• Molecular Determination of Frequency of Human Papillomavirus Infection and it's genotypes among Patients with Esophageal Cancer in Bushehr Province, 2009-2019
  • Reza Taherkhani,1 Fatemeh Farshadpour,2,*
    1. Department of Virology, School of Medicine, Bushehr University of Medical Sciences
    2. Department of Virology, School of Medicine, Bushehr University of Medical Sciences


  • Introduction: Esophageal cancer is the eighth malignant tumor and the sixth cause of cancer deaths in the world. The role of infectious agents and oncoviruses such as human papillomaviruses in contaminating esophageal, which can occur by oral transmission or through blood or lymph, is mentioned as a potential risk factor for esophageal cancer. This study was conducted to determine the prevalence and genotype distribution of human papillomavirus in paraffin-embedded tissue specimens from patients with esophageal cancer in a 10-year period in Bushehr province using nested-PCR technique.
  • Methods: This study is a descriptive cross-sectional study. The study population includes paraffin-embedded specimens of patients with esophageal cancer referred to the Shohadaie Khalij-Fars Hospital in Bushehr during 2009 to 2019. Paraffin-embedded tissue specimens from 44 patients with esophageal cancer, as well as 103 paraffin-embedded tissue samples with benign lesions of esophagus (inflammatory, hyperplasia, polyp specimens) as control group were investigated for nested PCR. Data were analyzed using SPSS software, Chi-square and Fisher's statistical tests.
  • Results: The mean age of 44 patients with esophageal cancer, which were investigated in molecular analysis, is 69.77 ± 14.52 (range from 35 to 94 years). Most of the patients are age 80 and older, and then in the age range of 70 to 79 years. There were 29 men with a mean age of 67.24 ± 16.13 and 15 women with a mean age of 74.66 ± 9.43. The prevalence of esophageal cancer in men is higher than that of women, and the mean age in women is higher than that of men, but the difference in mean was not statistically significant. Most cases of esophageal cancer were from 2014 to 2019. In men, the most common type of esophageal carcinoma was adenocarcinoma (69%) and in women, the most common type of esophageal carcinoma was squamous cell carcinoma (80%). The mean age in patients with squamous cell carcinoma was higher than that in adenocarcinoma, but the mean differences were not statistically significant. The prevalence of HPV infection in 44 samples of esophageal cancer was 9.1% (4 cases) and in 103 samples with benign lesions of esophagus (control group) was 1.9% (2 cases). In the case group, the prevalence of HPV infection in women was almost twice as high as that of men, and the mean age in individuals with HPV infection was higher than those without HPV infection. Most of the cases with esophageal cancer, which were positive for HPV infection, are squamous cell carcinoma. Overall, there was no significant statistically relationship between gender, age, city, year and type of malignant lesions of esophagus with the prevalence of HPV infection (p value> 0.05).
  • Conclusion: The overall prevalence of HPV infection in patients with esophageal cancer was 4.7 times the prevalence of HPV infection in non-cancer patients, although this increase was not statistically significant. However, the use of the human papillomavirus vaccine in some patients with benign lesions of esophagus may be effective in preventing the progression of these lesions to the malignancy. It is also suggested that, in addition to HPV, the role of other risk factors for esophageal cancer such as tobacco use, alcoholic beverages, dietary deficiencies and diet, as well as the role of other infectious agents will also be investigated.
  • Keywords: Human Papillomavirus, Esophageal cancer, Bushehr province, nested-PCR method