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Wang Q, Xu L, Li X, Yu M, Chen Q. Multifocal epithelial hyperplasia confined to the interdental papilla of an adult Chinese man: a rare case report and literature review. BMC Oral Health 2023; 23:699. [PMID: 37773130 PMCID: PMC10540325 DOI: 10.1186/s12903-023-03282-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 08/03/2023] [Indexed: 10/01/2023] Open
Abstract
BACKGROUND Multifocal epithelial hyperplasia (MEH), or focal epithelial hypertension (FEH), or Heck's disease, is an uncommon, benign oral mucosal disease associated with human papillomavirus infection. It is mostly observed in indigenous populations of the world, and has been rarely reported in China. However, previous research suggested there might be a greater prevalence of MEH in the Chinese population. While predominantly involves the lips, buccal mucosa and tongue, MEH was occasionally reported to affect the hard palate and gingiva as well. CASE PRESENTATION This paper reports a case of extensive MEH lesions that confined to the interdental papilla of a Chinese male without detection of HPV, and summarizes the published gingiva-involved MEH reports from 1966 until present. The lesions were excised with an Er: YAG laser after scaling and root planning, no recurrence was observed after 6-month follow-up. CONCLUSIONS The present report illustrates the need for clinicians to be aware of rare presentations of MEH to facilitate a prompt diagnosis and proper management. More reports are encouraged to determine a correct prevalence rate of MEH in China.
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Affiliation(s)
- Qianting Wang
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, 310006, China
| | - Lehan Xu
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, 310006, China
| | - Xiaojun Li
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, 310006, China
| | - Mengfei Yu
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, 310006, China.
| | - Qianming Chen
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, 310006, China
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2
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Focal Epithelial Hyperplasia. Viruses 2021; 13:v13081529. [PMID: 34452393 PMCID: PMC8402694 DOI: 10.3390/v13081529] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 07/28/2021] [Accepted: 07/29/2021] [Indexed: 01/18/2023] Open
Abstract
Focal epithelial hyperplasia (FEH) or Heck’s disease is a rare, benign, oral condition that is associated with infection by human papillomavirus type 13, 32 or both. The whiteish to mucosal-colored, soft, papular or nodular elevated lesions in the oral cavity are normally asymptomatic but can grow to a size or at a location where treatment is needed. The diagnosis is often based on clinical presentation and histopathology, and the HPV genotype can be determined using PCR utilizing specific primers or DNA sequencing. While FEH was reported to often affect several members of the same family and exist primarily among indigenous populations around the world, the number of reported cases within the European region is increasing. This contemporary review summarizes the main findings in relation to HPV genotypes, impact of superinfection exclusion and vaccination, transmission, diagnosis, geographical and ethnical distribution, comorbidities and treatment of FEH with an emphasis on including the most recent case reports within the field. Furthermore, we describe for the first time a FEH lesion infected with the low-risk HPV90.
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3
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Sethi S, Ali A, Ju X, Antonsson A, Logan R, Jamieson L. An update on Heck's disease-a systematic review. J Public Health (Oxf) 2021; 44:269-285. [PMID: 33501985 DOI: 10.1093/pubmed/fdaa256] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2020] [Revised: 12/12/2020] [Accepted: 12/13/2020] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Previous research has suggested an ethnic association of Heck's disease with a prominent genetic and familial inheritance pattern, but no systematic review has been reported, which has collected all the evidence in one paper. The aim was estimation of the updated age estimates and gender predilection of this disease and also questioning its proposed link to ethnic and geographical factors. METHODS Heck's disease from 1966 until present are tabulated, including various descriptive characteristics. After removal of duplicates and adhering to all the inclusion criteria, we shortlisted 95 case reports. The quality assessment of all included studies has been done following STROBE (STrengthening the Reporting of OBservational studies in Epidemiology) guidelines. RESULTS We found an age range of 3-92 years (mean: 23.1 years) with a male to female ratio of 3:4. Geographical distribution revealed one of the main findings of this study, which was an increased incidence of Heck's disease in the European region. CONCLUSIONS As already observed and established, there is a much greater prevalence of this disease in the indigenous populations of the world and more research should be encouraged to understand the correct transmission and pattern of spread of this disease.
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Affiliation(s)
- Sneha Sethi
- Australian Research Centre for Population Oral Health, Adelaide Dental School, University of Adelaide, Adelaide, Australia
| | - Anna Ali
- Robinson Research Institute, University of Adelaide, Adelaide, Australia
| | - Xiangqun Ju
- Australian Research Centre for Population Oral Health, Adelaide Dental School, University of Adelaide, Adelaide, Australia
| | | | - Richard Logan
- Adelaide Dental School, University of Adelaide, Adelaide, Australia
| | - Lisa Jamieson
- Australian Research Centre for Population Oral Health, Adelaide Dental School, University of Adelaide, Adelaide, Australia
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4
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Vale DAD, Ferracini LMA, Bueno MVDSR, Souza ACMF, Braz-Silva PH, Ortega KL. Unusual presentation of a disseminated oral HPV infection after combined antiretroviral therapy initiation. Rev Inst Med Trop Sao Paulo 2019; 61:e54. [PMID: 31618374 PMCID: PMC6792356 DOI: 10.1590/s1678-9946201961054] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Accepted: 09/16/2019] [Indexed: 12/27/2022] Open
Abstract
HPV clinical manifestations have their characteristics modified by the use of combined antiretroviral therapy (cART), although its incidence is unaffected by cART. We report an unusual presentation of oral HPV infection and discuss an effective treatment for disseminated HPV lesions. A 52-year-old male of Asian-origin, HIV-seropositive, presented with extensive nodular lesions throughout the oral mucosa extending to the oropharyngeal region. Biopsy followed by histopathological examination and HPV genotyping were performed. The treatment was initiated with topical application of podophyllin and trichloroacetic acid. HPV lesions in oral mucosa are generally easy to handle. Extensive lesions can make it difficult to choose an effective treatment that meets the patient's particularities and medication availability.
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Affiliation(s)
- Daniela Assis do Vale
- Universidade de São Paulo, Faculdade de Odontologia, Departamento de Estomatologia, São Paulo, São Paulo, Brazil
| | - Lais Magda Araújo Ferracini
- Universidade de São Paulo, Faculdade de Odontologia, Departamento de Estomatologia, São Paulo, São Paulo, Brazil
| | | | | | - Paulo Henrique Braz-Silva
- Universidade de São Paulo, Faculdade de Odontologia, Departamento de Estomatologia, São Paulo, São Paulo, Brazil.,Universidade de São Paulo, Instituto de Medicina Tropical de São Paulo, Laboratório de Virologia (LIM 52), São Paulo, São Paulo, Brazil
| | - Karem López Ortega
- Universidade de São Paulo, Faculdade de Odontologia, Departamento de Estomatologia, São Paulo, São Paulo, Brazil
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5
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Daigrepont J, Cameron JE, Wright KL, Cordell KG, Rosebush MS. Detection of human papillomavirus DNA in formalin-fixed, paraffin-embedded squamous papillomas of the oral cavity. J Clin Exp Dent 2018; 10:e979-e983. [PMID: 30386503 PMCID: PMC6203908 DOI: 10.4317/jced.55187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Accepted: 09/02/2018] [Indexed: 11/16/2022] Open
Abstract
Background Squamous papillomas are exophytic proliferations of surface oral epithelium. Human papillomavirus (HPV) infection is widely accepted as the etiology of squamous papillomas however the virus cannot be detected in a significant percentage of lesions. Material and Methods Using polymerase chain reaction (PCR), we tested 35 formalin-fixed paraffin-embedded (FFPE) squamous papillomas for the presence of HPV DNA. Results Six papillomas (17%) tested positive for HPV DNA; four contained HPV-6 and two contained HPV-11. Given that β–globin DNA was only identified in half of the samples, DNA degradation appears to have significantly impacted the results. Conclusions The results likely represent an underestimation of the true number of HPV-positive specimens in our study. Potential explanations for HPV-negative squamous papillomas include transient HPV infection, failure of the experiment to detect HPV if present, or the possibility that some lesions may not result from HPV infection. Key words:HPV, PCR, FFPE, papilloma, oral.
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Affiliation(s)
- Jack Daigrepont
- DDS, Staff Dentist, SWLA Center for Health Services, Lake Charles, LA, USA
| | - Jennifer E Cameron
- PhD, Assistant Professor of Microbiology, Immunology & Parasitology, Louisiana State University, New Orleans, LA, USA
| | - Kelly L Wright
- MS, Predoctoral student, University of Florida College of Pharmacy, Gainesville, FL, USA
| | - Kitrina G Cordell
- DDS, MS, Associate Professor of Oral and Maxillofacial Pathology, Louisiana State University, New Orleans, LA, USA
| | - Molly S Rosebush
- DDS, MS, Assistant Professor of Oral and Maxillofacial Pathology, Louisiana State University, New Orleans, LA, USA
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Rajendra Santosh AB, Christian NA, Jones T, Thoms-Rodriguez CAA, Condappa A, Thompson T, Pinkney J, Barton EN, Lindo J. Molecular epidemiology of human papillomavirus genotypes in oral rinses from HIV-positive and HIV-negative Jamaican patients. ACTA ACUST UNITED AC 2018; 10:e12365. [PMID: 30338674 DOI: 10.1111/jicd.12365] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Revised: 05/12/2018] [Accepted: 06/01/2018] [Indexed: 12/12/2022]
Abstract
AIM Human papillomavirus (HPV) has been reported to be associated with oral and oropharyngeal cancer. However, little information is available about the epidemiology of oral HPV infection in Jamaica. The purpose of the present study was to assess the prevalence of oral HPV strains using the oral rinse method in HIV and non-HIV Jamaican patients, as well as to determine the association of HPV with sexual practices, smoking, and alcohol use. METHODS A cross-sectional study was conducted on patients attending The University of the West Indies Mona Dental Polyclinic and the Centre for HIV/AIDS Research and Education Services. Salivary samples were tested through molecular analysis for 37 HPV genotypes using the linear array HPV genotyping test. A survey questionnaire was used to obtain demographic details, smoking history, alcohol practice, sexual practice, and history of HPV testing. RESULTS The HPV prevalence was 8.65% in 18-64 y olds (N = 104), with a slight female predilection (55%). No high-risk HPV types were found. HPV-84 was the most common type in both HIV and non-HIV patients; 66.7% of HPV-positive participants reported that they had six or more lifetime sexual partners. CONCLUSION The prevalence of oral HPV was similar to that in other countries. No statistically-significant relationship was observed between the prevalence of HPV and either the number of sexual partners, smoking, or alcohol history. A nationwide study on oral HPV detection might be helpful in developing a HPV vaccination policy in Jamaica.
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Affiliation(s)
- Arvind B Rajendra Santosh
- School of Dentistry, Faculty of Medical Sciences, The University of the West Indies, Kingston, Jamaica
| | - Nicole A Christian
- Department of Microbiology, Faculty of Medical Sciences, The University of the West Indies, Kingston, Jamaica
| | - Thaon Jones
- School of Dentistry, Faculty of Medical Sciences, The University of the West Indies, Kingston, Jamaica
| | | | - Andrew Condappa
- Department of Basic Medical Sciences, Faculty of Medical Sciences, The University of the West Indies, Kingston, Jamaica
| | - Tamara Thompson
- Department of Medicine, Faculty of Medical Sciences, The University of the West Indies, Kingston, Jamaica
| | - Jodian Pinkney
- Department of Medicine, Faculty of Medical Sciences, The University of the West Indies, Kingston, Jamaica
| | - Everard N Barton
- Department of Medicine, Faculty of Medical Sciences, The University of the West Indies, Kingston, Jamaica
| | - John Lindo
- Department of Microbiology, Faculty of Medical Sciences, The University of the West Indies, Kingston, Jamaica
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Khanal S, Shumway BS, Zahin M, Redman RA, Strickley JD, Trainor PJ, Rai SN, Ghim SJ, Jenson AB, Joh J. Viral DNA integration and methylation of human papillomavirus type 16 in high-grade oral epithelial dysplasia and head and neck squamous cell carcinoma. Oncotarget 2018; 9:30419-30433. [PMID: 30100997 PMCID: PMC6084396 DOI: 10.18632/oncotarget.25754] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Accepted: 05/25/2018] [Indexed: 12/19/2022] Open
Abstract
This study evaluated the integration and methlyation of human papillomavirus type 16 (HPV16) in head and neck squamous cell carcinoma (HNSCC) and its oral precursor, high-grade oral epithelial dysplasia (hgOED). Archival samples of HPV16-positive hgOED (N = 19) and HNSCC (N = 15) were evaluated, along with three HNSCC (UMSCC-1, -47 and -104) and two cervical cancer (SiHa and CaSki) cell lines. HgOED cases were stratified into three groups with increasing degrees of cytologic changes (mitosis, karyorrhexis and apoptosis). The viral load was higher and the E2/E6 ratio lower (indicating a greater tendency toward viral integration) in group 3 than in groups 1 or 2 (p = 0.002, 0.03). Methylation was not observed in hgOED cases and occurred variably in only three HNSCC cases (26.67%, 60.0% and 93.3%). In HNSCC cell lines, lower E7 expression correlated with higher levels of methylation. HgOED with increased cytologic change, now termed HPV-associated oral epithelial dysplasia (HPV-OED), exhibited an increased viral load and a tendency toward DNA integration, suggesting a potentially increased risk for malignant transformation. More detailed characterization and clinical follow-up of HPV-OED patients is needed to determine whether HPV-OED is a true precursor to HPV-associated HNSCC and to clarify the involvement of HPV in HNSCC carcinogenesis.
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Affiliation(s)
- Sujita Khanal
- Division of Human Biology, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Brian S Shumway
- Department of Surgical and Hospital Dentistry, University of Louisville School of Dentistry, Louisville, KY, USA
| | - Maryam Zahin
- James Graham Brown Cancer Center, University of Louisville, Louisville, KY, USA
| | - Rebecca A Redman
- James Graham Brown Cancer Center, University of Louisville, Louisville, KY, USA.,Department of Medicine, School of Medicine, University of Louisville, Louisville, KY, USA
| | - John D Strickley
- James Graham Brown Cancer Center, University of Louisville, Louisville, KY, USA.,Department of Medicine, School of Medicine, University of Louisville, Louisville, KY, USA
| | - Patrick J Trainor
- James Graham Brown Cancer Center, University of Louisville, Louisville, KY, USA
| | - Shesh N Rai
- James Graham Brown Cancer Center, University of Louisville, Louisville, KY, USA
| | - Shin-Je Ghim
- James Graham Brown Cancer Center, University of Louisville, Louisville, KY, USA
| | | | - Joongho Joh
- James Graham Brown Cancer Center, University of Louisville, Louisville, KY, USA.,Department of Medicine, School of Medicine, University of Louisville, Louisville, KY, USA.,Center for Predictive Medicine, University of Louisville, Louisville, KY, USA
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8
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HPV genotypes detected by linear array and next-generation sequencing in anal samples from HIV positive men who have sex with men in Mexico. Arch Virol 2018; 163:925-935. [PMID: 29299683 DOI: 10.1007/s00705-017-3697-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2017] [Accepted: 11/20/2017] [Indexed: 12/17/2022]
Abstract
The incidence of anal cancer has been rising, especially in HIV+ patients and has been associated with HPV infection. HIV+ patients are more at risk of HPV coinfection and are seven times more likely to have persistent HPV infection; moreover, HIV+ men have an increased risk of developing anal cancer compared to HIV+ women. The development of screening strategies for the detection of HPV in HIV+ men is of major importance; however, there is not enough information about the HPV genotypes and variants that are colonizing the anal epithelia of HIV+ men in diverse geographical regions. Therefore, this work was aimed at identifying HPV genotypes present in the anal epithelium of HIV+ men who have sex with men (MSM), with or without anal lesions (n = 75). For HPV genotyping, two approaches were performed: Linear Array HPV Genotyping Test and next-generation sequencing (NGS). In general, the six most frequent HPV genotypes found by Linear Array were HPV6, 62, 61, 81, 16 and 51. On the other hand, employing NGS, a total of 36 HPV genotypes belonging to both alpha and beta genera were found. The genotypes with the greatest number of reads, according to the diagnostic group, were: HPV81, 45, 6, 51 and 61 in MSM without anal lesions (WAIN); HPV6, 61, 70, 62 and 66 in MSM with atypical lesions (AAL); HPV6, 11, 66, 81 and 61 in MSM with anal intraepithelial neoplasia grade I (AIN I); and HPV16, 81, 58, 61 and 52 with AIN III. Additionally, a great diversity of L1 variants was observed, especially in genotypes HPV16, 58, 61, 52, 45 and 59.
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Lin SI, Mort JR, Hinchey PM, Lewis JS, Zwerner J. Clinical pathologic conference: diffuse papillomatous lesions of the gingiva with posterolateral neck skin tags. Oral Surg Oral Med Oral Pathol Oral Radiol 2017; 125:209-214. [PMID: 29195813 DOI: 10.1016/j.oooo.2017.10.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Revised: 10/11/2017] [Accepted: 10/27/2017] [Indexed: 11/16/2022]
Affiliation(s)
- Susie I Lin
- Department of Oral and Maxillofacial Surgery, Vanderbilt Medical Center, Nashville, Tennessee, USA.
| | - Joseph R Mort
- Department of Oral and Maxillofacial Surgery, Vanderbilt Medical Center, Nashville, Tennessee, USA
| | - Paul M Hinchey
- Department of Oral and Maxillofacial Surgery, Vanderbilt Medical Center, Nashville, Tennessee, USA
| | - James S Lewis
- Department of Pathology, Microbiology and Immunology, Vanderbilt Medical Center, Nashville, Tennessee, USA
| | - Jeffrey Zwerner
- Department of Medicine, Division of Dermatology, Vanderbilt Medical Center, Nashville, Tennessee, USA
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Khanal S, Trainor PJ, Zahin M, Ghim SJ, Joh J, Rai SN, Jenson AB, Shumway BS. Histologic variation in high grade oral epithelial dysplasia when associated with high-risk human papillomavirus. Oral Surg Oral Med Oral Pathol Oral Radiol 2017; 123:566-585. [PMID: 28407985 DOI: 10.1016/j.oooo.2017.01.008] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Revised: 01/05/2017] [Accepted: 01/10/2017] [Indexed: 01/05/2023]
Abstract
OBJECTIVES Reported cytologic alterations associated with high-risk human papillomavirus (HR-HPV) in oral epithelial dysplasia (HPV-OED) need further characterization. STUDY DESIGN Archival cases of high-grade oral epithelial dysplasia (hgOED) (N = 38) were assigned a cytologic score (CS) based on the average number of mitotic, karyorrhectic, and apoptotic cells per high-power field. Three groups were then generated on the basis of increasing CS: Focal (group 1, N = 14), Intermediate (group 2, N = 12), and Diffuse (group 3, N = 12). Polymerase chain reaction-based HPV genotyping and p16 immunohistochemistry were performed. RESULTS HR-HPV was found significantly more in group 3 (83.3%) compared with groups 1 and 2 (group 1&2; 42.9% and 41.7%, respectively; P = .047). HPV16 predominated in HR-HPV-positive cases (90.5%). By location, the tongue or the floor of mouth was associated with all groups (P = .04). Increasing CS was associated with a slightly younger age (P = .04) and increased expression of p16 (P = .005). CS and p16 expression were not sensitive but were highly specific predictors for HR-HPV presence. Based on limited follow-up information, HPV-OED does not differ in clinical aggressiveness compared with conventional OED. CONCLUSIONS Increased CS in hgOED is strongly associated with HR-HPV (mostly HPV16) and p16 expression. CS and p16 expression are specific predictors of HR-HPV presence. Further molecular study and long-term follow-up of HPV-OED are needed.
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Affiliation(s)
- Sujita Khanal
- James Graham Brown Cancer Center, Department of Biochemistry and Molecular Genetics, University of Louisville, Louisville, KY, USA
| | - Patrick J Trainor
- Research Associate, Biostatistics Shared Facility, James Graham Brown Cancer Center, University of Louisville, Louisville, KY, USA
| | - Maryam Zahin
- Postdoctoral Associate, James Graham Brown Cancer Center, University of Louisville, Louisville, KY, USA
| | - Shin-Je Ghim
- Assistant Professor, Department of Medicine, James Graham Brown Cancer Center, University of Louisville, Louisville, KY, USA
| | - Joongho Joh
- Assistant Professor, Department of Medicine, James Graham Brown Cancer Center, University of Louisville, Louisville, KY, USA
| | - Shesh N Rai
- Professor, Wendell Cherry Chair in Clinical Trial Research; Director, Biostatistics Shared Facility, James Graham Brown Cancer Center, University of Louisville, Louisville, KY, USA
| | - Alfred Bennett Jenson
- Senior scientist, Professor of Vaccinology, James Graham Brown Cancer Center, University of Louisville, Louisville, KY, USA
| | - Brian S Shumway
- Associate Professor, Oral and Maxillofacial Pathology, Department of Surgical and Hospital Dentistry, University of Louisville School of Dentistry, Louisville, KY, USA.
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