Barrett Esophagus Clinical Trial
Official title:
Prevalence of Human Papillomavirus in Barrett Esophagus Compared With Controls
The aim of this study was to determine whether the prevalence of Human PapillomaVirus (HPV) was increased in patients with Barrett esophagus compared with controls in a prospective study. Secondary objective was to identify, if present, the type of Human PapillomaVirus (HPV) associated in Barrett esophagus.
Barrett's esophagus (BE) is defined by the replacement of normal stratified squamous
epithelium in the distal third of esophagus by specialized intestinal metaplasia. It is
related to gastro-esophageal reflux disease. Diagnosis is suspected during endoscopy and
confirmed on biopsy. The classification of CM from Prague is validated to describe BE during
endoscopy. The main complication of the BE is adenocarcinoma, according to
metaplasia-dysplasia-cancer sequence. The incidence of esophageal adenocarcinoma is
variable, ranging from 0.4 to 3 %. BE is found in 100% esophageal adenocarcinoma and in 42%
junction adenocarcinoma. Among the unknown risk factors involved in the onset of dysplasia,
viruses can't be excluded.
It is well established that Human Papillomavirus (HPV) is strongly associated with squamous
cell dysplasia of female uterine cervix and its progression to cervical carcinoma. HPV is
also implicated in others invasive carcinomas including uterine cervix, vulvar, vaginal,
anal, penile, head and neck squamous cell carcinoma. Several studies showed that HPV could
be associated in head and neck cancers and that tumor HPV status in patients with
oropharyngeal squamous cell carcinomas was an independent prognostic factor for survival.
The association between HPV and esophageal squamous cell carcinomas is still controversed
with epidemiological studies reporting prevalence of mucosal HPV DNA ranging from 0 to 70%.
Studies that have investigated HPV and adenocarcinoma of esophagus or Barrett's esophagus
(BE) are scarce and data are not clear. A recent prospective study showed that HPV was
strongly associated with Barrett'dysplasia and esophageal adenocarcinoma.
The aim of this study was to determine whether the prevalence of HPV was increased in
patients with BE compared with controls in a prospective study. Secondary objective was to
identify, if present, the type of HPV associated in BE.
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Allocation: Non-Randomized, Intervention Model: Parallel Assignment, Masking: Open Label
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