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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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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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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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Liu T, Zhang H, Yang X, Li X, Shi Y, Niu W, Liu T. Study on expression of p16 and human papillomavirus 16 and 18 (E6) in OLP and its malignant transformation. Pathol Res Pract 2018; 214:296-302. [DOI: 10.1016/j.prp.2017.09.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2017] [Revised: 09/03/2017] [Accepted: 09/15/2017] [Indexed: 01/08/2023]
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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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Bahl A, Kumar P, Dar L, Mohanti BK, Sharma A, Thakar A, Karthikeyan V, Sikka K, Singh C, Poo K, Lodha J. Prevalence and trends of human papillomavirus in oropharyngeal cancer in a predominantly north Indian population. Head Neck 2013; 36:505-10. [PMID: 23729189 DOI: 10.1002/hed.23317] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/08/2013] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND Human papillomavirus (HPV) prevalence in oropharyngeal squamous cell cancer (SCC) remains variable and studies have estimated that up to 60% may be positive. METHODS One hundred five treatment-naïve oropharyngeal SCC patients were included. HPV genotyping was done by consensus polymerase chain reaction (PCR) and reverse line-blot hybridization assay. HPV prevalence was co-related with sex, age, tobacco consumption, alcohol use, and high-risk sexual behavior. RESULTS HPV prevalence was 22.8%. No significant associations were seen between tobacco or alcohol consumption with HPV status. The mean number of lifetime sexual partners and indulgence in high-risk sexual behavior was significantly more in patients who are HPV positive. There were no significant associations between the 2 groups with respect to the stage of the tumor. CONCLUSION Results of this study confirms that patients who are HPV positive are younger, and with high-risk sexual behavior. We did not find any impact of smoking and alcohol consumption on HPV status.
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Affiliation(s)
- Ankur Bahl
- Department of Medical Oncology, Dr. B. R. A. Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, All India Institute of Medical Sciences, New Delhi, India
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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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Jalouli J, Ibrahim SO, Mehrotra R, Jalouli MM, Sapkota D, Larsson PA, Hirsch JM. Prevalence of viral (HPV, EBV, HSV) infections in oral submucous fibrosis and oral cancer from India. Acta Otolaryngol 2010; 130:1306-11. [PMID: 20441534 DOI: 10.3109/00016481003782041] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
CONCLUSION There is a high prevalence of human papilloma viruses (HPV) in oral submucous fibrosis (OSMF) and the etiologic implication of this finding warrants further studies. OBJECTIVE The prevalence of oral squamous cell carcinoma (OSCC) and OSMF is high in India, and the diseases are partly attributed to high consumption of betel quid containing areca nut and tobacco. This study investigated the prevalence of HPV, herpes simplex virus (HSV), and Epstein–Barr virus (EBV) DNA in two groups of patients using betel quid with tobacco, those with OSMF (n = 12) and those with OSCC (n = 62). METHODS DNA was extracted from all the samples and viral genome was examined by PCR/DNA sequencing. HPV-positive samples were analyzed separately for the high-risk types HPV 16 and 18. RESULTS HPV DNA, HSV DNA, and EBV DNA were detected in 11 (91%), 1 (8%), and 3 (25%) of the 12 samples from patients with OSMF compared with 15 (24%), 3 (5%), and 18 (29%), respectively, from 62 patients with OSCC. HPV 16 and 18 DNA was detected in 8/12 (67%) in the OSMF group and 10/62 (16%) in the OSCC group. The difference between presence of HPV DNA in OSMF and OSCC groups was statistically significant, while the difference between HSV and EBV DNA content in OSMF and OSCC groups was insignificant.
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Affiliation(s)
- Jamshid Jalouli
- Department of Surgical Sciences, Oral & Maxillofacial Surgery, Uppsala University, Sweden
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