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Ślebioda Z, Woźniak T, Wyganowska ML. Human Papillomavirus in Oral Lichen Planus: Is There an Association? A Meta-Analysis. J Clin Med 2024; 13:3698. [PMID: 38999264 PMCID: PMC11242649 DOI: 10.3390/jcm13133698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2024] [Revised: 06/21/2024] [Accepted: 06/22/2024] [Indexed: 07/14/2024] Open
Abstract
Lichen planus (LP) is a chronic, recurrent mucocutaneous inflammatory disease with unclearly defined etiology, where a potential role of several viruses has been considered. This meta-analysis aimed to determine the potential association between HPV and oral LP based on case-control and cross-sectional study results. A systematic search was performed in PubMed, Web of Science (SCI), Google Scholar, and Scopus databases with the last update on 6 March 2024. Pooled data were analyzed by calculating odds ratios (OR) and 95% confidence intervals (CI) with the metafor package for R. A total of 13 studies on 541 cases and 413 controls were included in this meta-analysis. It covered eight countries: India, Iran, Turkey, Czech Republic, Hungary, Italy, Macedonia, and the UK. In seven papers, the differentiation into the erosive-atrophic type and non-erosive-atrophic type of OLP was utilized. HPV infection was associated with at least a two times higher risk for a person with HPV to have OLP, depending on whether original data or filled/trimmed data were used. The OR values were 3.54 [2.01, 6.24] and 2.10 [1.16, 3.82], respectively. This meta-analysis was performed to identify the association between HPV and OLP and revealed that HPV infection was associated with at least a high risk for a person with HPV to develop OLP.
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Affiliation(s)
- Zuzanna Ślebioda
- Department of Dental Surgery, Periodontology and Oral Mucosa Diseases, Poznań University of Medical Sciences, 61-701 Poznań, Poland
| | - Tomasz Woźniak
- Institute of Human Genetics, Polish Academy of Sciences, 60-479 Poznań, Poland
| | - Marzena Liliana Wyganowska
- Department of Dental Surgery, Periodontology and Oral Mucosa Diseases, Poznań University of Medical Sciences, 61-701 Poznań, Poland
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Agha‐Hosseini F, Hafezi Motlagh K. The correlation between human papillomavirus and oral lichen planus: A systematic review of the literature. Immun Inflamm Dis 2023; 11:e960. [PMID: 37647448 PMCID: PMC10408375 DOI: 10.1002/iid3.960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 06/28/2023] [Accepted: 07/13/2023] [Indexed: 09/01/2023] Open
Abstract
INTRODUCTION Oral lichen planus (OLP) is a chronic inflammatory disorder with cell-induced immunopathological responses and is considered a potential malignancy disorder in the oral cavity. Due to the high prevalence of OLP as well as the potential for malignancy, human papillomaviruses (HPVs) may play an important role in it. Although previous studies have explored the possible relationship between HPV and OLP, the findings have been conflicting and nonconclusive. This study aims to review the studies that investigated HPV-16 and HPV-18 in OLP. METHODS AND MATERIALS The research protocol followed the Preferred Reporting Items for Systematic Reviews (PRISMA2020) checklist. The online databases Pubmed, Scopus, Embase, Google Scholar, and Cochrane were searched using the following individual keywords: "OLP" OR "Oral Lichen Planus" OR "HPV" OR "Human Papillomavirus." The search strategy resulted in the selection of 80 articles. The articles were evaluated, and after duplication removal, 53 abstracts were reviewed, resulting in the selection of 25 studies according to inclusion and exclusion criteria. The risk of bias assessment was done by using the Modified Newcastle-Ottawa quality assessment scale. The overall prevalence of HPV in OLP lesions varied from 2.7% to 70%, depending on the type of diagnostic method used. CONCLUSION Despite the studies conducted on the relationship between OLP and HPV infection, there is still no conclusive evidence that HPV can play a role in the etiopathogenesis of OLP, either in clinical manifestations or in the malignant transformation of lesions.
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Affiliation(s)
- Farzaneh Agha‐Hosseini
- Dental Research CenterDentistry Research Institute, Tehran University of Medical SciencesTehranIran
- Department of Oral Medicine, Faculty of DentistryTehran University of Medical SciencesTehranIran
- The Academy of Medical SciencesTehranIran
| | - Kimia Hafezi Motlagh
- Department of Oral Medicine, School of DentistryTehran University of Medical SciencesTehranIran
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Mohammadi M, Abbaszadeh H, Mohtasham N, Salehiniya H, Shafaie E. The association between high-risk human papillomavirus and oral lichen planus. Clin Exp Dent Res 2023; 9:93-99. [PMID: 36636987 PMCID: PMC9932238 DOI: 10.1002/cre2.707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 12/07/2022] [Accepted: 12/10/2022] [Indexed: 01/14/2023] Open
Abstract
OBJECTIVES Oral lichen planus (OLP) is a cell-mediated inflammatory mucosal disorder and is classified as an oral potentially malignant disorder. Some research has shown that apoptosis in OLP cells is similar to a viral infection such as human papillomavirus (HPV). So, the aim of this case-control study was to investigate the association of high-risk HPV with OLP. MATERIAL AND METHODS DNA was extracted from 25 formalin-fixed, paraffin-embedded (FFPE) OLP tissues and 25 FFPE normal oral tissues as case and control groups, respectively. The presence of high-risk HPV16 and HPV18 DNA was investigated by polymerase chain reaction (PCR). p-value<.05 was considered significant. RESULTS Twelve samples (48%) of OLPs were positive for HPV16, compared with six samples (24%) of controls; although the difference was not significant, it was borderline (p = .07). Three samples (12%) of OLPs were positive for HPV18 compared with one sample (4%) of controls; the difference was not significant (p = .3). The total frequency of both high-risk HPV were 14 samples (56%) of OLPs and 7 samples (28%) of controls; there was a significant association between the high-risk HPV and OLP (p = .04). High-risk HPVs was more prevalent in erosive-atrophic (EA) form of OLP as compared to non-EA form, although the difference was not significant (p = .13). CONCLUSIONS The results suggest a significant association between high-risk HPVs and OLP.
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Affiliation(s)
- Maryam Mohammadi
- Student Research CommitteeBirjand University of Medical SciencesBirjandIran
| | - Hamid Abbaszadeh
- Department of Oral and Maxillofacial Pathology, Faculty of DentistryBirjand University of Medical SciencesBirjandIran
| | - Nooshin Mohtasham
- Oral and Maxillofacial Disease Research Center, Faculty of DentistryMashhad University of Medical ScienceMashhadIran
| | - Hamid Salehiniya
- Social Determinants of Health Research CenterBirjand University of Medical SciencesBirjandIran
| | - Ebrahim Shafaie
- Infectious Diseases Research CenterBirjand University of Medical SciencesBirjandIran
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Correlation between Oral Lichen Planus and Viral Infections Other Than HCV: A Systematic Review. J Clin Med 2022; 11:jcm11185487. [PMID: 36143134 PMCID: PMC9501453 DOI: 10.3390/jcm11185487] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 09/15/2022] [Accepted: 09/16/2022] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVES This review aimed to evaluate the correlation between viral infections (HPV, EBV, HSV-1, CMV) other than HCV and oral lichen planus to assess if there is sufficient evidence to establish if these viruses can play a role in the etiopathogenesis of the disease. MATERIALS AND METHODS We reviewed the literature using different search engines (PubMed, ISI Web of Science, and the Cochrane Library), employing MeSH terms such as "oral lichen planus" and "OLP" in conjunction with other terms. We utilized the Population, Intervention, Comparison, Outcomes, and Study design (PICOS) method to define our study eligibility criteria. RESULTS A total of 43 articles of the 1219 results initially screened were included in the study. We allocated the 43 selected items into four groups, according to each related virus: HPV, EBV, HSV-1, and CMV. CONCLUSIONS Heterogeneous results neither confirm nor exclude a direct correlation between the investigated viral infections and oral lichen planus etiopathogenesis and its feasible malignant transformation. Many viral agents can cause oral lesions and act as cancerizing agents. Future studies could be desirable to produce comparable statistical analyses and enhance the quantity and quality of the outcomes to promote the translation of research into clinical practice.
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Vijayan A, Muthukrishnan A, Nair A, Fathima S, Nair P, Roshan J. PCR-based evaluation of human papillomavirus genotypes in oral lichen planus. JOURNAL OF PHARMACY AND BIOALLIED SCIENCES 2022; 14:S449-S453. [PMID: 36110742 PMCID: PMC9469342 DOI: 10.4103/jpbs.jpbs_147_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 02/15/2022] [Accepted: 02/22/2022] [Indexed: 11/26/2022] Open
Abstract
Objective: The objective of the study was to use polymerase chain reaction (PCR) to examine and compare the genotype distribution of human papillomavirus (HPV) in oral lichen planus (OLP). Materials and Methods: Deoxyribonucleic acid (DNA) was extracted from 20 OLP biopsy specimens. Conventional PCR assay employing consensus HPV primers was used to identify HPV DNA. Positive PCR samples were then subjected to PCR assay with HPV type-specific primers. Results: Out of the total 20 OLP specimens evaluated, eight samples (40%) were positive for HPV. Females had a 41.7% higher HPV-positive rate than males. The most common type in the HPV type-specific PCR assay was HPV-18 (75%), which is a high-risk type of HPV linked to malignant diseases. The erosive kind of OLP had the greatest percentage of HPV positives (50%). Conclusion: The present study confirms the detection of HPV in OLP lesions, as determined by PCR-coupled HPV gene sequencing, as well as its likely mechanism of malignant transformation.
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Erira AT, Navarro AFR, Robayo DAG. Human papillomavirus, Epstein-Barr virus, and Candida albicans co-infection in oral leukoplakia with different degrees of dysplasia. Clin Exp Dent Res 2021; 7:914-923. [PMID: 34101999 PMCID: PMC8543472 DOI: 10.1002/cre2.435] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 03/30/2021] [Accepted: 04/05/2021] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVES To identify human papillomavirus (HPV), Epstein-Barr virus (EBV), and Candida albicans in oral leukoplakia with different degrees of dysplasia. MATERIALS AND METHODS An observational, cross-sectional, descriptive study was performed using 30 formalin-fixed and paraffin-embedded tissues from patients with clinical suspicion of leukoplakia and confirmed diagnosis of oral dysplasia. Histological analyses were performed by two pathologists (interobserver) and dysplasias were classified as mild, moderate, or severe. Conventional PCR was used to detect HPV and EBV viruses and C. albicans. To determine the association between each microorganism with different degrees of dysplasia a Chi-square test was employed. RESULTS The tongue was the most common site for leukoplakias (71.4%) in females with a mean age of 50 years (ranging between 30 to 50 years old; 57.1%). EBV was the most frequently detected (73.3%), followed by HPV (43.3%), mainly of type 16 (40%), and C. albicans (23.3%). Significant differences were observed between degrees of dysplasia and HPV presence (p = 0.005). In lesions positive for HPV, EBV, and C. albicans the most frequent histological changes were hyperkeratosis, irregular interpapillary ridges, and loss of basal stratum cell polarity. CONCLUSION Co-infection with human papillomavirus, Epstein Barr virus, and Candida albicans in oral leukoplakia could be associated with dysplastic changes.
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Affiliation(s)
- Alveiro T Erira
- Facultad de Odontología, Universidad Cooperativa de Colombia, Bogotá, Colombia
| | | | - Dabeiba Adriana García Robayo
- Centro de Investigaciones Odontológicas - Facultad de Odontología, Pontificia Universidad Javeriana, Bogotá, Colombia
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Detection of Human Papillomavirus 33 in Erosive Oral Lichen Planus. INTERNATIONAL JOURNAL OF CANCER MANAGEMENT 2020. [DOI: 10.5812/ijcm.101488] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Background: A correlation is suggested between oral lichen planus (OLP) and the human papillomavirus (HPV) with possible malignant transformation potential in OLP. Objectives: The present study aimed at evaluating the prevalence of HPV-16 and HPV-18 as the most recognized oncogenic subtypes and relatively recently introduced subtype HPV33 in OLP samples. Methods: This retrospective study was carried out on 32 OLP samples (consisting of 12 reticular and 20 erosive forms) and 20 healthy oral mucosa samples. Polymerase chain reaction (PCR) was undertaken to identify HPV Deoxyribonucleic Acid (DNA). Subsequently, the samples positive for HPV DNA underwent PCR analysis again with the specific primers. The data were analyzed statistically by Fisher’s exact test regarding the significance level of lower than 0.05. Results: Eight out of 32 OLP samples (25%) and none of the 20 normal mucosa samples (0%) exhibited HPV DNA. The presence of HPV in the OLP group was significantly higher than that in the normal mucosa (P = 0.014). Also, all the samples that exhibited HPV DNA were registered as the erosive form. Besides, one sample (3.12%) exhibited the 873-bp band, which was attributed to HPV-18, and 7 samples (21.87%) exhibited the 300-bp band, which was attributed to HPV-33. Conclusions: Based on the recent findings in the current study of the Iranian population, the presence of high-risk HPV subtypes, whether primarily or as a secondary infection, can suggest the malignant transformation potential for the studied OLP samples. The exclusive presence of these subtypes in the erosive type of this lesion and the noticeable presence of HPV-33 might reflect this issue’s importance. However, further studies are necessary to evaluate the possibility of a higher proliferation rate of HPV in erosive lichen planus and identify its possible malignant transformation mechanism.
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Shang Q, Peng J, Zhou Y, Chen Q, Xu H. Association of Human Papillomavirus With Oral Lichen Planus and Oral Leukoplakia: A Meta-analysis. J Evid Based Dent Pract 2020; 20:101485. [PMID: 33303094 DOI: 10.1016/j.jebdp.2020.101485] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 08/01/2020] [Accepted: 08/16/2020] [Indexed: 02/08/2023]
Abstract
OBJECTIVES To estimate the association of human papillomavirus (HPV) infection with oral lichen planus (OLP) and oral leukoplakia (OLK), and determine risk cofactors. STUDY DESIGN Seven databases were searched for case-control or cross-sectional studies of OLP and OLK with healthy controls, published between 1976 and 2020. The Meta package of R software was applied to calculate the pooled odds ratios (OR) and 95% confidence interval (CI). RESULTS Thirty-six articles were finally included. OLP and OLK cases had a higher association with HPV infection than controls (OLP: OR: 4.91, 95% CI: 2.76-8.72; OLK: OR: 2.51, 95% CI: 1.55-4.07). In subgroup analyses, the OR of HPV infection was higher with erosive lesions than with nonerosive lesions (OLP: OR: 5.36 and 3.47, respectively; OLK: OR: 3.34 and 3.21, respectively). Oral lesions were more strongly associated with HPV16/18 than with HPV6/11 (OLP: OR: 7.84 and 1.42, respectively; OLK: OR: 6.05 and 1.87, respectively) and varied by geographic region (OLP: OR: 4.01-7.02; OLK: OR: 1.46-27.13). CONCLUSIONS Oral HPV infection, particularly infection with HPV 16/18, was strongly associated with OLP and OLK. Risk cofactors included erosive lesions and geographic region.
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Affiliation(s)
- Qianhui Shang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Chinese Academy of Medical Sciences Research Unit of Oral Carcinogenesis and Management, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Jiakuan Peng
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Chinese Academy of Medical Sciences Research Unit of Oral Carcinogenesis and Management, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Yu Zhou
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Chinese Academy of Medical Sciences Research Unit of Oral Carcinogenesis and Management, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Qianming Chen
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Chinese Academy of Medical Sciences Research Unit of Oral Carcinogenesis and Management, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Hao Xu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Chinese Academy of Medical Sciences Research Unit of Oral Carcinogenesis and Management, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China.
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Della Vella F, Pannone G, Patano A, Ninivaggi R, Del Prete R, Lauritano D, Petruzzi M. Detection of HPV in oral leukoplakia by brushing and biopsy: prospective study in an Italian cohort. Clin Oral Investig 2019; 24:1845-1851. [PMID: 31402398 DOI: 10.1007/s00784-019-03048-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Accepted: 08/05/2019] [Indexed: 12/15/2022]
Abstract
AIM The aim of the present study was to evaluate the prevalence of HPV infection in oral leukoplakia, specifying the HPV genotypes eventually involved. We also compared the micro-biopsy and brushing HPV detecting efficacy. MATERIALS AND METHODS Consecutive patients with a presumptive diagnosis of oral leukoplakia were enrolled. Demographical, behavioral data (smoking, alcohol) and lesion features were recorded. Each patient underwent a brushing procedure, performed with a cytobrush rubbed on the lesion, and then a biopsy was performed. The brushing and micro-biopsy specimens were both analyzed with the HPV 28 Anyplex II Seegene RT-PCR. The prevalence of HPV infection was calculated considering the two methods' outcomes separately and then combining both. Cohen's k coefficient was used to assess the agreement between the two methods. RESULTS Sixty-five patients were enrolled with a mean age of 60 years. The HPV infection prevalence was 17%, decreasing to 5% considering the brushing outcomes alone. The most frequently detected genotypes were 6 (12%), 11 (3%), 42 (3%), and 16 (3%). No statistically significant correlation was found between HPV infection and the variables analyzed, except for smoking and the type of mucosa (p < 0.05). The strength of agreement between cytobrush and micro-biopsy was "fair" (k = 0.384). CONCLUSIONS The present study showed a low prevalence of HPV infection in oral leukoplakia. The micro-biopsy appeared to be more reliable than brushing in detecting HPV DNA in oral leukoplakia, but the method invasiveness discourages its employ as a screening tool. The importance of HPV in the etiopathogenesis of oral potentially malignant lesions remains unclear; further studies are needed to establish the HPV role in oral leukoplakia. CLINICAL RELEVANCE HPV involvement in oral leukoplakia and an effective and appropriate detecting technique are still a debated issue. From this study, the restricted use of brushing did not appear sufficient to assess the presence of HPV infection with PCR techniques in samples obtained from oral leukoplakia.
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Affiliation(s)
- Fedora Della Vella
- Interdisciplinary Department of Medicine, University of Bari "Aldo Moro", Bari, Italy.
| | - Giuseppe Pannone
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Assunta Patano
- Interdisciplinary Department of Medicine, University of Bari "Aldo Moro", Bari, Italy
| | - Rossella Ninivaggi
- Interdisciplinary Department of Medicine, University of Bari "Aldo Moro", Bari, Italy
| | - Raffaele Del Prete
- Interdisciplinary Department of Medicine, University of Bari "Aldo Moro", Bari, Italy
| | - Dorina Lauritano
- Department of Medicine and Surgery
- University of Milan-Bicocca, Monza, Italy
| | - Massimo Petruzzi
- Interdisciplinary Department of Medicine, University of Bari "Aldo Moro", Bari, Italy.
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Gomez-Armayones S, Chimenos-Küstner E, Marí A, Tous S, Penin R, Clavero O, Quirós B, Pavon MA, Taberna M, Alemany L, Servitje O, Mena M. Human papillomavirus in premalignant oral lesions: No evidence of association in a Spanish cohort. PLoS One 2019; 14:e0210070. [PMID: 30650110 PMCID: PMC6335078 DOI: 10.1371/journal.pone.0210070] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Accepted: 12/17/2018] [Indexed: 01/25/2023] Open
Abstract
Background Human papillomavirus (HPV) is the cause of a fraction of head and neck squamous cell carcinoma. Although this relation is well-known, it is still not clear the role of HPV in premalignant oral lesions such as oral lichen planus (OLP) and dysplasia. We aimed to evaluate the HPV-DNA prevalence and type distribution in a set of oral biopsies obtained from patients diagnosed with OLP and dysplasia, as well as the role of HPV in these lesions. Methods A retrospective cohort of all premalignant oral lesions consecutively diagnosed from March 30th 1995 to May 21st 2014 at Hospital of Bellvitge and Odontological University Hospital of Bellvitge was identified and classified in four groups: OLP (groups 1 and 2) and dysplasias (groups 3 and 4) that progressed or not to invasive cancer during follow-up. A random selection targeting 25 cases was aimed to be performed for each group. All selected cases were subjected to pathological evaluation, DNA quality control and HPV-DNA detection. HPV-DNA positive samples were further subject to p16INK4a analysis. Results A total of 83 cases yielded a valid HPV-DNA result. From those, 7 and 34 cases were OLP that progressed or not to invasive cancer during follow-up, whereas 24 and 18 cases were displasias that progressed or not to invasive cancer during follow-up, respectively. HPV-DNA was detected in 4 samples (3 dysplastic lesions and 1 OLP). Two samples were HPV16 positive (2%), 1 sample HPV18 positive (1%) and 1 sample (1%) was HPV indeterminate. Two out of four HPV-DNA positive cases had high p16INK4a expression and none of the HPV positive cases progressed to invasive cancer during long-term follow-up. Conclusions We found a low HPV-DNA attributable fraction in premalignant lesions of the oral cavity, suggesting that HPV is unlikely to play a significant role in oral carcinogenesis in our setting.
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Affiliation(s)
- Sara Gomez-Armayones
- Department of Dermatology, Bellvitge University Hospital, L’Hospitalet de Llobregat, Barcelona, Spain
- Department of Medicine, Bellvitge University Hospital, L’Hospitalet de Llobregat, Barcelona, Spain
- * E-mail:
| | - Eduardo Chimenos-Küstner
- Department of Odontostomatology, Odontological University Hospital of Barcelona, L’Hospitalet de Llobregat, Barcelona, Spain
| | - Antonio Marí
- Department of Medicine, Bellvitge University Hospital, L’Hospitalet de Llobregat, Barcelona, Spain
- Department Oral and Maxillofacial Surgery, Bellvitge University Hospital, L’Hospitalet de Llobregat, Barcelona, Spain
| | - Sara Tous
- Cancer Epidemiology Research Program, IDIBELL, Catalan Institute of Oncology (ICO), L’Hospitalet de Llobregat, Barcelona, Spain
- CIBER in primary and secondary prevention of viral induced cancers (CIBERONC), Madrid, Spain
| | - Rosa Penin
- Department of Medicine, Bellvitge University Hospital, L’Hospitalet de Llobregat, Barcelona, Spain
- Department of Pathology, Bellvitge University Hospital, L’Hospitalet de Llobregat, Barcelona, Spain
| | - Omar Clavero
- Cancer Epidemiology Research Program, IDIBELL, Catalan Institute of Oncology (ICO), L’Hospitalet de Llobregat, Barcelona, Spain
- CIBER in primary and secondary prevention of viral induced cancers (CIBERONC), Madrid, Spain
| | - Beatriz Quirós
- Cancer Epidemiology Research Program, IDIBELL, Catalan Institute of Oncology (ICO), L’Hospitalet de Llobregat, Barcelona, Spain
- CIBER in primary and secondary prevention of viral induced cancers (CIBERONC), Madrid, Spain
| | - Miguel Angel Pavon
- Cancer Epidemiology Research Program, IDIBELL, Catalan Institute of Oncology (ICO), L’Hospitalet de Llobregat, Barcelona, Spain
- CIBER in primary and secondary prevention of viral induced cancers (CIBERONC), Madrid, Spain
| | - Miren Taberna
- Department of Medical Oncology, Catalan Institute of Oncology (ICO), ONCOBELL, IDIBELL, L’Hospitalet de Llobregat, Barcelona, Spain
- University of Barcelona, Barcelona, Spain
| | - Laia Alemany
- Cancer Epidemiology Research Program, IDIBELL, Catalan Institute of Oncology (ICO), L’Hospitalet de Llobregat, Barcelona, Spain
- Epidemiology and Public Health, Centro de Investigación Biomédica en Red: Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - Octavio Servitje
- Department of Dermatology, Bellvitge University Hospital, L’Hospitalet de Llobregat, Barcelona, Spain
- Department of Medicine, Bellvitge University Hospital, L’Hospitalet de Llobregat, Barcelona, Spain
| | - Marisa Mena
- Cancer Epidemiology Research Program, IDIBELL, Catalan Institute of Oncology (ICO), L’Hospitalet de Llobregat, Barcelona, Spain
- CIBER in primary and secondary prevention of viral induced cancers (CIBERONC), Madrid, Spain
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Raj AT, Patil S, Gupta AA, Rajkumar C, Awan KH. Reviewing the role of human papillomavirus in oral cancer using the Bradford Hill criteria of causation. Dis Mon 2018; 65:155-163. [PMID: 30502099 DOI: 10.1016/j.disamonth.2018.09.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Human papillomavirus is a well-established risk factor for oropharyngeal cancer, although its role in oral cancer is still debated. Inconclusive evidence of its role in oral cancer is due to conflicting data arising from methodological differences, mostly due to the use of diagnostic tests with varying sensitivity and specificity. In addition, there is a lack of experimental data linking HPV to oral cancer. Recent epidemiological studies provide data on HPV prevalence in oral squamous cell carcinoma and other potentially malignant oral disorders. Further, molecular data from in vivo and in vitro models have led to new insights into the role of human papillomavirus in oral cancer. The clinical significance of identifying HPV as an etiology for oral squamous cell carcinoma is that if proven, vaccination could be an effective prevention tool. Further, like oropharyngeal squamous cell carcinoma, prognostic differences may exist between human papillomavirus positive and negative oral squamous cell carcinoma. This manuscript reviews data from the published literature using Bradford Hill criteria of causation to assess the role of human papillomavirus in oral cancer. Due to the advancement in molecular biology, the requirements of each of the Bradford Hill criteria of causation are modified to include integrated data from both epidemiological studies and experimental studies exploring molecular carcinogenesis.
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Affiliation(s)
- A Thirumal Raj
- Department of Oral Pathology and Microbiology, Sri Venkateswara Dental College and Hospital, Thalambur, Chennai 600130, India.
| | - Shankargouda Patil
- Department of Maxillofacial Surgery and Diagnostic Sciences, Division of Oral Pathology, College of Dentistry, Jazan University, Jazan, Saudi Arabia
| | - Archana A Gupta
- Department of Oral Pathology and Microbiology, Dr. D. Y. Patil Dental College and Hospital, Dr. D. Y. Patil Vidyapeeth, Pune, India
| | - Chandini Rajkumar
- Department of Oral Pathology and Microbiology, Sathyabama University Dental College and Hospital, Chennai, India
| | - Kamran H Awan
- College of Dental Medicine, Roseman University of Health Sciences, South Jordan, UT 84095, United States
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Chakrabarti S, Banerjee D, Qayyumi BN, Nair D, Nair S, Kane S, Chaturvedi P. Oral Cancer with Verrucous Pattern is Not Associated with Human Papilloma Virus in Indian Population. Indian J Med Paediatr Oncol 2018. [DOI: 10.4103/ijmpo.ijmpo_122_17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Abstract
Background: The etiology of verrucous lesions of the oral cavity is debatable, and many western studies attribute it to human papillomavirus (HPV) infection. Although most Indian studies have found a strong association with tobacco chewing, the role of HPV has not been studied in the Indian context. Materials and Methods: A prospective study was conducted on the clinicopathological profile of 21 consecutive patients of verrucous lesions of the oral cavity. The patients were evaluated on the basis of addictions, pretreatment biopsy, p16 immunohistochemistry (IHC), and histopathological parameters. Results: Preoperative incisional biopsy revealed no dysplasia in 52.38%, mild-to-moderate dysplasia in 19.04%, and invasive carcinoma in 28.57% of the patients. About 67% of patients underwent surgical excision in our institute all of whom had invasive malignancy on final histopathology. This included 42.85% patients whose initial biopsy was no or mild dysplasia. All of the patients were negative for p16 IHC. Conclusions: Verrucous lesions in Indian population are caused by smokeless tobacco unlike that in the western countries where HPV is the main etiology. Clinical distinction between benign and malignant lesions is difficult, and we recommend complete surgical excision of the lesion with adequate margins whenever possible.
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Affiliation(s)
- Swagnik Chakrabarti
- Departments of Surgical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Devmalya Banerjee
- Departments of Pathology, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | | | - Deepa Nair
- Departments of Surgical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Sudhir Nair
- Departments of Surgical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Subhada Kane
- Departments of Pathology, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Pankaj Chaturvedi
- Departments of Surgical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India
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14
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Porter S, Gueiros LA, Leão JC, Fedele S. Risk factors and etiopathogenesis of potentially premalignant oral epithelial lesions. Oral Surg Oral Med Oral Pathol Oral Radiol 2018; 125:603-611. [PMID: 29891084 DOI: 10.1016/j.oooo.2018.03.008] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Revised: 03/03/2018] [Accepted: 03/06/2018] [Indexed: 12/27/2022]
Abstract
Potentially malignant oral mucosal disease has some ability to give rise to malignancy of the oral epithelium, that is, oral squamous cell carcinoma (OSCC). The present article provides a succinct review of the possible or probable causes of potentially premalignant oral epithelial lesions. There is a focus upon studies that examined the causes or etiologic associations with clinically likely or histopathologically detectable oral epithelial dysplasia.
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Affiliation(s)
| | - Luiz Alcino Gueiros
- Oral Medicine Unit. Departamento de Clínica e Odontologia Preventiva, Universidade Federal de Pernambuco, Brazil
| | - Jair Carneiro Leão
- Oral Medicine Unit. Departamento de Clínica e Odontologia Preventiva, Universidade Federal de Pernambuco, Brazil
| | - Stefano Fedele
- UCL Eastman Dental Institute, London, UK; Oral Theme of the UCL/UCLH NIHR Biomedical Research Centre, UK
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15
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Zil-E-Rubab, Baig S, Zaman U, Lucky MH. Human papilloma virus 16/18: Fabricator of trouble in oral squamous cell carcinoma. Int J Infect Dis 2018; 69:115-119. [PMID: 29432879 DOI: 10.1016/j.ijid.2018.02.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Revised: 01/22/2018] [Accepted: 02/03/2018] [Indexed: 12/21/2022] Open
Abstract
AIM To find out the association between Human Papilloma Virus (HPV) genotypes 16/18 in Pakistani patients with oral squamous cell carcinoma (OSCC). METHODS DNA from oral rinse of 300 subjects was taken. The subjects included 100 cases with OSCC and 200 controls. Samples were analyzed by both conventional and real time PCR using "HPV consensus Gp5+/Gp6+ and HPV 16, 18 specific primers". RESULTS Out of 300 persons, 74/300 (25%) were found to be infected with HPV: "46/100(46%) from cases and 74/200(14%) from controls". The distribution was: HPV16, 6/300 (8%): 4/100 (9%) from OSCC group and 2/200 (8%) from controls while HPV 18 was 9/300(12%): 5/100(11%) from cases and 4/200(16%) from controls. Out of 300 subjects, 26(35%) were infected by "both HPV 16/18 (23(50%) from cases and 3(12%) from controls". Persons who were infected with HPV 16&18 had higher chances to develop OSCC as compared to those who didn't have HPV 16/18 (AOR: 21.4, 95% CI: 5.73 - 80.8). CONCLUSION The exposure to high risk strains of Human papilloma virus (16/18) in combination can be fabricotor of trouble (p<0.001, Adjusted odds ratio; 21.42) in OSCC.
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Affiliation(s)
- Zil-E-Rubab
- MDRL Laboratory, Department of Biochemistry, Ziauudin University, 4/B Shahra e Ghalib, Clifton-6, Karachi, Pakistan.
| | - Saeeda Baig
- MDRL Laboratory, Department of Biochemistry, Ziauudin University, 4/B Shahra e Ghalib, Clifton-6, Karachi, Pakistan.
| | - Uzma Zaman
- MDRL Laboratory, Department of Biochemistry, Ziauudin University, 4/B Shahra e Ghalib, Clifton-6, Karachi, Pakistan.
| | - Mohammad Haris Lucky
- MDRL Laboratory, Department of Biochemistry, Ziauudin University, 4/B Shahra e Ghalib, Clifton-6, Karachi, Pakistan.
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Candotto V, Lauritano D, Nardone M, Baggi L, Arcuri C, Gatto R, Gaudio RM, Spadari F, Carinci F. HPV infection in the oral cavity: epidemiology, clinical manifestations and relationship with oral cancer. ACTA ACUST UNITED AC 2017; 10:209-220. [PMID: 29285322 DOI: 10.11138/orl/2017.10.3.209] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Purpose The aim of this paper is to describe epidemiology and clinical manifestations of oral infection by Human papillomavirus (HPV), with particular attention to potential malignant lesions. Materials and methods A systematic review of the literature was conducted to describe the state of the art about HPV infection in oropharyngeal mucosa and its modalities of transmission, with particular attention to possible simultaneous infection in multiple anatomic sites. The aspects of prevention and control of infection by administering vaccines and the diffusion of sexual education campaigns are discussed also. Therapeutic protocols are also described where necessary. Results In recent years there has been a growing interest in HPV oral medicine, suggesting a role of such a family of viruses in the development of neoplasms of the oropharyngeal district as well as of the uterine cervix. Even if the mass media have increasingly faced the problem, causing frequent alarming among patients, the dentist therefore needs a complete and up-to-date knowledge of this infectious condition that is one of the most common causes of sexually transmitted mucous membrane infections (e.g. genital, anal and oral). Conclusions Recent studies about HPV infection are a basic requirement in order to promote the health of patients and provide them with the most exhaustive indications from dentists.
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Affiliation(s)
- V Candotto
- Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Ferrara, Italy
| | - D Lauritano
- Department of Medicine and Surgery, University of Milan-Bicocca, Milan, Italy
| | - M Nardone
- Ministry of Public Health, Rome, Italy
| | - L Baggi
- Department of Clinical Sciences and Translational Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - C Arcuri
- Department of Clinical Sciences and Translational Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - R Gatto
- Department of Life, Health and Environmental Sciences, School of Dentistry, University of L'Aquila, L'Aquila, Italy
| | - R M Gaudio
- Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - F Spadari
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, "Ospedale Maggiore Policlinico Ca' Granda" Foundation, Unit of Oral Pathology and Medicine, Milan, Italy
| | - F Carinci
- Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Ferrara, Italy
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Poulopoulos A, Hempel M, Karakitsos G, Fakis A, Andreadis D. Assessment of HPV screening methods and sample storage in oral lichen planus lesions. TRANSLATIONAL RESEARCH IN ORAL ONCOLOGY 2017. [DOI: 10.1177/2057178x17727674] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Affiliation(s)
- Athanasios Poulopoulos
- Department of Oral Medicine and Oral Pathology, School of Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Mattias Hempel
- Genome Identification Diagnostics GmbH, Strassberg, Germany
| | | | | | - Dimitrios Andreadis
- Department of Oral Medicine and Oral Pathology, School of Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece
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18
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Ai R, Tao Y, Hao Y, Jiang L, Dan H, Ji N, Zeng X, Zhou Y, Chen Q. Microenvironmental regulation of the progression of oral potentially malignant disorders towards malignancy. Oncotarget 2017; 8:81617-81635. [PMID: 29113419 PMCID: PMC5655314 DOI: 10.18632/oncotarget.20312] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Accepted: 08/04/2017] [Indexed: 02/05/2023] Open
Abstract
Oral potentially malignant disorders (OPMD) develop in a complex tissue microenvironment where they grow sustainably, acquiring oral squamous cell carcinoma (OSCC) characteristics. The malignant tumor depends on interactions with the surrounding microenvironment to achieve loco-regional invasion and distant metastases. Unlike abnormal cells, the multiple cell types in the tissue microenvironment are relatively stable at the genomic level and, thus, become therapeutic targets with lower risk of resistance, decreasing the risk of OPMD acquiring cancer characteristics and carcinoma recurrence. However, deciding how to disrupt the OPMD and OSCC microenvironments is itself a daunting challenge, since their microenvironments present opposite capacities, resulting in diverse consequences. Furthermore, recent studies revealed that tumor-associated immune cells also participate in the process of differentiation from OPMD to OSCC, suggesting that reeducating stromal cells may be a new strategy to prevent OPMD from acquiring OSCC characteristics and to treat OSCC. In this review, we discuss the characteristics of the microenvironment of OPMD and OSCC as well as new therapeutic strategies.
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Affiliation(s)
- Ruixue Ai
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral Medicine of West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Yan Tao
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral Medicine of West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Yilong Hao
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral Medicine of West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Lu Jiang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral Medicine of West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Hongxia Dan
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral Medicine of West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Ning Ji
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral Medicine of West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Xin Zeng
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral Medicine of West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Yu Zhou
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral Medicine of West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Qianming Chen
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral Medicine of West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
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Chen X, Zhao Y. Human papillomavirus infection in oral potentially malignant disorders and cancer. Arch Oral Biol 2017; 83:334-339. [PMID: 28886585 DOI: 10.1016/j.archoralbio.2017.08.011] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Revised: 08/21/2017] [Accepted: 08/21/2017] [Indexed: 12/18/2022]
Abstract
Human papillomavirus (HPV) infects keratinocytes in the mucosa or skin, and persistent infection with HPV may lead to premalignant lesions and invasive cancer, especially cervical cancer. It has also been hypothesized that HPV infection is an etiological factor of oral squamous cell carcinoma and oral precancerous disorders such as lichen planus, leukoplakia, and erythroplakia. A high percentage of HPV in oral lesions supports the possible viral contribution, but an association of HPV infection with these lesions remains to be established. The current paper will update the latest progress of HPV infection in several oral potentially malignant disorders and oral squamous cell carcinoma and discuss the impact of HPV infection on the progression of oral potentially malignant disorders.
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Affiliation(s)
- Xun Chen
- Department of Prosthodontics, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology, Guangzhou 510055, People's Republic of China.
| | - Yu Zhao
- Department of Prosthodontics, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology, Guangzhou 510055, People's Republic of China.
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20
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Sushma CN, Birur NP, Suresh A, Keerthi G, Sunny SP, Shubhasini AR, Shubha G, Kuriakose MA. Detection of HPV16 in tissues of oral leukoplakia by polymerase chain reaction and p16 immunohistochemistry. TRANSLATIONAL RESEARCH IN ORAL ONCOLOGY 2017. [DOI: 10.1177/2057178x17713880] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Affiliation(s)
- CN Sushma
- Sapthagiri Medical College and Hospital, Bengaluru, Karnataka, India
| | - N Praveen Birur
- Department of Oral Medicine and Radiology, KLE Society’s Institute of Dental Sciences, Bengaluru, Karnataka, India
| | - Amritha Suresh
- Integrated Head and Neck Oncology Program, Mazumdar Shaw Center for Translational Research, Bengaluru, Karnataka, India
| | - G Keerthi
- Department of Oral Medicine and Radiology, KLE Society’s Institute of Dental Sciences, Bengaluru, Karnataka, India
| | - Sumsum P Sunny
- Mazumdar Shaw Medical Center, Bengaluru, Karnataka, India
| | - AR Shubhasini
- Department of Oral Medicine and Radiology, KLE Society’s Institute of Dental Sciences, Bengaluru, Karnataka, India
| | - G Shubha
- Department of Oral Medicine and Radiology, KLE Society’s Institute of Dental Sciences, Bengaluru, Karnataka, India
| | - Moni Abraham Kuriakose
- Mazumdar Shaw Medical Center, Bengaluru, Karnataka, India
- Department of Head and Neck, Plastic and Reconstructive Surgery, Roswell Park Cancer Institute, Buffalo, NY, USA
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21
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Ma J, Zhang J, Zhang Y, Lv T, Liu J. The Magnitude of the Association between Human Papillomavirus and Oral Lichen Planus: A Meta-Analysis. PLoS One 2016; 11:e0161339. [PMID: 27571417 PMCID: PMC5003373 DOI: 10.1371/journal.pone.0161339] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Accepted: 08/03/2016] [Indexed: 12/03/2022] Open
Abstract
Background The role of human papilloma virus (HPV) in oral lichen planus (OLP) is controversial. Objectives The primary aim of the current study is to calculate the pooled risk estimates of HPV infection in OLP when compared with healthy controls. Methods Bibliographic searches were conducted in three electronic databases. Articles on the association between HPV and OLP were selected from case-control studies or cross-sectional studies, following predefined criteria. Pooled data were analyzed by calculating odds ratios (OR) and 95% confidence interval (CI). Results Of the 233 publications identified, 22 case-control studies met the inclusion criteria. Collectively, 835 cases and 734 controls were available for analysis. The summary estimate showed that OLP patients have significantly higher HPV prevalence (OR: 6.83; 95% CI: 4.15–11.27) than healthy controls. In subgroup analyses, the association of HPV and OLP varied significantly by geographic populations. The ORs ranged from 2.43 to 132.04. The correlation of HPV and erosive-atrophic oral lichen planus (EA-OLP) (OR: 9.34) was comparable and well above that of HPV and non-EA-OLP (OR: 4.32). Among HPV genotypes, HPV 16 showed an extremely strong association with OLP (OR: 11.27), and HPV 18 showed a relatively strong one (OR: 6.54). Conclusion In conclusion, a significant association was found between HPV and OLP. The strength of the association varied across geographic populations, clinical types of OLP, and HPV genotypes. The results suggest that HPV might play an important causal role in OLP and in its malignant to progression.
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Affiliation(s)
- Junxian Ma
- Department of Rheumatology and Immunology, Tangdu hospital, The Fourth Military Medical University, Xi'an, China
| | - Jinshan Zhang
- Department of Human Anatomy and Histology and Embryology, The Fourth Military Medical University, Xi'an, China
| | - Yan Zhang
- Department of Rheumatology and Immunology, Tangdu hospital, The Fourth Military Medical University, Xi'an, China
- * E-mail:
| | - Tingting Lv
- Department of Rheumatology and Immunology, Tangdu hospital, The Fourth Military Medical University, Xi'an, China
| | - Jie Liu
- Department of Rheumatology and Immunology, Tangdu hospital, The Fourth Military Medical University, Xi'an, China
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22
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Pierangeli A, Cannella F, Scagnolari C, Gentile M, Sciandra I, Antonelli G, Ciolfi C, Russo C, Palaia G, Romeo U, Polimeni A. Frequent detection of high human papillomavirus DNA loads in oral potentially malignant disorders. Clin Microbiol Infect 2016; 22:95.e9-95.e15. [DOI: 10.1016/j.cmi.2015.09.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2015] [Revised: 07/23/2015] [Accepted: 09/10/2015] [Indexed: 12/13/2022]
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Gupta S, Jawanda MK. Oral Lichen Planus: An Update on Etiology, Pathogenesis, Clinical Presentation, Diagnosis and Management. Indian J Dermatol 2015; 60:222-9. [PMID: 26120146 PMCID: PMC4458931 DOI: 10.4103/0019-5154.156315] [Citation(s) in RCA: 148] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
The mouth is a mirror of health or disease, a sentinel or early warning system. The oral cavity might well be thought as a window to the body because oral manifestations accompany many systemic diseases. In many instances, oral involvement precedes the appearance of other symptoms or lesions at other locations. Oral lichen planus (OLP) is a chronic mucocutaneous disorder of stratified squamous epithelium of uncertain etiology that affects oral and genital mucous membranes, skin, nails, and scalp. LP is estimated to affect 0.5% to 2.0% of the general population. This disease has most often been reported in middle-aged patients with 30-60 years of age and is more common in females than in males. The disease seems to be mediated by an antigen-specific mechanism, activating cytotoxic T cells, and non-specific mechanisms like mast cell degranulation and matrix metalloproteinase activation. A proper understanding of the pathogenesis, clinical presentation, diagnosis of the disease becomes important for providing the right treatment. This article discusses the prevalence, etiology, clinical features, oral manifestations, diagnosis, complications and treatment of oral LP.
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Affiliation(s)
- Sonia Gupta
- Department of Oral Pathology, Swami Devi Dyal Hospital and Dental College, Golpura, Barwala, Punjab, India
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Gupta S, Gupta S. Role of human papillomavirus in oral squamous cell carcinoma and oral potentially malignant disorders: A review of the literature. Indian J Dent 2015; 6:91-8. [PMID: 26097339 PMCID: PMC4455162 DOI: 10.4103/0975-962x.155877] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Human papillomaviruses (HPVs) are epitheliotropic viruses with an affinity for keratinocytes and are principally found in the anogenital tract, urethra, skin, larynx, tracheobronchial and oral mucosa. On the basis of high, but variable frequency of HPV in oral squamous cell carcinoma (OSCC), malignant potential of HPV infection has been hypothesized but not definitely confirmed. The aim of this review was to highlight the genomic structure and possible mechanism of infection and carcinogenesis by HPV in the oral mucosa and to review the frequency of HPV prevalence in OSCC and oral potentially malignant disorders. A computer database search was performed through the use of PubMed from 1994 to 2014. Search keywords used were: HPV and oral cancer, HPV and oral leukoplakia, HPV and oral lichen planus, HPV and OSCC, HPV and verrucous carcinoma, HPV and proliferative verrucous leukoplakia, HPV and oral papilloma.
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Affiliation(s)
- Shikha Gupta
- Department of Oral Medicine and Radiology, Maulana Azad Institute of Dental Sciences, New Delhi, India
| | - Sunita Gupta
- Department of Oral Medicine and Radiology, Maulana Azad Institute of Dental Sciences, New Delhi, India
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25
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Termine N, Campisi G. Infezione orale da Human papillomavirus: dalla verruca al carcinoma orale. Epidemiologia, clinica, prevenzione e terapia. DENTAL CADMOS 2015. [DOI: 10.1016/s0011-8524(15)30037-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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26
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Hernández Vigueras S, Donoso Zúñiga M, Jané-Salas E, Salazar Navarrete L, Segura-Egea JJ, Velasco-Ortega E, López-López J. Viruses in pulp and periapical inflammation: a review. Odontology 2015; 104:184-91. [PMID: 25796386 DOI: 10.1007/s10266-015-0200-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2014] [Accepted: 01/31/2015] [Indexed: 12/16/2022]
Abstract
The presence of viruses in endodontic disease has been studied in the last decade. Their presence is associated with periapical radiolucency and with clinical findings, such as pain. The aim of this review is to analyze the scientific evidence currently published about viruses in pulp and periapical inflammation, and its possible clinical implications. A literature review was carried out using the Medline/Pubmed database. The search was performed, in English and Spanish, using the following keyword combinations: virus AND endodontic; virus AND periapical; virus AND pulpitis; herpesvirus AND periapical; papillomavirus AND periapical. We subsequently selected the most relevant studies, which complied with the search criterion. A total of 21 articles were included, of which 18 detected the present of viruses in the samples. In 3 of the studies, viral presence was not found in the samples studied. The Epstein-Barr virus was found in about 41 % of cases compared to controls, in which it was present in about 2 %. The main association between viruses and endodontic pathosis is between Cytomegalovirus and Epstein-Barr virus; these are found in 114 of the 406 samples of different endodontic pathosis. Some evidence supports that the Epstein-Barr virus is present in a significant number of endodontic diseases, without exact knowledge of their action in these diseases.
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Affiliation(s)
- Scarlette Hernández Vigueras
- Faculty of Medicine, School of Dentistry, Universidad Austral de Chile, Valdivia, Chile.,PhD Program in Odontology Science, Faculty of Dentistry, University of Barcelona, Barcelona, Spain
| | - Manuel Donoso Zúñiga
- Faculty of Medicine, School of Dentistry, Universidad Austral de Chile, Valdivia, Chile
| | - Enric Jané-Salas
- Department of Odonto-Stomatology, School of Dentistry, University of Barcelona, Barcelona, Spain
| | - Luis Salazar Navarrete
- Laboratory of Molecular Biology and Pharmacogenetics, Department of Basic Science, Faculty of Medicine, Universidad de La Frontera, Temuco, Chile
| | | | | | - José López-López
- Department of Odonto-Stomatology, School of Dentistry, University of Barcelona, Barcelona, Spain. .,Department of Odontostomatology, Pabellón de Gobierno 2ª Planta, Bellvitge University Campus, C/Feixa Llarga s/n, L'Hospitalet de Llobregat, 08907, Barcelona, Spain.
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27
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Kato S, Kawai R, Isomura M, Sato N, Yoshida W, Kamiya K, Nagaya Y, Hattori T, Sato E, Sugita Y, Kubo K, Maeda H. Human Papillomavirus in Oral Lichen Planus of Japanese Patients. J HARD TISSUE BIOL 2015. [DOI: 10.2485/jhtb.24.181] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Seeta Kato
- Department of Oral Pathology, School of Dentistry, Aichi Gakuin University
| | - Ryoko Kawai
- Department of Oral Pathology, School of Dentistry, Aichi Gakuin University
| | - Madoka Isomura
- Department of Oral Pathology, School of Dentistry, Aichi Gakuin University
| | - Nobuaki Sato
- Department of Oral Pathology, School of Dentistry, Aichi Gakuin University
| | - Waka Yoshida
- Research Institute of Advanced Oral Science, Graduate School of Dentistry, Aichi Gakuin University
- Department of Oral Pathology, School of Dentistry, Aichi Gakuin University
| | - Kei Kamiya
- Department of Oral Pathology, School of Dentistry, Aichi Gakuin University
| | - Yoshitaka Nagaya
- Department of Oral Pathology, School of Dentistry, Aichi Gakuin University
| | - Tomofumi Hattori
- Department of Oral Pathology, School of Dentistry, Aichi Gakuin University
| | - Emiko Sato
- Research Institute of Advanced Oral Science, Graduate School of Dentistry, Aichi Gakuin University
- Department of Oral Pathology, School of Dentistry, Aichi Gakuin University
| | - Yoshihiko Sugita
- Research Institute of Advanced Oral Science, Graduate School of Dentistry, Aichi Gakuin University
- Department of Oral Pathology, School of Dentistry, Aichi Gakuin University
| | - Katsutoshi Kubo
- Research Institute of Advanced Oral Science, Graduate School of Dentistry, Aichi Gakuin University
- Department of Oral Pathology, School of Dentistry, Aichi Gakuin University
| | - Hatsuhiko Maeda
- Research Institute of Advanced Oral Science, Graduate School of Dentistry, Aichi Gakuin University
- Department of Oral Pathology, School of Dentistry, Aichi Gakuin University
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28
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p16INK4 Expression is not associated with human papillomavirus in oral lichen planus. Oral Surg Oral Med Oral Pathol Oral Radiol 2014; 118:694-702. [DOI: 10.1016/j.oooo.2014.09.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2014] [Revised: 07/22/2014] [Accepted: 09/03/2014] [Indexed: 01/09/2023]
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29
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Abidullah M, Kiran G, Gaddikeri K, Raghoji S, Ravishankar T S. Leuloplakia - review of a potentially malignant disorder. J Clin Diagn Res 2014; 8:ZE01-4. [PMID: 25302287 DOI: 10.7860/jcdr/2014/10214.4677] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2014] [Accepted: 06/04/2014] [Indexed: 11/24/2022]
Abstract
Leukoplakias are oral white lesions that have not been diagnosed as any other specific disease. They are grouped under premalignant lesions, now redesignated as potentially malignant disorders. Their significance lies in the fact that they have propensity for malignant transformation at a higher rate when compared to other oral lesions. This article reviews aetiology, epidemiology, clinical characteristics, histopathologic features, malignant potential and treatment of oral leukoplakia.
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Affiliation(s)
- Mohammed Abidullah
- Assistant Professor, Department of Oral & Maxillofacial Pathology, GDCH , Hyderabad. A.P., India
| | - G Kiran
- Assistant Professor, Department of Oral & Maxillofacial Pathology, S.B Patil Dental College and Hospital , Bidar, Karnataka, India
| | - Kavitha Gaddikeri
- Assistant Professor, Department of Oral & Maxillofacial Pathology, GDCH , Hyderabad. A.P., India
| | - Swetha Raghoji
- Assistant Professor, Department of Oral & Maxillofacial Pathology, GDCH , Hyderabad. A.P., India
| | - Shilpa Ravishankar T
- Assistant Professor, Department of Oral & Maxillofacial Pathology, GDCH , Hyderabad. A.P., India
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Mravak-Stipetić M, Sabol I, Kranjčić J, Knežević M, Grce M. Human papillomavirus in the lesions of the oral mucosa according to topography. PLoS One 2013; 8:e69736. [PMID: 23922786 PMCID: PMC3726768 DOI: 10.1371/journal.pone.0069736] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2013] [Accepted: 06/12/2013] [Indexed: 11/18/2022] Open
Abstract
Background The association between human papillomavirus (HPV) types and oral lesions has been shown in many studies. Considering the significance that HPV has in the development of malignant and potentially malignant disorders of the oral mucosa, the purpose of this study was to investigate the prevalence of HPV DNA in different oral lesions. In addition, we wanted to elucidate whether the HPV infection is associated predominantly with either the lesion or a particular anatomic site of the oral cavity. Methodology/Principal Findings The study included 246 subjects with different oral lesions, and 73 subjects with apparently healthy oral mucosa (controls). The oral lesions were classified according to their surface morphology and clinical diagnosis. The epithelial cells were collected with a cytobrush from different topographic sites in the oral cavity of the oral lesions and controls. The presence of HPV DNA was evaluated by consensus and type-specific primer-directed polymerase chain reaction. The HPV positivity was detected in 17.7% of oral lesions, significantly more than in apparently healthy mucosa (6.8%), with a higher presence in benign proliferative mucosal lesions (18.6%). High-risk HPV types were predominantly found in potentially malignant oral disorders (HPV16 in 4.3% and HPV31 in 3.4%), while benign proliferative lesions as well as healthy oral mucosa contained mainly undetermined HPV type (13.6 and 6.8%, respectively). Conclusions/Significance The distribution of positive HPV findings on the oral mucosa seems to be more associated with a particular anatomical site than the diagnosis itself. Samples taken from the vermilion border, labial commissures, and hard palate were most often HPV positive. Thus, topography plays a role in HPV prevalence findings in oral lesions. Because of the higher prevalence of the high-risk HPV types in potentially malignant oral disorders, these lesions need to be continuously controlled and treated.
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Affiliation(s)
- Marinka Mravak-Stipetić
- Department of Oral Medicine, School of Dental Medicine, University of Zagreb, Zagreb, Croatia.
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Oral lichen planus in thai patients has a low prevalence of human papillomavirus. ISRN DENTISTRY 2013; 2013:362750. [PMID: 23762572 PMCID: PMC3677628 DOI: 10.1155/2013/362750] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/17/2013] [Accepted: 05/08/2013] [Indexed: 01/01/2023]
Abstract
Background. Oral lichen planus (OLP) is a common chronic inflammatory immune-mediated disease, with an etiopathogenesis associated with cell-mediated immunological dysfunction. Viral infection has been hypothesized as a predisposing factor in the pathogenesis of this disease. Viruses may alter host cell function by inducing the abnormal expression of cellular proteins leading to disease development. However, reports on the relationship between human papillomavirus (HPV) and OLP are inconclusive. Objective. To explore the association between HPV and OLP in Thai patients. Materials and Methods. DNA was extracted from thirty-seven fresh-frozen tissue biopsy specimens from OLP lesions, and polymerase chain reaction assay for the L1 and E1 genes covering 32 types of high- and low-risk HPV was performed. Results. HPV DNA was detected in one tissue biopsy from an atrophic-type OLP lesion. All control samples were negative. Genomic sequencing of the E1 gene PCR product demonstrated that the HPV-type 16 found in the lesion is closely related to the East Asian type. Conclusion. Our data indicate a low prevalence of HPV infection in OLP lesions in Thai patients.
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Payeras MR, Cherubini K, Figueiredo MA, Salum FG. Oral lichen planus: focus on etiopathogenesis. Arch Oral Biol 2013; 58:1057-69. [PMID: 23660124 DOI: 10.1016/j.archoralbio.2013.04.004] [Citation(s) in RCA: 145] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2012] [Revised: 03/09/2013] [Accepted: 04/11/2013] [Indexed: 02/07/2023]
Abstract
Lichen planus is a chronic mucocutaneous inflammatory disease, which frequently affects the oral mucosa of white females over 40 years old. Its aetiology remains uncertain and the pathogenesis is still the object of much speculation. The present paper presents the most well known antigens, and describes the action of different cells and proteins associated with the development of that disease, as well as the possible agents involved with its malignant transformation. Different external agents, especially virus, and internal agents, like stress, and the heat shock protein antigen expression, associated or not, can alter the basal keratinocytes of the oral mucosa making them susceptible to apoptosis by CD8(+) cytotoxic T cell as well as activate matrix metalloproteinase and mast cell degranulation, which produce a great range of inflammatory mediators and cytokines determining the clinical onset of the disease. Regarding carcinogenesis, since it is a complex process and presents multifactorial origin, it is believed that there may be a synergism between intrinsic, such as inflammation mediators, and extrinsic agents (tobacco, alcohol, viral infections) for the OLP malignant transformation to occur. However, further studies are needed to better understand the origin, pathogenesis and process of malignant transformation of OLP.
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Affiliation(s)
- Márcia Rodrigues Payeras
- Oral Medicine Division, Pontifical Catholic University of Rio Grande do Sol, Av. Ipiranga 6690, Porto Alegre, RS, Brazil.
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Mattila R, Rautava J, Syrjänen S. Human papillomavirus in oral atrophic lichen planus lesions. Oral Oncol 2012; 48:980-984. [DOI: 10.1016/j.oraloncology.2012.04.009] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2011] [Revised: 04/05/2012] [Accepted: 04/23/2012] [Indexed: 01/18/2023]
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Giovannelli L, Campisi G, Colella G, Capra G, Di Liberto C, Caleca MP, Matranga D, D'Angelo M, Lo Muzio L, Ammatuna P. Brushing of Oral Mucosa for Diagnosis of HPV Infection in Patients with Potentially Malignant and Malignant Oral Lesions. Mol Diagn Ther 2012; 10:49-55. [PMID: 16646577 DOI: 10.1007/bf03256442] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Adequate brushing of oral mucosa is important for accurate human papillomavirus (HPV) detection in potentially malignant (oral leukoplakia [OL], oral lichen planus [OLP]) and malignant (oral squamous cell carcinoma [OSCC]) lesions. Since various factors may limit the adequacy of oral brushing and, consequently, the accuracy of HPV detection, modified sampling procedures should be evaluated for their effect on HPV frequency and/or types detected. AIM To compare the HPV frequency in samples obtained by brushing the lesion site with the frequency in samples obtained by brushing an apparently normal adjacent site. The correlation between HPV frequency and keratinization of the site affected by the lesion, as well as sociodemographic variables (age, sex, smoking and drinking habits), was also examined. METHODS HPV DNA was detected in brushing samples from 50 patients with OL, 49 with OLP, and 17 with OSCC. Polymerase chain reaction (PCR) amplification was performed by MY09/MY11 and GP05+/GP06+ primers; the HPV type was identified by DNA sequencing and a reverse hybridization (line probe) assay. Data were analyzed by the Z test, the Fisher's exact test, the chi-square test, odds ratio (OR), and a logistic regression model. RESULTS HPV DNA was detected in 22% of samples from lesion sites and in 16% of samples from adjacent sites (p = 0.22) in patients with OL, in 24.5% and 22.4% of samples from lesion and adjacent sites, respectively, in patients with OLP (p = 0.40), and in 35.3% and 41.2% of samples from lesion and adjacent sites, respectively, in patients with OSCC (p = 0.36). Lesions adjacent to HPV-positive normal sites had an increased rate of HPV detection (OR = 30; 95% CI 9.57, 94.1). HPV-18 was the most frequent genotype, followed by HPV-6, -16, -33, and -53. HPV prevalence was reduced in lesions at keratinized sites (14.5%) compared with non-keratinized sites (34.4%; p = 0.007; OR = 0.32; 95% CI 0.13, 0.81). DISCUSSION In patients with OL, OLP, or OSCC, a high prevalence of HPV infection was shown in apparently normal sites adjacent to lesion sites infected by HPV. The lower HPV frequency in lesions at keratinized sites suggests that HPV detection by lesion brushing is affected by keratinization. The keratinized epithelium may be less susceptible to HPV infection or, alternatively, the highly proliferative activity in non-keratinized sites may predispose to HPV infection. CONCLUSION Results from this study indicate that taking samples from normal sites adjacent to oral lesions may be of value in HPV detection, particularly when the lesions are located at keratinized sites. This sampling procedure may allow more accurate diagnosis of HPV infection compared with sampling only the lesion site, and may also represent a reliable method to investigate the biological characteristics of HPV infection and related oral carcinogenesis.
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Affiliation(s)
- Lucia Giovannelli
- Dipartimento di Igiene e Microbiologia, Università di Palermo, Palermo, Italy
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Oral Leukoplakia as It Relates to HPV Infection: A Review. Int J Dent 2012; 2012:540561. [PMID: 22505902 PMCID: PMC3299253 DOI: 10.1155/2012/540561] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2011] [Revised: 09/02/2011] [Accepted: 12/19/2011] [Indexed: 12/13/2022] Open
Abstract
Leukoplakia is the most common potentially malignant lesion of the oral cavity and can be categorised according to its clinical appearance as homogeneous or nonhomogenous. Tobacco and areca nut use, either alone or in combination are the most common risk factors for oral leukoplakia, but some oral leukoplakias are idiopathic. Some leukoplakias arise within fields of precancerized oral epithelium in which the keratinocytes may be at different stages of cytogenetic transformation. Leukoplakias may unpredictably regress, may remain stable, or may progress to carcinoma. There is a greater risk of carcinomatous transformation of idiopathic leukoplakia, of non-homogenous leukoplakia, of leukoplakia affecting the floor of the mouth; the ventrolateral surface of the tongue and the maxillary retromolar and adjoining soft palate (collectively called high-risk sites), of leukoplakia with high-grade epithelial dysplasia, and of leukoplakia in which the keratinocytes carry cytogenetic alterations associated with carcinomatous transformation. Although there appears to be some link between human papillomavirus (HPV) and oral leukoplakia, there is little evidence to support a causal relationship either between HPV infection and oral leukoplakia or between HPV-infected leukoplakic keratinocytes and their carcinomatous transformation.
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Olthof NC, Straetmans JMJAA, Snoeck R, Ramaekers FCS, Kremer B, Speel EJM. Next-generation treatment strategies for human papillomavirus-related head and neck squamous cell carcinoma: where do we go? Rev Med Virol 2011; 22:88-105. [PMID: 21984561 DOI: 10.1002/rmv.714] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2011] [Revised: 07/29/2011] [Accepted: 08/08/2011] [Indexed: 12/20/2022]
Abstract
Oncogenic human papillomavirus (HPV) is currently recognised as a major risk factor for the development of head and neck squamous cell carcinomas (HNSCC). HPV is mostly detected in tumours arising from the oropharynx and more specifically from the tonsil. HPV-related tumours display clinical and molecular characteristics that are distinct from HPV-unrelated tumours, which are generally induced by alcohol and tobacco abuse. Detection of biologically active HPV in HNSCC has prognostic relevance, which warrants the separate classification of HPV-induced tumours and is a prerequisite for further optimisation of treatment protocols for this distinct group. Current guidelines for the treatment of oropharyngeal squamous cell carcinoma (OPSCC) have not incorporated specific treatment modalities for HPV-related tumours. The development of such treatment options is still in a preclinical phase or in early clinical trials. Recent data on treatment response of OPSCC have been obtained by retrospectively analysing HPV-status and indicate that patients with HPV-related tumours show a favourable prognosis, independent of the type of treatment. These patients may benefit from de-intensified treatment, which should be assessed in prospective clinical trials. The development and future use of new antiviral and immunomodulatory therapeutics may be instrumental in this approach to improve survival rates and decrease disease-and-treatment-related morbidity. In this review we will focus on present therapeutic HPV-targeting strategies and discuss future directions for de-intensified treatment of HPV-positive HNSCC.
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Affiliation(s)
- Nadine C Olthof
- Departments of Otorhinolaryngology and Head and Neck Surgery, GROW-School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, the Netherlands.
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Human papillomavirus types 16 and 18 in epithelial dysplasia of oral cavity and oropharynx: a meta-analysis, 1985-2010. Oral Oncol 2011; 47:1048-54. [PMID: 21816661 DOI: 10.1016/j.oraloncology.2011.07.009] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2011] [Revised: 07/01/2011] [Accepted: 07/09/2011] [Indexed: 12/20/2022]
Abstract
Human papillomavirus (HPV) types 16 and 18 are causally related to a sub-set of oral cavity and oropharyngeal squamous cell cancers. However, a clear estimate of the prevalence of HPV-16/18 in oral cavity and oropharyngeal dysplasia (OOPD) is not available. This literature review and meta-analysis was conducted to provide a prevalence estimate for HPV-16/18 in OOPD. Twenty-two studies that reported prevalence of HPV-16 and/or 18 in 458 OOPD lesions were analyzed. Meta-analysis was used to evaluate the prevalence of HPV-16/18 and logistic regression was used for stratified analysis by age, gender, and histological grade. The overall prevalence of HPV-16/18 in OOPD lesions was 24.5% [95% confidence interval (CI), 16.4-36.7%)]. The individual prevalence for HPV-16 alone was 24.4%. The prevalence of HPV-16/18 in oral cavity lesions alone was 25.3% (95% CI, 14.2-45.2%). The odds of detection of HPV-16/18 in dysplastic lesions in males were twice that of females [odds ratio (OR), 2.44]. HPV-16/18 were 3 times more common in dysplastic lesions (OR, 3.29; 95% CI, 1.95-5.53%) and invasive cancers (OR, 3.43; 95% CI, 2.07-5.69%), when compared to normal biopsies. There was no significant difference in HPV-16/18 rates between dysplastic lesions and cancers or between mild, moderate or severe dysplastic lesions. This meta-analysis provides a quantification of the prevalence of HPV types 16/18 in OOPD lesions. These results also support the assumption that HPV-16/18 infection occurs during the early phase of the oral cavity and oropharyngeal carcinogenesis.
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Syrjänen S, Lodi G, von Bültzingslöwen I, Aliko A, Arduino P, Campisi G, Challacombe S, Ficarra G, Flaitz C, Zhou HM, Maeda H, Miller C, Jontell M. Human papillomaviruses in oral carcinoma and oral potentially malignant disorders: a systematic review. Oral Dis 2011; 17 Suppl 1:58-72. [PMID: 21382139 DOI: 10.1111/j.1601-0825.2011.01792.x] [Citation(s) in RCA: 206] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
OBJECTIVES Human papillomavirus (HPV) in oral carcinoma (OSCC) and potentially malignant disorders (OPMD) is controversial. The primary aim was to calculate pooled risk estimates for the association of HPV with OSCC and OPMD when compared with healthy oral mucosa as controls. We also examined the effects of sampling techniques on HPV detection rates. METHODS Systematic review was performed using PubMed (January 1966-September 2010) and EMBASE (January 1990-September 2010). Eligible studies included randomized controlled, cohort and cross-sectional studies. Pooled data were analysed by calculating odds ratios, using a random effects model. Risk of bias was based on characteristics of study group, appropriateness of the control group and prospective design. RESULTS Of the 1121 publications identified, 39 cross-sectional studies met the inclusion criteria. Collectively, 1885 cases and 2248 controls of OSCC and 956 cases and 675 controls of OPMD were available for analysis. Significant association was found between pooled HPV-DNA detection and OSCC (OR = 3.98; 95% CI: 2.62-6.02) and even for HPV16 only (OR = 3.86; 95% CI: 2.16-6.86). HPV was also associated with OPMD (OR = 3.87; 95% CI: 2.87-5.21). In a subgroup analysis of OPMD, HPV was also associated with oral leukoplakia (OR = 4.03; 95% CI: 2.34-6.92), oral lichen planus (OR = 5.12; 95% CI: 2.40-10.93), and epithelial dysplasia (OR = 5.10; 95% CI: 2.03-12.80). CONCLUSIONS The results suggest a potentially important causal association between HPV and OSCC and OPMD.
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Affiliation(s)
- S Syrjänen
- Department of Oral Pathology, Institute of Dentistry, Faculty of Medicine, University of Turku, Turku, Finland.
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Gorsky M, Epstein JB. Oral lichen planus: malignant transformation and human papilloma virus: A review of potential clinical implications. ACTA ACUST UNITED AC 2011; 111:461-4. [DOI: 10.1016/j.tripleo.2010.11.007] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2010] [Revised: 11/02/2010] [Accepted: 11/03/2010] [Indexed: 11/17/2022]
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Incidence of Low Risk Human Papillomavirus in Oral Cancer: A Real Time PCR Study on 278 Patients. Int J Immunopathol Pharmacol 2011; 24:83-7. [DOI: 10.1177/03946320110240s215] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Squamous cell carcinoma is the most frequent malignant tumour of the oral cavity. It is widely known that tobacco and alcohol consumption are the major causes of the development of oral squamous cell carcinoma (OSCC). The human papilloma virus infection has also been postulated as a risk factor for squamous cell carcinoma, although conflicting results have been reported. The aim of this study is to evaluate the presence of high-risk and low-risk type human papillomavirus in a large sample of squamous cell carcinoma limited to the oral cavity by means of quantitative real-time polymerase chain reaction. Data were obtained from 278 squamous cell carcinoma limited to oral cavity proper. Sequencing revealed that 5 samples were positive for HPV type 16, 5 for HPV type 11, and 1 for HPV type 6. Human papillomavirus 11 was detected in 5 tumours out of the 278 examined. The prevalence rate for Human papillomavirus 11 was 1.8% (C.I. 0.7–3.9). The matched case-controls analysis indicated that the prevalence among controls did not significantly differ with respect to cases and that Human papillomavirus 11 alone did not correlate with squamous cell carcinoma.
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Feller L, Khammissa RA, Wood NH, Lemmer J. Epithelial maturation and molecular biology of oral HPV. Infect Agent Cancer 2009; 4:16. [PMID: 19930727 PMCID: PMC2788520 DOI: 10.1186/1750-9378-4-16] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2009] [Accepted: 11/25/2009] [Indexed: 12/12/2022] Open
Abstract
Human papillomavirus (HPV) is widespread and can cause latent infection in basal cells, with low HPV DNA copy-number insufficient for transmission of infection; can cause subclinical infection that is active but without clinical signs; or can cause clinical infection leading to benign, potentially malignant or malignant lesions. The HPV cycle is influenced by the stage of maturation of the infected keratinocytes, and the production of virions is restricted to the post-mitotic suprabasal epithelial cells where all the virus genes are expressed.Low-risk HPV genotypes are associated with the development of benign oral lesions, whereas high-risk HPV genotypes are implicated in the development of malignant epithelial neoplasms. The rôle of high-risk HPV as a causative agent in epithelial malignancy is different at different anatomical sites: it is almost invariably implicated in squamous cell carcinoma of the uterine cervix, fairly frequently implicated in squamous cell carcinoma of the oropharynx, and it is seldom implicated in squamous cell carcinoma of the mouth.
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Affiliation(s)
- Liviu Feller
- Department of Periodontology and Oral Medicine, School of Dentistry, University of Limpopo, Medunsa Campus, South Africa.
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Szarka K, Tar I, Fehér E, Gáll T, Kis A, Tóth ED, Boda R, Márton I, Gergely L. Progressive increase of human papillomavirus carriage rates in potentially malignant and malignant oral disorders with increasing malignant potential. ACTA ACUST UNITED AC 2009; 24:314-8. [PMID: 19572894 DOI: 10.1111/j.1399-302x.2009.00516.x] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
INTRODUCTION We investigated the potential role of human papillomaviruses (HPVs) in potentially malignant oral disorders, oral leukoplakia (OL) and oral lichen planus (OLP), and in oral squamous cell cancer (OSCC) in an Eastern Hungarian population with a high incidence of OSCC. METHODS Excised tumor samples (65 OSCC patients) and exfoliated cells from potentially malignant lesions (from 44 and 119 patients with OL and OLP, respectively) as well as from healthy controls (72 individuals) were analysed. OLPs were classified based on clinical appearance, 61 patients had erosive-atrophic lesions (associated with higher malignancy risk, EA-OLP) and 58 had non-erosive non-atrophic lesions (with lower risk of becoming malignant, non-EA-OLP), respectively. Exfoliated cells collected from apparently healthy mucosa accompanied each lesion sample. HPV was detected by MY/GP polymerase chain reaction (PCR) and genotyped by restriction analysis of amplimers. Copy numbers in lesions were determined using real-time PCR. Prevalence rates, copy number distributions, and association with risk factors and diseases were analysed using chi-square test, t-test, and logistic regression, respectively. RESULTS We detected HPVs significantly more frequently in lesions than in controls (P < or = 0.001 in all comparisons). HPV prevalence increased gradually with increasing severity of lesions (32.8, 40.9, and 47.7% in OLP, OL, and OSCC, respectively). Copy number distribution patterns roughly corresponded to prevalence rates, but OLP and OL were comparable. HPV prevalence differed significantly between EA-OLP and non-EA-OLP groups (42.6 vs. 22.4%); EA-OLP group showed a prevalence similar to that found in OL. CONCLUSION HPVs may be involved in the development or progression of not only OSCC but also of potentially malignant oral lesions.
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Affiliation(s)
- K Szarka
- Department of Medical Microbiology, Medical and Health Science Center, University of Debrecen, H-4032 Debrecen, Nagyerdei krt. 98, Hungary.
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Chaudhary AK, Singh M, Sundaram S, Mehrotra R. Role of human papillomavirus and its detection in potentially malignant and malignant head and neck lesions: updated review. HEAD & NECK ONCOLOGY 2009; 1:22. [PMID: 19555477 PMCID: PMC2706235 DOI: 10.1186/1758-3284-1-22] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/28/2009] [Accepted: 06/25/2009] [Indexed: 12/17/2022]
Abstract
Head and neck malignancies are characterized by a multiphasic and multifactorial etiopathogenesis. Tobacco and alcohol consumption are the most common risk factors for head and neck malignancy. Other factors, including DNA viruses, especially human papilloma virus (HPV), may also play a role in the initiation or development of these lesions. The pathways of HPV transmission in the head and neck mucosal lesions include oral-genital contact, more than one sexual partner and perinatal transmission of HPV to the neonatal child. The increase in prevalence of HPV infection in these lesions may be due to wider acceptance of oral sex among teenagers and adults as this is perceived to be a form of safe sex. The prevalence of HPV in benign lesions as well as malignancies has been assessed by many techniques. Among these, the polymerase chain reaction is the most sensitive method. Review of literature reveals that HPV may be a risk factor for malignancies, but not in all cases. For confirmation of the role of HPV in head and neck squamous cell carcinoma, large population studies are necessary in an assortment of clinical settings. Prophylactic vaccination against high-risk HPV types eventually may prevent a significant number of cervical carcinomas. Of the two vaccines currently available, Gardasil (Merck & Co., Inc.) protects against HPV types 6, 11, 16 and 18, while the other vaccine, Cervarix (GlaxoSmithKline, Rixensart, Belgium) protects against HPV types 16 and 18 only. However, the HPV vaccine has, to the best of our knowledge, not been tried in head and neck carcinoma. The role of HPV in etiopathogenesis, prevalence in benign and malignant lesions of this area and vaccination strategies are briefly reviewed here.
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DEBANTH S, SINGH PA, MEHROTRA R, SINGH M, GUPTA SC, PANDYA S, CHOWDHURY A, SINGH M. Human papillomavirus infection and premalignant lesions of the oral cavity: A cross-sectional study in Allahabad, North India. Asia Pac J Clin Oncol 2009. [DOI: 10.1111/j.1743-7563.2009.01200.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Low prevalence of human papillomavirus in squamous-cell carcinoma limited to oral cavity proper. Mod Pathol 2009; 22:366-72. [PMID: 18978731 DOI: 10.1038/modpathol.2008.180] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Several investigations have reported that the human papillomavirus may play a role in head and neck squamous-cell carcinoma development and may have a prognostic impact. However, inconsistent results regarding human papillomavirus prevalence have been obtained so far. Variables which may account for these discrepancies may be related to site of the samples' origin, detection methods and sample size. The aim of this study is to evaluate the presence of high-risk type human papillomavirus in a large, well defined sample of squamous-cell carcinoma limited to the oral cavity in its strictest definition-ie with no pharynx or larynx cancers included-by means of quantitative real-time polymerase chain reaction, a method which ensures high sensitivity and offers the opportunity to exclude false-positive results. Data were obtained from 314 squamous-cell carcinoma limited to oral cavity proper, indicated that the prevalence of high-risk human papillomavirus was as low as 2% (CI 0.6-3). Matched pairs case-control analysis indicated that the prevalence among controls did not significantly differ with respect to cases and thus did not support a major role for the human papillomavirus in the etiology of squamous-cell carcinoma of the oral cavity.
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van der Waal I. Potentially malignant disorders of the oral and oropharyngeal mucosa; terminology, classification and present concepts of management. Oral Oncol 2008; 45:317-23. [PMID: 18674954 DOI: 10.1016/j.oraloncology.2008.05.016] [Citation(s) in RCA: 505] [Impact Index Per Article: 31.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
In a recently held WHO workshop it has been recommended to abandon the distinction between potentially malignant lesions and potentially malignant conditions and to use the term potentially malignant disorders instead. Of these disorders, leukoplakia and erythroplakia are the most common ones. These diagnoses are still defined by exclusion of other known white or red lesions. In spite of tremendous progress in the field of molecular biology there is yet no single marker that reliably enables to predict malignant transformation in an individual patient. The general advice is to excise or laser any oral of oropharyngeal leukoplakia/erythroplakia, if feasible, irrespective of the presence or absence of dysplasia. Nevertheless, it is actually unknown whether such removal truly prevents the possible development of a squamous cell carcinoma. At present, oral lichen planus seems to be accepted in the literature as being a potentially malignant disorder, although the risk of malignant transformation is lower than in leukoplakia. There are no means to prevent such event. The efficacy of follow-up of oral lichen planus is questionable. Finally, brief attention has been paid to oral submucous fibrosis, actinic cheilitis, some inherited cancer syndromes and immunodeficiency in relation to cancer predisposition.
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Affiliation(s)
- Isaäc van der Waal
- VU University Medical Center/Academic Centre for Dentistry Amsterdam, Department of Oral and Maxillofacial Surgery/Pathology, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands.
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Napier SS, Speight PM. Natural history of potentially malignant oral lesions and conditions: an overview of the literature. J Oral Pathol Med 2008; 37:1-10. [PMID: 18154571 DOI: 10.1111/j.1600-0714.2007.00579.x] [Citation(s) in RCA: 327] [Impact Index Per Article: 20.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
At a workshop coordinated by the WHO Collaborating Centre for Oral Cancer and Pre-cancer in the UK issues related to potentially malignant disorders of the oral cavity were discussed by an expert group. The consensus views of the Working Group are presented in a series of papers. In this report we review the literature on the epidemiology and natural history of potentially malignant disorders (PMD), detailing those characteristics of the patients and lesions thought to be associated with future development of oral squamous cell carcinoma (OSCC). Older patients, particularly females are more at risk than younger patients; the duration of PMD may be important. Those who have never used tobacco seem at greater risk than smokers. OSCC is more likely with PMD on the lateral and ventral tongue, floor of mouth and retromolar/soft palate complex than with those elsewhere. The vast majority of PMD in which OSCC develop are non-homogenous although 5% of homogenous PMD will develop carcinoma. Large lesions covering several intraoral subsites also appear more at risk.
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Affiliation(s)
- Séamus S Napier
- Department of Tissue Pathology, Institute of Pathology, Royal Group of Hospitals, Belfast, Northern Ireland
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Marini A, Wagenmann M, Ting E, Hengge UR. Squamous cell cancer and human papillomavirus infection in oral lichen planus: case report and literature review. Dermatol Surg 2007; 33:756-60. [PMID: 17550459 DOI: 10.1111/j.1524-4725.2007.33157.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Alessandra Marini
- Department of Dermatology, Heirich-Heine University, Düsseldorf, Germany
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