Department of Surgical Sciences, Oral and Maxillofacial Surgery, Medical Faculty, Uppsala University, SE-751 85 Uppsala, Sweden.
Anticancer Res. 2012 Feb;32(2):571-80.
Oral squamous cell carcinoma (OSCC) is a major health problem in many parts of the world, and the major causative agents are thought to be the use of alcohol and tobacco. Oncogenic viruses have also been suggested to be involved in OSCC development. This study investigated the prevalence of human papillomaviruses (HPV), herpes simplex virus (HSV) and Epstein-Barr virus (EBV) in 155 OSCC from eight different countries from different ethnic groups, continents and with different socioeconomic backgrounds. 41 A total of OSCCs were diagnosed in the tongue (26%) and 23 in the floor of the mouth (15%); the other 91 OSCCs were diagnosed in other locations (59%). The patients were also investigated regarding the use of alcohol and smoking and smokeless tobacco habits. Tissue samples were obtained from formalin-fixed, paraffin-embedded samples of the OSCC. DNA was extracted and the viral genome was examined by single, nested and semi-nested PCR assays. Sequencing of double-stranded DNA from the PCR product was carried out. Following sequencing of the HPV-, HSV- and EBV-positive PCR products, 100% homology between the sampels was found. Of all the 155 OSCCs examined, 85 (55%) were positive for EBV, 54 (35%) for HPV and 24 (15%) for HSV. The highest prevalence of HPV was seen in Sudan (65%), while HSV (55%) and EBV (80%) were most prevalent in the UK. In 34% (52/155) of all the samples examined, co-infection by two (46/155=30%) or three (6/155=4%) virus specimens was detected. The most frequent double infection was HPV with EBV in 21% (32/155) of all OSCCs. There was a statistically significant higher proportion of samples with HSV (p=0.026) and EBV (p=0.015) in industrialized countries (Sweden, Norway, UK and USA) as compared to developing countries (Sudan, India, Sri Lanka and Yemen). Furthermore, there was a statistically significant higher co-infection of HSV and EBV in samples from industrialized countries (p=0.00031). No firm conclusions could be drawn regarding the relationship between alcohol, tobacco and virus infections. The significance of our findings must be put in relation to other risk factors and these observations warrant further studies to determine the possible role of viral infections and co-infections with HPV, EBV and HSV as risk markers for the development of OSCC.
口腔鳞状细胞癌（OSCC）是世界上许多地区的一个主要健康问题，其主要致病因素被认为是酒精和烟草的使用。致癌病毒也被认为与 OSCC 的发展有关。本研究调查了来自不同种族、大陆和不同社会经济背景的 8 个不同国家的 155 例 OSCC 中人类乳头瘤病毒（HPV）、单纯疱疹病毒（HSV）和 Epstein-Barr 病毒（EBV）的流行情况。总共在 41 例 OSCC 中诊断出舌部（26%）和 23 例口底（15%）；其他 91 例 OSCC 则位于其他部位（59%）。还对患者的饮酒、吸烟和无烟烟草习惯进行了调查。从福尔马林固定、石蜡包埋的 OSCC 组织样本中提取 DNA，并通过单重、嵌套和半嵌套 PCR 检测病毒基因组。对 PCR 产物的双链 DNA 进行测序。对 HPV-、HSV-和 EBV-PCR 产物进行测序后，发现样本之间存在 100%的同源性。在所检查的 155 例 OSCC 中，85 例（55%）为 EBV 阳性，54 例（35%）为 HPV 阳性，24 例（15%）为 HSV 阳性。苏丹的 HPV 阳性率最高（65%），而英国的 HSV（55%）和 EBV（80%）阳性率最高。在检查的所有 155 个样本中，有 34%（52/155）检测到两种（46/155=30%）或三种（6/155=4%）病毒标本的合并感染。最常见的双重感染是 HPV 与 EBV，占所有 OSCC 的 21%（32/155）。与发展中国家（苏丹、印度、斯里兰卡和也门）相比，工业化国家（瑞典、挪威、英国和美国）的 HSV（p=0.026）和 EBV（p=0.015）样本比例有统计学意义更高。此外，工业化国家 HSV 和 EBV 的合并感染率有统计学意义（p=0.00031）。关于酒精、烟草和病毒感染之间的关系，不能得出明确的结论。我们的研究结果必须与其他风险因素相关联，这些观察结果需要进一步研究，以确定 HPV、EBV 和 HSV 病毒感染及其合并感染作为 OSCC 发展的风险标志物的可能作用。
