Prevalence of high risk human papilloma virus in patients with oesophageal squamous cell carcinoma as seen at the Department of Pathology, Makerere University College of Health Sciences, Uganda.

Abstract

BACKGROUND: Oesophageal cancer is a global health problem being the 8th commonest cancer and the 6th leading cause of cancer related deaths in the world with the majority of cases occurring in developing countries. It is aggressive and carries a poor prognosis especially if diagnosed in its late stage. A variety of risk factors have been implicated in the aetiology of this disease including high risk human papilloma virus (hr HPV) especially in geographic areas with a high prevalence of the disease. No study has evaluated the prevalence of high risk HPV among patients with oesophageal squamous cell carcinoma in Uganda. OBJECTIVE: The objective of the study was to establish the prevalence of high risk HPV among patients with oesophageal squamous cell carcinoma (OSCC) seen at the department of pathology, Makerere university college of health sciences. METHODS: This was a cross sectional descriptive laboratory based retrospective study in which 49 archival blocks of OSCC obtained in 2007 were retrieved from the pathology repository by the investigator. Sections 4-5u thickness were cut and stained using H&E staining method and then subjected to in situ hybridization using Gunpoint detection methods. RESULTS: Forty nine paraffin blocks from patients with oesophageal squamous cell carcinoma, median age 60 years (range 35-86 years) collected between January 2007 and December 2007 were retrieved from makerere university pathology archives to study the prevalence of high risk HPV in patients with OSCC. The study revealed a HPV prevalence of high risk HPV of 6.1%. All patients with high risk HPV were>_50 years and all the tumours with high risk HPV serotypes were confined to the mid and lower third of the oesophagus. It was difficult to assess whether there was statistically significant difference in the mean age of patients with high risk of HPV as compared to those without high risk HPV because of the smaller number of patents with high risk HPV. The mean age of patients with high risk HPV was higher than that of patients without high risk HPV. There was no scientific explanation for this finding (probably occurred by chance). We could not satisfactorily correlate a relationship between tumour differentiation and presence of high risk HPV because of the small number of patients with high risk HPV. CONCLUSION: The prevalence of high risk HPV in OSCC was found to be 6.1%. It was statistically difficult to assess whether there was significant difference in expression of high risk HPV in relation to age, gender and tumour differentiation because of the small number of patients with high risk HPV.