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Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jun 7, 2020; 26(21): 2729-2739
Published online Jun 7, 2020. doi: 10.3748/wjg.v26.i21.2729
Importance of investigating high-risk human papillomavirus in lymph node metastasis of esophageal adenocarcinoma
Preeti Sharma, Shweta Dutta Gautam, Shanmugarajah Rajendra
Preeti Sharma, Shweta Dutta Gautam, Shanmugarajah Rajendra, Gastro-Intestinal Viral Oncology Group, Ingham Institute for Applied Medical Research, Liverpool, Sydney, New South Wales 2170, Australia
Preeti Sharma, Shweta Dutta Gautam, Shanmugarajah Rajendra, South Western Sydney Clinical School, University of New South Wales, Kensington, Sydney, New South Wales 2052, Australia
Shanmugarajah Rajendra, Department of Gastroenterology & Hepatology, Bankstown-Lidcombe Hospital, South Western Sydney Local Health Network, Bankstown, Sydney, New South Wales 2200, Australia
Author contributions: All authors equally contributed to this paper with conception and design of the study. Sharma P did the literature review and analysis. All authors equally contributed to the drafting, critical revision, editing and approval of the final version.
Conflict-of-interest statement: No potential conflicts of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Shanmugarajah Rajendra, MD, Department of Gastroenterology & Hepatology, Bankstown-Lidcombe Hospital, South Western Sydney Local Health Network, Bankstown, Sydney, New South Wales 2200, Australia. shan.rajendra@health.nsw.gov.au
Received: January 30, 2020
Peer-review started: January 30, 2020
First decision: March 15, 2020
Revised: March 18, 2020
Accepted: May 21, 2020
Article in press: May 21, 2020
Published online: June 7, 2020
Processing time: 128 Days and 9.2 Hours
Abstract

High-risk human papillomavirus has been suggested as a risk factor for esophageal adenocarcinoma. Tumor human papillomavirus status has been reported to confer a favorable prognosis in esophageal adenocarcinoma. The size of the primary tumor and degree of lymphatic spread determines the prognosis of esophageal carcinomas. Lymph node status has been found to be a predictor of recurrent disease as well as 5-year survival in esophageal malignancies. In human papillomavirus driven cancers, e.g. cervical, anogenital, head and neck cancers, associated lymph nodes with a high viral load suggest metastatic lymph node involvement. Thus, human papillomavirus could potentially be useful as a marker of micro-metastases. To date, there have been no reported studies regarding human papillomavirus involvement in lymph nodes of metastatic esophageal adenocarcinoma. This review highlights the importance of investigating human papillomavirus in lymph node metastasis of esophageal adenocarcinoma based on data derived from other human papillomavirus driven cancers.

Keywords: Esophageal cancer; Esophageal adenocarcinoma; Metastasis; Lymph nodes; Human papillomavirus

Core tip: Esophageal adenocarcinoma (EAC) is one of the fastest growing cancers in the western world. EAC has been associated with high-risk human papillomavirus and has been shown to grant a positive prognosis in EAC. In some human papillomavirus (HPV) driven malignancies (e.g., cervical and head and neck tumors), associated lymph nodes with a high viral load suggest metastatic lymph node involvement. Therefore, HPV is a potential marker of micro-metastases. This review highlights the importance of investigating HPV in lymph node metastasis of EAC based on data derived from other HPV driven malignancies.