Detection of human papillomavirus in esophageal papillomas: systematic review and meta‐analysis

Abstract

Since first suggested (in 1982), etiological role for human papillomavirus (HPV) in esophageal papillomas has aroused increasing interest. The objective of this study was to perform systematic review and formal meta-analysis of the literature reporting on HPV detection in esophageal squamous cell papillomas (ESCP). Literature was searched through May 2012. The effect size was calculated as event rates (95% CI), with homogeneity testing using Cochran's Q and I(2) statistics. Meta-regression was used to test the impact of study-level covariates (HPV detection method, geographic origin) on effect size, and potential publication bias was estimated using funnel plot symmetry. Thirty nine studies were eligible, covering 427 ESCPs from different geographic regions. Altogether, 132 (30.9%) cases tested HPV positive; effect size 0.375 (95% CI 0.319-0.434) using the fixed-effects (FE) model and 0.412 (95% CI 0.295-0.540) using the random-effects model. In meta-analysis stratified by (i) HPV detection technique and (ii) geographic study origin, the between-study heterogeneity was not significant (p = 0.071 and p = 0.105, respectively). In meta-regression, HPV detection method (p = 0.260) and geographic origin (p = 0.436) were not significant study-level covariates accounting for the heterogeneity in HPV prevalence. Some evidence for publication bias was found only for PCR-based studies, with a marginal impact on summary effect size estimates. In sensitivity analysis, all meta-analytic results were robust to all one-by-one study removals. In stratified meta-analysis and formal meta-regression, the variability in HPV detection rates in ESCPs is not explained by the HPV detection method or geographic origin of the study.

Combined Extensive Esophageal Squamous Papillomas and Florid Cardiac Gland Hyperplasia in a Patient with Adenocarcinoma

“…HPV infection was not detected by either the PCR or p16 immunohistochemistry methods, the possibility of HPV infection cannot be completely ruled out as the detection rate of HPV by DNA analysis remains low [22]. The relationship between EPS and the adenocarcinoma of the EGJ in our case is not clear.…”

A Rare Case of Esophageal Papilloma Due to Human Papillomavirus With Uncommon Presentation of Dysphagia in a 2-Year-Old Child

“…1 In adult literature, most lesions are reported as single papillomas (85%) and located in the distal esophagus (70%). 3 However, multiple ESPs have also been reported, mostly in children and sometimes, associated with papillomatosis of the upper respiratory tract. 3,4 The pathogenesis appears to be an underlying inflammatory process caused by gastroesophageal reflux, trauma, chemical irritants, or viruses.…”

“…3 However, multiple ESPs have also been reported, mostly in children and sometimes, associated with papillomatosis of the upper respiratory tract. 3,4 The pathogenesis appears to be an underlying inflammatory process caused by gastroesophageal reflux, trauma, chemical irritants, or viruses. 1,5,6 In adults, about one fifth of ESPs are reported to be caused by HPV infection.…”

Human Papillomavirus 16/18 Infections in Lung Cancer Patients in Mexico

“…Syrjänen [16,21,22] performed a systematic review and meta-analysis of the literature reporting on HPV detection in lung cancer and reported that the HPV prevalence was 22.4%, which is practically similar as in all other HPV-associated lesions in the respiratory and upper gastrointestinal tract. In addition, HPV is an epitheliotropic double-stranded DNA virus, and experimental data accumulated so far suggest that similar mechanisms as those detected in HPV-associated cervical carcinogenesis might also be involved in bronchial carcinogenesis [9,10,23].…”