Özofageal skuamöz papi̇llomada ve özofagusun mali̇gn ve premali̇gn lezyonlarinda hpv pozi̇ti̇fli̇ği̇ni̇n ve genoti̇pi̇ni̇n patoloji̇k preparatlarda araştirilmasi

Objective: Esophageal cancers are the 8th most common cancers in the world. Because of the high mortality, the role of the factors involved in the etiology of esophageal cancers and premalign lesions have increased. Although squamous papilloma of the esophagus are known as benign, the studies that have been conducted in recent years have attracted the attention that premalignant lesions may be present. The aim of our study is to determine the relationship between esophageal papilloma and high-risk human papillomavirus (HPV) infection which is thought to play a role in the etiology of the disease. We also attempted to determine the presence and genotype of HPV with adenocarcinoma of the esophagus, squamous cell carcinoma, granular cell carcinoma and barrett dysplasia detected by upper gastrointestinal (GI) endoscopy. The fact that HPV differs geographically and that there is not enough research on this issue in our country reveals the importance of this study. Materials and Methods: Esophageal biopsies from the patients who underwent upper gastrointestinal endoscopy due to gastrointestinal symptoms were examined in our hospital. Esophageal biopsy data was obtained from 256 patients in 5 years. The patients were separated into two groups according to the biopsy results: Group 1 esophageal squamous papilloma (ESP) group (42 patients), Group 2 pre-malign / malign group (17 patients, (squamous cell cancer, adenocarcinoma, granular cell cancer and barrett dysplasia)). Demographic, endoscopic and histological findings of the patients were noted. HPV genotyping was performed in the microbiology laboratory with the Polymerase Chain Reaction (PCR) method using samples from pathology slides. Results: The mean age of the malignancy group was significantly high, body mass index was low and the lesion diameter was large and this difference was found to be statistically significant (age, p = 0.015; BMI, p: 0.028, lesion diameter, p <0.01). Smoking was more common in the malignancy group and there was a statistically significant difference between the two groups (p = 0.03). While 4, 8% (2/42) of the patients with ESP presented with difficulty in swallowing, 64, 7% (11/17) of the patients in the malignancy group presented with these symptoms. In the malignancy group, swallowing difficulty was significantly higher and a statistically significant difference was found (p <0.001). The HPV infection which was examined by PCR method from pathology slides was found to be positive in only a single person in the ESP group and could not be detected in the malignancy group. Squamous papilloma was found in 2 (2/6, 33.3%) of the patients who underwent control endoscopy. No significant difference was found between the groups in terms of other features. Conclusion: In conclusion, although there are researchers who claim to have a premalignant lesion for ESP lesions; in our study, it was observed that the age, gender and risk factors were different in the ESP group and the malignancy group. In addition, HPV, which is thought to play a role in the etiology of malignancies and the mechanism of malignant transformation, has been found in only one papilloma patient, therefore eliminating the hypothesis of its role in the etiology of the disease. In the malignancy group, the absence of HPV positivity in none of the patients suggests that there is no such role in the development of malignancy. In addition, two patients with ESP had recurrences of papilloma lesions during control endoscopy in 6 patients, but none of them had suspicious lesion in terms of malignancy, raising the belief of ESP lesions as benign in our region. Key words: human papillomavirus, esophageal squamous papilloma, esophageal cancer