Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, Brazil.
Department of Oral Diagnosis and Pathology, School of Dentistry, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil.
Head Neck Pathol. 2023 Dec;17(4):921-931. doi: 10.1007/s12105-023-01589-z. Epub 2023 Oct 16.
Human papillomavirus-associated oral epithelial dysplasia (HPV-OED) is a distinct oral epithelial disorder characterized by viral cytopathic changes caused by transcriptionally active high-risk HPV. The aim of the present study was to report 5 additional cases from Latin America.
Clinical data from five patients with HPV-OED were obtained from the archives of three oral pathology services from Brazil and Chile. All cases were submitted to morphological, p16 expression and in situ hybridization (ISH) for HPV analyses.
Four patients were male and one patient was female, with a mean age of 55.4 years. Four patients were HIV seropositive and two were smokers. Three cases affected the buccal mucosa and commissure, one of which had an additional plaque in the soft palate, and one case each occurred on the floor of mouth and lower labial mucosa. Most cases presented as well-demarcated white plaques with a verrucous surface. One case presented multiple lesions ranging from normal to white-colored slightly elevated plaques with a cobblestone surface. Peripheral mucosal pigmentation was observed in two cases. All five cases presented with the characteristic microscopic features of HPV-OED, including severe dysplasia with numerous karyorrhectic and apoptotic cells, full-thickness "block positivity" for p16 and high Ki-67 index (> 90%) sharply demarcated from the adjacent non-dysplastic epithelium. Wide-spectrum DNA ISH-HPV was positive in 4 cases. All patients were treated with conservative surgical excision with no signs of recurrence after a mean of 39-month follow-up.
This represents the first series of HPV-OED from Latin America; most cases presented as well-demarcated papillary white plaques affecting the buccal mucosa and commissure of HIV-positive middle-aged men, two of them exhibiting peripheral pigmentation caused by reactive melanocytes. The typical microscopic findings of HPV-OED were observed in all cases, which also showed strong p16 positivity in a continuous band through the full thickness of the epithelium and high Ki67.
人乳头瘤病毒相关口腔上皮异型增生（HPV-OED）是一种独特的口腔上皮疾病，其特征为转录活跃的高危型 HPV 引起的病毒细胞病理学改变。本研究旨在报告来自拉丁美洲的另外 5 例病例。
从巴西和智利的 3 个口腔病理服务机构的档案中获取了 5 例 HPV-OED 患者的临床数据。所有病例均进行形态学、p16 表达和原位杂交（ISH）分析 HPV。
4 例患者为男性，1 例为女性，平均年龄 55.4 岁。4 例患者 HIV 血清阳性，2 例为吸烟者。3 例病变累及颊黏膜和口轮匝肌，其中 1 例软腭上有 1 个斑块，1 例病变位于口底，1 例位于下唇黏膜。大多数病例表现为界限清楚的白色斑块，表面呈疣状。1 例表现为多个病变，从正常到白色略高起的斑块，表面呈鹅卵石状。2 例病例可见周围黏膜色素沉着。所有 5 例均表现出 HPV-OED 的特征性组织学特征，包括严重异型增生，有大量核碎裂和凋亡细胞，p16 呈全层“块状阳性”，与相邻非异型增生上皮界限分明，Ki-67 指数（>90%）高。4 例病例广谱 DNA ISH-HPV 阳性。所有患者均接受保守性外科切除，平均随访 39 个月后无复发迹象。
这是拉丁美洲首例 HPV-OED 系列病例；大多数病例表现为界限清楚的乳头白色斑块，累及颊黏膜和口轮匝肌，HIV 阳性的中年男性，其中 2 例有反应性黑素细胞引起的周围色素沉着。所有病例均观察到 HPV-OED 的典型组织学表现，上皮全层连续强阳性表达 p16，Ki67 高。
