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 Table of Contents  
Year : 2022  |  Volume : 17  |  Issue : 3  |  Page : 713-714

Human papillomavirus immunohistochemistry in high grade squamous cell lesions of esophagus

Department of Pathology, Jawaharlal Nehru Medical College (DMIMS), Wardha, Maharashtra, India

Date of Submission14-Oct-2019
Date of Decision09-Sep-2020
Date of Acceptance07-Dec-2020
Date of Web Publication2-Nov-2022

Correspondence Address:
Dr. Purvee Agrawal
Jawaharlal Nehru Medical College Campus, Sawangi (Meghe), Wardha, Maharashtra
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jdmimsu.jdmimsu_158_19

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Background: Over the past decade, the cause–effect relationship between human papillomavirus (HPV) and squamous cell carcinoma (SCC) of the esophagus has been worked over. A few reports in the literature have demonstrated HPV protein within premalignant and malignant cells of SCC of the esophagus. Aims and Objectives: The aim was to study the high-grade squamous cell lesions and its relation with high-risk HPV infection to be evident on immunohistochemistry for high-risk HPV on biopsies of esophageal lesions. Materials and Methods: Biopsy from 20 esophageal growth processed conventionally, and histological section is stained by hematoxylin and eosin stains; paraffin-embedded tissue of esophageal lesions is processed and stained for immunohistochemistry in the detection of HPV by cocktail HPV16 and HPV18 antibodies by the standard procedure. Results: The present poster describes the results of immunohistochemistry for high-risk HPV on 20 cases of esophagus premalignant squamous cell lesions along with the SCC types and its grade. It has been observed that five cases have been demonstrated for positive results of immunohistochemistry for high-risk HPV. Conclusions: It may be postulated that HPV plays an important role in the pathogenesis of SCC esophagus.

Keywords: Human papillomavirus, immunohistochemistry, squamous cell carcinoma esophagus

How to cite this article:
Agrawal P, Bhake A. Human papillomavirus immunohistochemistry in high grade squamous cell lesions of esophagus. J Datta Meghe Inst Med Sci Univ 2022;17:713-4

How to cite this URL:
Agrawal P, Bhake A. Human papillomavirus immunohistochemistry in high grade squamous cell lesions of esophagus. J Datta Meghe Inst Med Sci Univ [serial online] 2022 [cited 2023 Feb 1];17:713-4. Available from: http://www.journaldmims.com/text.asp?2022/17/3/713/360182

  Introduction Top

The demonstration of human papillomavirus (HPV) structural protein in the squamous cell lesions of esophageal mucosa using immunohistochemistry and polymerase chain reaction (PCR) prompted the role of HPV in the pathogenesis of high-grade squamous cell lesions of the esophagus.[1],[2]

Since then, squamous cell carcinoma (SCC) and benign squamous cell tumors of the esophagus have been scrutinized for the role of high-risk HPV in its pathogenesis.

The detection of HPV in these lesions, as described in literature, has been carried by immunohistochemistry (IHC), PCR, in situ hybridization, and others.[3]

Although recently published articles on this topic are sourced in China, but India too carries a good burden of malignant squamous pathology of the esophagus and esophageal precancerous conditions.

Therefore, a study has been conducted at the Department of Pathology, JNMC, Sawangi Meghe, Wardha, over the endoscopic biopsies reported as high-grade lesions, including SCC for HPV infections and its demonstration in the tissues.

Aims and objectives

  • The study was carried out over the years duration with the aim of demonstrating high-risk HPV 16 and 18 by IHC on previously diagnosed endoscopic biopsies of severe squamous dysplasia and well-differentiated SCC
  • The objective of this study was to compare their results of high-risk HPV IHC on high-grade SCC lesions to the results of normal, hyperplastic squamous histology of esophageal biopsies.

  Materials and Methods Top

  • Preliminary data, including habits of chewing and endoscopic findings of patients, were recorded
  • The study comprised of two groups:
  • The Group 1 comprised 20 cases of esophageal growth reported as SCC or severe squamous cell dysplasia and Group 2 comprised 20 cases of normal or hyperplastic squamous cell biopsies (control group)
  • These biopsies were sampled by endoscopy
  • All the biopsies were conventionally processed and viewed as on hematoxylin and eosin stain
  • Group 1 and Group 2 biopsies underwent IHC for high-risk HPV by the three-step method
  • The antibodies used were monoclonal mouse anti-HPV clone K1H8 by Dako North America, Inc., 6392 Via Real Carpinteria, CA 93013, USA
  • The IHC was reported by standard protocols.[4]

The comparison between the findings of Group 1 and Group 2 for IHC results was performed.

  Results Top

  • The youngest patient in Group 1 was of 27 years. Group 1 had a mean age of 54 years, and the mean age for Group 2 was 40 years
  • Males (12 cases) predominated over females (8 cases) in both groups
  • The distribution of diagnosis of 20 cases in Group 1 was as follows: well-differentiated SCC 17 cases and severe squamous cell dysplasia three cases
  • Results of IHC for high-risk HPV

  • 1) Group 1 – five biopsies of five cases showed positive IHC with nuclear staining, but no positive staining was seen in the rest of the 15 cases

    Of the five positive IHC staining, only one had strong positive nuclear staining [Figure 1], while other four were weakly positive.

  Discussion Top

The studies from China reported a high incidence of HPV infection in esophageal cancers. These studies used the detection method of IHC, ISH, and PCR.[4],[5],[6],[7],[8],[9],[10],[11],[12],[13] The present study is discordant with the high detection rate of HPV in the biopsies of esophageal squamous cancers. Of the five positive results of the present study, only one showed intense immunostaining for high-risk HPV, while others had weak nuclear staining.[5],[6],[7],[8],[9],[10],[11],[12],[13],[14]

  Conclusions Top

The results of IHC for high-risk HPV in the biopsies of high-risk lesions of the esophagus do not conclude the cause–effect relationship, but a larger study is required to postulate for conclusive evidence that HPV plays a pathogenetic role in the pathogenesis of SCC in context to the Indian population.

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form, the patient has given her consent for her images and other clinical information to be reported in the journal. The patient understands that her name and initials will not be published and due efforts will be made to conceal her identity, but anonymity cannot be guaranteed.

Financial support and sponsorship


Conflicts of interest

There are no conflicts of interest.

  References Top

Chang F, Syrjänen S, Shen Q, Cintorino M, Santopietro R, Tosi P, et al. Evaluation of HPV, CMV, HSV and EBV in esophageal squamous cell carcinomas from a high-incidence area of China. Anticancer Res 2000;20:3935-40.  Back to cited text no. 1
Turner JR, Shen LH, Crum CP, Dean PJ, Odze RD. Low prevalence of human papillomavirus infection in esophageal squamous cell carcinomas from North America: Analysis by a highly sensitive and specific polymerase chain reaction-based approach. Hum Pathol 1997;28:174-8.  Back to cited text no. 2
Syrianen KJ. HPV infections and oesophageal cancer. J Clin Pathol 2002;55:721-8.  Back to cited text no. 3
Zhang D, Zhang Q, Zhou L, Huo L, Zhang Y, Shen Z, et al. Comparison of prevalence, viral load, physical status and expression of human papillomavirus-16, -18 and -58 in esophageal and cervical cancer: A case-control study. 2010. doi: 10.1186/1471-2407-10-650.  Back to cited text no. 4
Tripodi S, Chang F, Syrjänen S, Shen Q, Cintorino M, Alia L, et al. Quantitative image analysis of oesophageal squamous cell carcinoma from the high-incidence area of China, with special reference to tumour progression and papillomavirus (HPV) involvement. Anticancer Res 2000;20:3855-62.  Back to cited text no. 5
Sur M, Cooper K. The role of the human papilloma virus in esophageal cancer. Pathology 1998;30:348-54.  Back to cited text no. 6
Poljak M, Cerar A, Seme K. Human papillomavirus infection in esophageal carcinomas: A study of 121 lesions using multiple broad-spectrum polymerase chain reactions and literature review. Hum Pathol 1998;29:266-71.  Back to cited text no. 7
Matsha T, Erasmus R, Kafuko AB, Mugwanya D, Stepien A, Parker MI, et al. Human papillomavirus associated with oesophageal cancer. J Clin Pathol 2002;55:587-90.  Back to cited text no. 8
zur Hausen H. Yohei ito memorial lecture: Papillomaviruses in human cancers. Leukemia 1999;13:1-5.  Back to cited text no. 9
Parkin DM, Bray F, Ferlay J, Pisani P. GLOBOCAN 2000: Cancer Incidence, Mortality and Prevalence Worldwide, Version 1.0. IARC Cancer Base No. 5. Lyon: IARC Press; 2001.  Back to cited text no. 10
Chang F, Syrjänen S, Shen Q, Wang L, Wang D, Syrjänen K. Human papillomavirus involvement in esophageal precancerous lesions and squamous cell carcinomas as evidenced by microscopy and different DNA techniques. Scand J Gastroenterol 1992;27:553-63.  Back to cited text no. 11
Lu S, Luo F, Li H. Detection of human papilloma virus in esophageal squamous cell carcinoma and adjacent tissue specimens in Linxian. Zhonghua Zhong Liu Za Zhi 1995;17:321-4.  Back to cited text no. 12
He D, Tsao SW, Bu H. Human papillomavirus infection and esophageal squamous cell carcinoma. Zhonghua Bing Li Xue Za Zhi 1996;25:351-4.  Back to cited text no. 13
Ashworth MT, McDicken IW, Southern SA, Nash JR. Human papillomavirus in squamous cell carcinoma of the oesophagus associated with tylosis. J Clin Pathol 1993;46:573-5.  Back to cited text no. 14


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