Abstract B13: High-risk human papillomavirus prevalence in oral and oropharyngeal premalignant lesions: A critical literature review

Abstract

Abstract Introduction: During the past decade, there has been a significant increase in the incidence of human papillomavirus (HPV) related squamous cell cancer of the oropharynx, especially those of the tonsil and tongue base. HPV-16 and HPV-18 have been linked to these malignant neoplasms. Generally, oral epithelium undergoes a sequence of histopathological pre-malignant transformations before the development of invasive carcinoma. A study evaluating the prevalence of HPV-16/18 types in histopathologically diagnosed oral pre-malignant lesions (OPL) is lacking. Therefore, we conducted a comprehensive literature review to estimate the prevalence of HR HPV types in different grades of OPLs. Study Design: A critical literature search was conducted using Pubmed and SCOPUS databases for the key terms human papillomavirus infection, head and neck cancer, oral cancer, oral hyperplasia, oral dysplasia, and oral leukoplakia. A total of 90 articles related to HPV in oral tissue and pre-malignant lesions were identified. Of these, 29 articles evaluated the prevalence of HPV in histopathological OPLs (hyperplasia and dysplasia). In addition, 11 out of these 29 articles determined the prevalence of HPV in histologically evaluated leukoplakic samples. Only research articles published from 1990 — 2009 were used for this review. Results: Overall, the 29 articles evaluated high-risk (HR) HPV in 1,171 OPLs. This included 140 hyperplasias, 467 dysplasias, 425 leukoplakic lesions without dysplasia, and 139 leukoplakic lesions with dysplasia. The prevalence of any type of HPV in hyperplasia, dysplasia, leukoplakia without dysplasia, and leukoplakia with dysplasia was 24%, 25%, 28%, and 20% respectively. The prevalence of HR HPV-16/18 in these lesions was 24%, 21%, 26% and 26% respectively. The difference in prevalence of different grades of OPLs was not statistically significant. The prevalence of any HPV type in mild, moderate, and severe dysplastic lesions was 43%, 39%, and 33% respectively. The prevalence of HR HPV-16/18 in mild, moderate, and severe dysplastic lesions was 39%, 32%, and 28% respectively. Conclusion: High-risk HPV infection has been noted even in early stage histopathological OPLs like hyperplasias and mild dysplasias, and their prevalence rate is very similar to high grade OPLs, and oral (OC) and oropharyngeal cancers (OPC). Larger studies are needed to obtain a more precise estimate of the prevalence and persistence of HR HPV in histopathologically diagnosed OPLs in order to better understand the etiopathogenesis of HPV related OC and OPC. Citation Information: Cancer Prev Res 2010;3(12 Suppl):B13.