Detection of human papillomavirus infection in oral mucosal diseases

Abstract

Background

Human papillomavirus (HPV) infection accounts for more than 70% of oropharyngeal cancers but only a small proportion of oral cavity cancers. This study aimed to investigate the presence of HPV DNA in oral diseases to understand better the possible correlation between oral lesions and HPV infections.

Methods

This was a cross-sectional study of 99 adult patients seen for the evaluation of oral diseases. All patients received an oral biopsy and histopathologic examination and a brush biopsy for HPV-DNA detection and genotyping by real-time polymerase chain reaction. Immunohistochemistry was used to assess p16INK4a expression.

Results

HPV was identified in 15 of 99 (15.2%) patients (males, 66.6%). Patients with oral leukoplakia (OL) (46.6%), followed by patients with oral lichen planus (OLP) (33.3%) had the highest rate of HPV infection, with a predilection for the buccal mucosa (17.5%). Most patients with high-risk HPV infections had OLP (4/10, 40.0%), whereas most of the patients with low-risk HPV infections had nonreactive epithelial hyperkeratosis (3/6, 50.0%). Among all benign lesions, 19.0% were positive for any HPV infection. One patient with OL showing mild epithelial dysplasia had a positive p16INK4a expression.

Conclusions

The highest rate of HPV infection was in male patients, patients with OL and OLP, and conditions affecting the buccal mucosa. Larger studies are needed to elucidate the role of HPV in the development of these conditions.