Abstract
BackgroundOral malignancy is a major global health problem. Besides the main risk factors of tobacco, smoking and alcohol, infection by human papillomavirus (HPV) and genetic alterations are likely to play an important role in these lesions. The purpose of this study was to compare the efficacy of HC-II assay and PCR for the detection of specific HPV type (HPV 16 E6) in OSMF and OSCC cases as well as find out the prevalence of the high risk HPV (HR-HPV) in these lesions.Methods and materialsFour hundred and thirty patients of the potentially malignant and malignant oral lesions were taken from the Department of Otorhinolaryngology, Moti Lal Nehru Medical College, Allahabad, India from Sept 2007-March 2010. Of which 208 cases were oral submucous fibrosis (OSMF) and 222 cases were oral squamous cell carcinoma (OSCC). The HC-II assay and PCR were used for the detection of HR-HPV DNA.ResultThe overall prevalence of HR-HPV 16 E6 DNA positivity was nearly 26% by PCR and 27.4% by the HC-II assay in case of potentially malignant disorder of the oral lesions such as OSMF. However, in case of malignant oral lesions such as OSCC, 32.4% HPV 16 E6 positive by PCR and 31.4% by the HC-II assay. In case of OSMF, the two test gave concordant result for 42 positive samples and 154 negative samples, with an overall level of agreement of 85.4% (Cohen's kappa = 66.83%, 95% CI 0.553-0.783). The sensitivity and specificity of the test were 73.7% and 92.05% (p < 0.00). In case of OSCC, the two test gave concordant result for 61 positive samples and 152 negative samples, with an overall level of agreement of 88.3% (Cohen's kappa = 79.29, 95% CI 0.769-0.939) and the sensitivity and specificity of the test were 87.14% and 92.76% (p < 0.00).ConclusionThis study concluded that slight difference was found between the positivity rate of HR-HPV infection detected by the HC-II and PCR assay in OSMF and OSCC cases and the HC II assay seemed to have better sensitivity in case of OSCC.
Highlights
Oral malignancy is a major global health problem
More than 90% of these malignancies representing a squamous cell carcinoma (SCC), which are often preceded by preexisting oral lesions termed as potentially malignant disorders of the oral mucosa such as oral sub mucous
Mehrotra et al reported that potentially malignant and malignant disorders of the oral mucosa were widespread in the patients visiting in the Medical College and SRN hospital, Allahabad and suggested that oral submucous fibrosis (OSMF) constituted the highest number of the patients in the potentially malignant group while in case of malignant group, oral squamous cell carcinoma (OSCC) was most prevalent in this region [4]
Summary
The purpose of this study was to compare the efficacy of HC-II assay and PCR for the detection of specific HPV type (HPV 16 E6) in OSMF and OSCC cases as well as find out the prevalence of the high risk HPV (HR-HPV) in these lesions. Besides the main risk factors of tobacco, smoking and alcohol, infection by human papillomavirus (HPV) and genetic alterations are likely to play an important role in these lesions [5]. Molecular evidences provide support to the role of high risk HPV, HPV16, in the pathogenesis of OSCC of the head and neck [6]. Kreimer et al reported that genomic DNA of oncogenic HPV has been detected approximately 26% of all OSCC of the head and neck worldwide [7] but the most accurate and consistent study for OSMF and OSCC, in which viral integration and the expression of viral oncogenes (E6 and E7) have been shown [8]
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