78%) OSCC tissues testing positive for HPV DNA against 203/357 (57%) controls and had an unadjusted odds ratio of 2.71 (p-value < 0.0001). Conclusion: A rigorous meta-analysis would improve interpretation of the data and a well-designed large-scale case-control study is warranted. If a link is found between HPV and OSCC, prophylactic HPV vaccines could be of significant benefit in China.

Keywords

Human Papillomavirus; Oesophageal Carcinoma; Squamous Cell Carcinoma; HPV Vaccine; China

Conflicts of Interest

The authors declare no conflicts of interest.

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