Abstract
The role of human papillomavirus type 16 (HPV16) in oral potentially malignant disorders (OPMD) and oral cavity carcinoma (OC) is still under debate. We investigated HPV16 prevalence in unstimulated saliva, oral rinse samples, oral swabs and tumour biopsies collected from OPMD (n = 83) and OC (n = 106) patients. HPV16 genotype, viral load, physical status (episomal vs. integrated) and tumour p16INK4a expression were determined. Oral HPV16 prevalence was higher in OC than in OPMD, but this difference was not statistically significant (7.5% (8/106) versus 3.6% (3/83), odds ratio (OR): 2.18, 95% confidence interval (CI): 0.56, 8.48, p = 0.26). There was a significant association (p < 0.05) between oral HPV16 infection and heavy tobacco consumption. Real-time PCR results indicated that no integration events occurred in either OPMD or OC cases based on the HPV16 E2/E6 ratio. HPV16 positive OPMD and OC patients had similar HPV16 E2 and E6 viral loads. The inter-rater agreement between tumour p16INK4a expression and oral HPV16 infection was considered as fair (k = 0.361) for OC. Our data suggest that the involvement of HPV16 in oral carcinogenesis is limited.
Highlights
Oral cavity carcinoma (OC), which includes carcinomas of the mucosal part of the lip, is the most common subset of head and neck carcinomas (HNC), affecting approximately 300,000 patients annually worldwide [1]
Previous studies have demonstrated that the presence of human papillomavirus (HPV) DNA in tumour tissues is significantly correlated with HPV DNA positivity in saliva samples collected from oropharyngeal carcinoma (OPC) patients, suggesting the use of salivary HPV as a biomarker for the detection of HPV DNA in OPC patients [14,15]
Only the purely episomal human papillomavirus type 16 (HPV16) form was detected in all HPV16 positive oral potentially malignant disorders (OPMD) and oral cavity carcinoma (OC) cases
Summary
Oral cavity carcinoma (OC), which includes carcinomas of the mucosal part of the lip, is the most common subset of head and neck carcinomas (HNC), affecting approximately 300,000 patients annually worldwide [1]. Despite significant advances in cancer treatment, improvements in overall survival in OC have only been modest. Consistent with other malignant tumours, early detection has decreased treatment-associated morbidity and improved survival. Ample evidence suggests that the oral potentially malignant disorders (OPMD), which include leukoplakia, erythroplakia, oral lichen planus, oral submucous fibrosis, actinic cheilosis, and snuff patch, may contribute to the development of OC [6]. Human papillomavirus (HPV), an etiologic agent for cervical and oropharyngeal carcinoma (OPC) (which includes the tonsillar area, the base of tongue, the soft palate and the oropharynx), is a potential risk factor for OC. Over 200 types of HPV have been reported; only high-risk HPV types are associated with cancer development and progression. HPV16 is the most common high-risk HPV type, accounting for the majority of cases of cervical cancer and OPC [7,8]
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