Abstract. Epidemiological studies in endemic geographic regions for esophageal squamous cell carcinoma (ESCC) suggested a number of risk factors, including modifications of the p53 tumor suppressor by codon Arg72Pro polymorphism, loss of heterozygosity (LOH) or human papillomavirus type 16 or 18 (HPV 16/18) infection. The p53 Arg72 variant has been suggested to be a high-risk factor in HPV-associated tumors. The present study analysed these associations in a low incidence geographic region in Germany. Fifty-three paraffinembedded tumors and 53 surrounding normal squamous epithelium were investigated. For detection of p53 codon Arg72Pro polymorphism, direct sequencing for exon 4 was conducted. LOH analysis was performed using three microsatellite markers at the p53 gene locus, and all cases were screened for high-risk HPV infection (HPV 16 and 18) with primer specific PCR and confirmed by sequencing. The p53 codon 72 genotype distribution was identical to published studies of normal Caucasian population, suggesting no general influence of this polymorphism on esophageal cancer risk in Germany. One case showed a p53 mutation in exon 4. p53 LOH was found in 13/44 (30%) informative cases without any correlation to histopathological characteristics. Of 53 (17%) samples, 9 showed HPV 16 or 18 infection. We found no association between p53 codon 72 genotypes and increasing HPV infection rates. Interestingly, 8/9 HPV-positive cases showed at least one p53 Arg72 allele. These results indicate an important role of p53 in ESCC also in low-incidence regions. In combination with the p53 Arg72 variant HPV infection could contribute to the risk of ESCC development in these cases, as has been demonstrated for high-risk regions.
IntroductionEsophageal squamous cell carcinoma (ESCC) is one of the six most common malignant diseases in the world with a remarkable geographical distribution (1). Environmental exposures such as tobacco, alcohol, chronic mucosal irritation and ethnic background increase the risk of developing ESCC (2). Moreover, genetic changes affecting the p53 tumor suppressor such as different mutations, loss of heterozygosity (LOH) and high-risk human papillomavirus (HPV) infection are important for carcinogenesis in the esophagus. The p53 gene has a common sequence polymorphism resulting in either proline (CCC) or arginine (CGC) at amino-acid position 72. This polymorphism occurs in the proline-rich domain of the protein, which is necessary to induce apoptosis. The Arg72 variant induces apoptosis more effectively than does the Pro72 variant (3). In smokers, several studies have suggested an increased risk of lung cancer associated with the Pro/Pro genotype (4,5). In contrast, Arg/Arg homozygotes are frequently found in non-smoking patients with lung cancer (5,6).Allelic deletions detected as LOH have been proved useful for mapping regions of DNA that contain tumor suppressor genes (7). Cancer lesions show a high frequency of LOH in the p53 tumor suppressor gene locus on chromosome 17p13.1 measured by repetitive DN...