Esophageal Carcinogenesis in the High-risk Area-HPV infection and genetic abnormality, expression of HLA antigen-

为了阐明人乳头瘤病毒（HPV）与食道癌变的关系，我们用聚合酶链反应（PCR）检测了日本和中国食道鳞状细胞癌中HPV DNA的存在。PCR结果显示，日本患者中HPV阳性率为4.3%(1/23)，中国患者中HPV阳性率为22.2%(28/126)(p<0.05)，排除食管癌高危组。这些结果表明，至少在中国病例中，HPV DNA可能在食道癌变中起作用。日本的重度饮酒者和吸烟者分别为31.8%和30.0%，中国的重度饮酒者和吸烟者分别为7.9%和5.3% （p<0.0001）。在日本的病例中，重度吸烟者的p53蛋白积累频率高于轻度吸烟者（p< 0.01）。重度饮酒者与轻度饮酒者的比较结果相似（p<0.01）。同时有轻度吸烟和轻度饮酒史的25例患者中有9例（36.0%）存在p53蛋白积累，而同时有重度吸烟和重度饮酒史的15例患者中有14例（93.3%）存在p53蛋白积累（p< 0.05）。我们认为吸烟和饮酒导致食管鳞状细胞癌患者p53蛋白的高频率积累，在日本被认为是食管癌发生的主要途径。

To elucidate the association of Human Papillomavirus (HPV) with carcinogenesis of the esophagus, esophageal squamous cell .carcinomas in Japan and China were examined for the presence of HPV DNA by polymerase chane reaction (PCR). PCR showed that 4.3%(1/23) contained HPV in Japannese cases and 22.2%(28/126) in Chinese cases(p<0.05) excluded high risk group of esophageal carcinoma. These results suggested tat the HPV DNA might play a role in carcinogenesis of the esophagus at least in Chinese cases. The number of heavy drinkers and smokers were 31.8% and 30.0% in Japanese cases, and 7.9% and 5.3% in Chinese cases, respectively (p<0.0001). In Japanese cases, frequency of the p53 protein accumulations in cases with heavy smokers was higher than that with light smokers (p<0.0l). The similar result was observed in the comparison between the cases with heavy drinkers and light drinkers (p<0.01). Furthermore, the p53 protein accumulations were found in 9 of 25 (36.0%) in patients having both histories of light smoking and light drinking, whereas in 14 of 15 (93.3%) in patients having both histories of heavy smoking and heavy drinking (p<c0.05). We conclude that cigarette smoking and alcohol drinking caused a high frequency of the p53 protein accumulation in patients with esophageal squamous cell carcinoma and it is considered to be a main pathway of esophageal carcinogenesis in Japan.