Role of the Human Papillomavirus in Malignant Transformation of Oral Leukoplakia Distinct from Oropharyngeal Squamous Cell Carcinoma: A Study of 76 Patients with Internal-Control Specimens.

Publication date: Available online 19 January 2019

Source: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology

Author(s): Wenyan Wu, Zhen Wang, Zengtong Zhou

Abstract

Objective

This study sought to investigate the role of human papillomaviruses (HPV) in oral leukoplakia (OLK) carcinogenesis, with the oral cavity as the site of interest.

Study Design

A total of 76 patients (152 specimens) were enrolled. The patients were divided into two groups: the malignant transformation of OLK (OLK-MT) group and the non-malignant transformation of OLK (OLK-non-MT) group. HPV reverse dot blot analysis, HPV DNA polymerase chain reaction (PCR) and p16INK4A immunohistochemistry (IHC) were used to determine HPV infection status.

Results

Carcinogenesis of OLK was commonly located in the lateral/ventral tongue, buccal mucosa, and gingiva. Based on the initial specimens, only 5.3% (4/76) of patients were HPV-16 positive, and these patients' final specimens were negative. Overexpression of p16INK4A in the initial stage was associated with OLK carcinogenesis (p=0.013, OR=3.544).

Conclusions

OLK carcinogenesis was common in patients who were elderly, female, and non-smokers/non-drinkers; had lesions located in the lateral/ventral tongue; had OLK with dysplasia; and overexpressed p16INK4A during the initial stage. HPV might be an opportunistic infection in the oral cavity and may not be a cause of OLK carcinogenesis. p16INK4A expression that initially increases and then diminishes or disappears might be an early predictor of OLK carcinogenesis.

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