[Presence of human papillomavirus in malignant oral lesions]

Human papillomavirus prevalence in oral and oropharyngeal squamous cell carcinoma in South America

Some studies have addressed the prevalence of human papillomavirus (HPV) in head and neck cancer in South America; however, no studies have systematically gathered prevalence and conducted a meta-analysis. This study aims to estimate the prevalence of HPV in oral and oropharyngeal squamous cell carcinomas in South America. We performed a systematic review and metaanalysis using the following databases: PubMed, Embase, Lilacs, Medline, Scopus, and Web of Science. Data were extracted and analyzed using random-effects models to estimate the pooled prevalence of HPV. We identified 209 nonduplicated studies, of which 38 were selected. The overall prevalence of HPV was 24.31% (95% CI 16.87–32.64; I² = 96%, p_{heterogeneity} <0.001). HPV prevalence in oropharyngeal cancer was 17.9% (95% CI 7.6–31.4; I² = 96%, p_{heterogeneity} <0.001) and that in oral cavity cancer was 23.19% (95% CI 14.94–32.63; I² = 94%, p_{heterogeneity} <0.001). We found an overall prevalence of HPV in 24.31% of oral and oropharyngeal squamous cell carcinomas in South American patients. The prevalence of HPV was 17.9% for oropharyngeal cancer and 23.19% for oral cavity cancer.

Prevalence of oral and oropharyngeal human papillomavirus infection in Brazilian population studies: a systematic review

Introduction

Human papillomavirus has been associated with head and neck squamous cell carcinoma. However, there is no conclusive evidence on the prevalence of oral or pharyngeal infection by human papillomavirus in the Brazilian population.

Objective

To determine the rate of human papillomavirus infection in the Brazilian population.

Methods

Systematic review of published articles. Medline, The Cochrane Library, Embase, Lilacs (Latin American and Caribbean Health Sciences) and Scielo electronic databases were searched. The search included published articles up to December 2014 in Portuguese, Spanish and English. A wide search strategy was employed in order to avoid publication biases and to assess studies dealing only with oral and/or oropharyngeal human papillomavirus infections in the Brazilian population.

Results

The 42 selected articles enrolled 4066 patients. It was observed that oral or oropharyngeal human papillomavirus infections were identified in 738 patients (18.2%; IC 95 17.6–18.8), varying between 0.0% and 91.9%. The prevalences of oral or oropharyngeal human papillomavirus infections were respectively 6.2%, 44.6%, 44.4%, 27.4%, 38.5% and 11.9% for healthy people, those with benign oral lesions, pre-malignant lesions, oral or oropharyngeal squamous cell carcinoma, risk groups (patients with genital human papillomavirus lesions or infected partners) and immunocompromised patients. The risk of human papillomavirus infection was estimated for each subgroup and it was evident that, when compared to the healthy population, the risk of human papillomavirus infection was approximately 1.5–9.0 times higher, especially in patients with an immunodeficiency, oral lesions and squamous cell carcinoma. The rates of the most well-known oncogenic types (human papillomavirus 16 and/or 18) also show this increased risk.

Conclusions

Globally, the Brazilian healthy population has a very low oral human papillomavirus infection rate. Other groups, such as at-risk patients or their partners, immunocompromised patients, people with oral lesions and patients with oral cavity or oropharyngeal squamous cell carcinoma have a high risk of human papillomavirus infection.

Prevalência do papilomavírus humano (HPV) na cavidade oral e na orofaringe

A prevalência do papilomavírus humano (HPV) na cavidade oral e na orofaringe ainda não está bem esclarecida como nos estudos do trato genital, na qual é bem definida. Entretanto, novas pesquisas estão surgindo após o aparecimento dos exames de biologia molecular. Neste estudo foi realizada uma revisão da literatura com o objetivo de verificar a prevalência do papilomavírus humano na cavidade oral e na orofaringe. Os resultados desta pesquisa mostraram uma prevalência do HPV 16 na mucosa oral normal (infecção latente). Já nas lesões benignas orais associadas ao HPV mostraram uma prevalência do HPV 6 e 11 em papilomas de células escamosas e condilomas, e, nas verrugas, uma prevalência do HPV 2 e 57, enquanto na hiperplasia epitelial focal prevaleceram os HPVs 13 e 32, e no câncer oral, principalmente, no carcinoma de células escamosas (CCE), foi evidenciada uma alta prevalência do HPV 16, o que sugere sua participação na carcinogênese oral, apesar de ser um assunto controverso. Constatou-se também uma enorme discrepância nos resultados da prevalência do papilomavírus humano (HPV) na mucosa oral normal (infecção latente) e no câncer oral, enquanto nas lesões benignas associadas ao vírus, os resultados foram confirmatórios.

Prevalence of human papillomavirus (HPV) in oral cavity and oropharynx

The prevalence of human papillomavirus (HPV) in the oral cavity and oropharynx has not yet been as well studied as its infection of the vaginal tract. However, new study are emerge after the development of molecular biology techniques. The objective of this study is to show the prevalence of HPV in the oral cavity and the oropharynx. An ample bibliographic review was done showing a prevalence of HPV 6, 11 in a normal oral mucous membrane (latent infection). In oral benign lesions associated with HPV, a prevalence of HPV 6 and 11 was observed in squamous cell papilloma (SCP) and condylomas acuminatum, while HPV 2 and 57 were more prevalent in verruca vulgaris lesions. As for focal epithelial hyperplasia (FEH) and oral cancer, especially squamous cell carcinoma (SCC), the prevalence was of HPV 13 and 32, and HPV 16, respectively. The last findings are, nonetheless, controversial. The last findings are, nonetheless, controversial. Showed also discrepancy result the prevalence of human papillomavírus (HPV) in normal oral mucous (latent infection) and in oral cancer, however evidenced confirmatory result in oral benign lesions associated with virus.