Prevalence of HPV in Oesophageal Biopsies and its Correlation with Expression Of P16INK4A

Background: The association of Human papillomavirus (HPV ) and p16INK4a is well established with cervical malignancies and has been studied in oral mucosa also. Koilocytosis, that is considered to be a hallmark of HPV infection is also seen in oesophageal mucosa. Aims: This study was designed to determine the prevalence of HPV in biopsies from inflammatory and neoplastic lesions of oesophagus and correlate it with expression of p16INK4a. Materials and Methods: The study included 102 oesophageal biopsies. Haematoxylin & Eosin stained sections were examined for morphological details including koilocytosis. Immunohistochemistry for HPV and p16INK4a were done on 50 biopsies. HPV positivity was graded and scoring for p16INK4a was done. Results: Various grades of koilocytosis was noted in 68.75%, 94.73% and 72.91% controls, inflammatory and neoplastic lesions respectively. IHC for HPV was positive in 80% control, 75% inflammatory and 100% cases of neoplastic lesion. Complete score for p16INK4a was 0.60, 0.59 and 3.63 in control, inflammatory and neoplastic lesion. The difference in expression of p16INK4a between neoplastic and inflammatory lesion was statistically significant. Conclusion: Expression of p16INK4a protein showed good correlation with HPV infection in inflammatory and neoplastic lesions. Thus IHC for p16INK4a which is easily available can be used as an indirect evidence of HPV infection in neoplastic lesion where expensive molecular technique for HPV DNA measurement is not feasible.