Abstract
Oral squamous cell carcinoma (OSCC) is the most prevalent malignancy among males in India. While tobacco and alcohol are main aetiological factors, human papilloma virus (HPV) presence has surprisingly increased in head and neck Squamous Cell Carcinoma (HNSCC) in the past two decade but its frequency in OSCCS is still uncertain. We aim to explore the frequency of HPV and its major genotypes in North Indian patients and their association with clinicopathological and histopathological features and p16 expression pattern. The study group comprised 250 histologically proven cases of OSCC. HPV was detected by real time PCR in tumor biopsy specimens and confirmed by conventional PCR with PGMY09/ PGMY11 primers. Genotyping for high-risk types 16/ 18 was conducted by type specific PCR. p16 expression was assessed by immunohistochemsitry. HPV presence was confirmed in 23/250 (9.2%) OSCC cases, of which 30.4% had HPV 16 infection, 17.4%were positive for HPV 18 and 26.1% had co-infections. HPV presence was significantly associated with male gender (p=0.02) and habit of pan masala chewing (p=0.01). HPV positive cases also had a history of tobacco consumption in 91.3% cases. p16 over expression was observed in 39.1% of HPV positive cases but this was not significantly different from negative cases (p=0.54). The frequency of HPV in OSCC is low in North-India and majority of cases are associated with a tobacco habit. It appears that tobacco shows a confounding effect in HPV positive cases and use of p16 protein as a reliable marker to assess the potential etiological role of HPV in OSCC in our population is not suggested.
Highlights
Oral squamous cell carcinoma (OSCC) is one of the most prevalent malignancy in India with approximately 83,000 new cases and more than 46,000 deaths occur yearly (Bray et al, 2013)
The study encompasses 250 histologically proven cases of OSCC. Out of these human papilloma virus (HPV) presence was confirmed in 23(9.2%) cases (Figure 1A&B) according to diagnostic criteria predefined in data analysis
HPV has been identified as a prime suspect in the etiology of head and neck Squamous Cell Carcinoma (HNSCC) due to their morphological similarities with genital epithelia and their ability to transform and immortalize oral keratinocytes (Termine et al, 2008)
Summary
Oral squamous cell carcinoma (OSCC) is one of the most prevalent malignancy in India with approximately 83,000 new cases and more than 46,000 deaths occur yearly (Bray et al, 2013). It ranks number one in terms of incidence among men and third among women (Byakodi et al, 2012). While tobacco and alcohol are main aetiological factors, human papilloma virus (HPV) presence has surprisingly increased in head and neck Squamous Cell Carcinoma (HNSCC) in the past two decade but its frequency in OSCCS is still uncertain. Conclusions: The frequency of HPV in OSCC is low in North-India and majority of cases are associated with a tobacco habit. It appears that tobacco shows a confounding effect in HPV positive cases and use of p16 protein as a reliable marker to assess the potential etiological role of HPV in OSCC in our population is not suggested
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