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Iodine staining and p16 immunohistochemistry as a novel screening for secondary esophageal neoplasm after hematopoietic stem cell transplantation

Bone Marrow Transplantation volume 53, pages 1359–1363 (2018)Cite this article

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Regarding allogeneic hematopoietic stem cell transplantation (HSCT) survivors, several studies have reported a twofold to fourfold increased risk of secondary solid tumors, and incidence ratios of oral, pharyngeal and esophageal cancers were significantly higher than the general population [1,2,3]. Notably, increased risk of oral squamous cell carcinoma (SCC) has been reported in patients with chronic graft-versus-host disease (GVHD) [4,5,6]. Considering the dismal prognosis of esophageal cancer found in the advanced stage, detection in the asymptomatic early stages is highly desirable.

Human papillomavirus (HPV) infection is suspected as an associated risk factor for oral and esophageal SCC in patients with immunodeficiency caused by the human immunodeficiency virus, solid organ transplantation, or allogeneic HSCT [5, 7, 8]. A case report has assessed the usefulness of p16 immunohistochemistry, a surrogate marker for HPV, for the early diagnosis of secondary oral and esophageal malignancy after HSCT [4]. Indeed, p16 immunohistochemistry is known as a pathologically good tool for the detection of oral and esophageal squamous cell neoplasm (SCN). The HPV-associated oncoprotein E6 and E7 interfere with cell cycle and inactivate tumor-suppressor protein p53 and pRb (retinoblastoma protein), which result in increased p16 expression levels caused by negative feedback control [9].

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Acknowledgements

The authors thank all the patients who consented to participate in this study.

Author contribution

AS, KM, and MI designed and launched the study; TS, AS, YK, NK, and DK collected data; TS and AS analyzed results and wrote the manuscript; MI evaluated biopsy samples; all authors contributed to discussion; YO, KM, TY, JH, and IM supervised the study and revised the manuscript.

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Authors and Affiliations

  1. Department of Hematology, Japanese Red Cross Nagoya First Hospital, Nagoya, Japan

    Takahiko Sato, Aika Seto, Yusuke Kagaya, Naomi Kawashima, Daisuke Koyama, Takanobu Morishita, Yukiyasu Ozawa & Koichi Miyamura

  2. Department of Gastroenterology, Japanese Red Cross Nagoya First Hospital, Nagoya, Japan

    Takeo Yamaguchi & Jun-ichi Haruta

  3. Department of Pathology, Japanese Red Cross Nagoya First Hospital, Nagoya, Japan

    Masafumi Ito

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  1. Takahiko Sato
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Correspondence to Masafumi Ito.

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Sato, T., Seto, A., Kagaya, Y. et al. Iodine staining and p16 immunohistochemistry as a novel screening for secondary esophageal neoplasm after hematopoietic stem cell transplantation. Bone Marrow Transplant 53, 1359–1363 (2018). https://doi.org/10.1038/s41409-018-0197-2

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