Skip to main content

Human papillomavirus type-18 prevalence in oesophageal cancer in the Chinese population: a meta-analysis

  • L. W. GUO (a1), S. K. ZHANG (a1), S. Z. LIU (a1), Q. CHEN (a1), M. ZHANG (a1), P. L. QUAN (a1), J. B. LU (a1) and X. B. SUN (a1)...

Globally, the prevalence of oesophageal cancer cases is particularly high in China. Since 1982, oncogenic human papillomavirus (HPV) has been hypothesized as a risk factor for oesophageal cancer, but no firm evidence of HPV infection in oesophageal cancer has been established to date. We aimed to conduct a meta-analysis to estimate the high-risk HPV-18 prevalence of oesophageal cancer in the Chinese population. Eligible studies published from 1 January 2005 to 12 July 2014 were retrieved via computer searches of English and Chinese literature databases (including Medline, EMBASE, Chinese National Knowledge Infrastructure and Wanfang Data Knowledge Service Platform). A random-effects model was used to calculate pooled prevalence and corresponding 95% confidence intervals (CIs). A total of 2556 oesophageal cancer cases from 19 studies were included in this meta-analysis. Overall, the pooled HPV-18 prevalence in oesophageal cancer cases was 4·1% (95% CI 2·7–5·5) in China, 6·1% (95% CI 2·9–9·3) in fresh or frozen biopsies and 4·0% (95% CI 2·3–5·8) in paraffin-embedded fixed biopsies, 8·2% (95% CI 4·6–11·7) by the E6/E7 region and 2·2% (95% CI 0·9–3·6) by the L1 region of the HPV gene. This meta-analysis indicated that China has a moderate HPV-18 prevalence of oesophageal cancer compared to cervical cancer, although there is variation between different variables. Further studies are needed to elucidate the role of HPV in oesophagus carcinogenesis with careful consideration of study design and laboratory detection method, providing more accurate assessment of HPV status in oesophageal cancer.

Corresponding author
* Author for correspondence: Dr X. B. Sun, Department of Cancer Epidemiology, Henan Cancer Hospital, Affiliated Cancer Hospital of Zhengzhou University, Henan Office for Cancer Control and Research, Dongming Road No. 127, PO Box 0061, Zhengzhou, China 450008. (Email:
Hide All
1. Anon FJ, et al. GLOBOCAN 2012 v. 1·0, Cancer Incidence and Mortality Worldwide: IARC CancerBase No. 11. Lyon, France: International Agency for Research on Cancer, 2013 ( Accessed 1 December 2014.
2. Islami F, et al. Alcohol drinking and esophageal squamous cell carcinoma with focus on light-drinkers and never-smokers: a systematic review and meta-analysis. International journal of cancer 2011; 129: 24732484.
3. Holmes RS, Vaughan TL. Epidemiology and pathogenesis of esophageal cancer. Seminars in Radiation Oncology 2007; 17: 29.
4. Wei WQ, et al. Prospective study of serum selenium concentrations and esophageal and gastric cardia cancer, heart disease, stroke, and total death. American Journal of Clinical Nutrition 2004; 79: 8085.
5. De Stefani E, et al. Meat consumption, cooking methods, mutagens, and risk of squamous cell carcinoma of the esophagus: a case-control study in Uruguay. Nutrition and Cancer 2012; 64: 294299.
6. Ciapponi A, et al. Type-specific HPV prevalence in cervical cancer and high-grade lesions in Latin America and the Caribbean: systematic review and meta-analysis. PLoS ONE 2011; 6: e25493.
7. Kreimer AR, et al. Human papillomavirus types in head and neck squamous cell carcinomas worldwide: a systematic review. Cancer Epidemiology, Biomarkers & Prevention 2005; 14: 467475.
8. Stelzer MK, et al. A mouse model for human anal cancer. Cancer Prevention Research (Philadelphia, PA) 2010; 3: 15341541.
9. Syrjanen KJ. Histological changes identical to those of condylomatous lesions found in esophageal squamous cell carcinomas. Archiv fur Geschwulstforschung 1982; 52: 283292.
10. Koh JS, et al. No association of high-risk human papillomavirus with esophageal squamous cell carcinomas among Koreans, as determined by polymerase chain reaction. Diseases of the Esophagus 2008; 21: 114117.
11. Li T, et al. Human papillomavirus type 16 is an important infectious factor in the high incidence of esophageal cancer in Anyang area of China. Carcinogenesis 2001; 22: 929934.
12. de Villiers EM, et al. Classification of papillomaviruses. Virology 2004; 324: 1727.
13. Zhang SK, et al. Prevalence of human papillomavirus 16 in esophageal cancer among the Chinese population: a systematic review and meta-analysis. Asian Pacific Journal of Cancer Prevention 2014; 15: 1014310149.
14. Syrjanen KJ. HPV infections and oesophageal cancer. Journal of Clinical Pathology 2002; 55: 721728.
15. Petrick JL, et al. Prevalence of human papillomavirus among oesophageal squamous cell carcinoma cases: systematic review and meta-analysis. British Journal of Cancer 2014; 110: 23692377.
16. Barendregt JJ, et al. Meta-analysis of prevalence. Journal of Epidemiology and Community Health 2013; 67: 974978.
17. DerSimonian R, Laird N. Meta-analysis in clinical trials. Controlled Clinical Trials 1986; 7: 177188.
18. Higgins JPT, Thompson SG. Quantifying heterogeneity in a meta-analysis. Statistics in Medicine 2002; 21: 15391558.
19. Liu HY, et al. Characteristics of HPV infection in cervical squamous cell carcinoma: comparison with esophageal squamous cell carcinoma. Chinese Journal of Clinical and Experimental Pathology 2009; 25: 119126.
20. Qu P, et al. Comparative study on the HPV infection rate of different esophageal squamous cell carcinoma in Anyang China. Chinese Journal of Experimental and Clinical Virology 2012; 26: 3436.
21. Wang X, et al. Detection of HPV DNA in esophageal cancer specimens from different regions and ethnic groups: a descriptive study. BMC Cancer 2010; 10: 19.
22. Zhao XY, et al. Detection of human papillomavirus in esophageal carcinoma tissues from Baoding City of Hebei Province. Chinese Journal of Experimental and Clinical Virology 2009; 23: 9193.
23. Li SY, et al. Detection of human papillomavirus in tissues of esophageal carcinomas by polymerase chain reaction. Chinese Journal of Experimental and Clinical Virology 2008; 22: 251253.
24. Yang WJ, et al. Detection of Human Papillomavirus Infection in the Esophageal Carcinoma in the Area of Inner Mongolia. Journal of Baotou Medical College 2005; 21: 215216.
25. Zhang K, et al. Detection of human papillomavirus infection in tumor tissues of patients with esophageal carcinoma. Chinese Journal of Gerontology 2013; 33: 41644165.
26. Cui X, et al. Heterozygote of PLCE1 rs2274223 increases susceptibility to human papillomavirus infection in patients with esophageal carcinoma among the Kazakh populations. Journal of Medical Virology 2014; 86: 608617.
27. Lu XM, et al. Human papillomavirus in esophageal squamous cell carcinoma of the high-risk Kazakh ethnic group in Xinjiang, China. European Journal of Surgical Oncology 2008; 34: 765770.
28. Shuyama K, et al. Human papillomavirus in high- and low-risk areas of oesophageal squamous cell carcinoma in China. British Journal of Cancer 2007; 96: 15541559.
29. Dai M, et al. Human papillomavirus infection among 100 oesophageal cancer cases in the People's Republic of China. International Journal of Cancer 2007; 121: 13961398.
30. Guo F, et al. Human papillomavirus infection and esophageal squamous cell carcinoma: a case-control study. Cancer Epidemiology, Biomarkers & Prevention 2012; 21: 780785.
31. Zhang QY, et al. Infection and integration of human papillomavirus in esophageal carcinoma. International Journal of Hygiene and Environmental Health 2011; 214: 156161.
32. Cao B, et al. LMP7/TAP2 gene polymorphisms and HPV infection in esophageal carcinoma patients from a high incidence area in China. Carcinogenesis 2005; 26: 12801284.
33. Koshiol J, et al. No role for human papillomavirus in esophageal squamous cell carcinoma in China. International Journal of Cancer 2010; 127: 93100.
34. Liu HY, et al. Prevalence of human papillomavirus infection in esophageal and cervical cancers in the high incidence area for the two diseases from 2007 to 2009 in Linzhou of Henan Province, Northern China. Archives of Virology 2014; 159: 13931401.
35. Wang XS, et al. Relationshap between human papillomavirus DNA testing and human telomerase RNA gene amplification detection in esophageal cancer tissue. Chinese Journal of Experimental Surgery 2012; 29: 13551356.
36. Liu M, et al. Study of association between HPV infection and squamous cell cancer as well as dysplasia tissues of esophageal. China Journal of Modern Medicine 2008; 18: 20842086.
37. Liu T, et al. Viral load of HPV 16/18 in esophageal squamous cell carcinoma in three ethnic groups living in Xinjiang Autonomous Region, China. Molecular Biology Reports 2013; 40: 20452052.
38. Clifford GM, et al. Human papillomavirus types in invasive cervical cancer worldwide: a meta-analysis. British Journal of Cancer 2003; 88: 6373.
39. Rosa MI, et al. The prevalence of human papillomavirus in ovarian cancer: a systematic review. International Journal of Gynecological Cancer 2013; 23: 437441.
40. Li X, et al. Human papillomavirus infection and laryngeal cancer risk: a systematic review and meta-analysis. Journal of Infectious Diseases 2013; 207: 479488.
41. Li N, et al. Human papillomavirus infection and bladder cancer risk: a meta-analysis. Journal of Infectious Diseases 2011; 204: 217223.
42. Srinivasan M, Taioli E, Ragin CC. Human papillomavirus type 16 and 18 in primary lung cancers–a meta-analysis. Carcinogenesis 2009; 30: 17221728.
43. Kamangar F, et al. Human papillomavirus serology and the risk of esophageal and gastric cancers: results from a cohort in a high-risk region in China. International Journal of Cancer 2006; 119: 579584.
44. Poljak M, Cerar A, Seme K. Human papillomavirus infection in esophageal carcinomas: a study of 121 lesions using multiple broad-spectrum polymerase chain reactions and literature review. Human Pathology 1998; 29: 266271.
45. Hubbard RA. Human papillomavirus testing methods. Archives of Pathology & Laboratory Medicine 2003; 127: 940945.
46. Garcia-Vallve S, Alonso A, Bravo IG. Papillomaviruses: different genes have different histories. Trends in Microbiology 2005; 13: 514521.
47. Munger K, Howley PM. Human papillomavirus immortalization and transformation functions. Virus Research 2002; 89: 213228.
48. Hebner CM, Laimins LA. Human papillomaviruses: basic mechanisms of pathogenesis and oncogenicity. Reviews in Medical Virology 2006; 16: 8397.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Epidemiology & Infection
  • ISSN: 0950-2688
  • EISSN: 1469-4409
  • URL: /core/journals/epidemiology-and-infection
Please enter your name
Please enter a valid email address
Who would you like to send this to? *



Full text views

Total number of HTML views: 2
Total number of PDF views: 33 *
Loading metrics...

Abstract views

Total abstract views: 255 *
Loading metrics...

* Views captured on Cambridge Core between September 2016 - 20th November 2017. This data will be updated every 24 hours.