Javed Maham, Anjum Rabia, Zulifqar Gulraiz, Rasheed Farhan, Amar Ali, Naseem Nadia
Maham Javed, MBBS, MPhil Department of Morbid Anatomy & Histopathology, University of Health Sciences, Lahore, Pakistan.
Rabia Anjum, BDS, MPhil Department of Oral Pathology, University of Health Sciences, Lahore, Pakistan.
Pak J Med Sci. 2024 Jan-Feb;40(1Part-I):101-109. doi: 10.12669/pjms.40.1.7532.
The proposed study was planned to screen Human Papilloma Virus (HPV) status in potentially malignant oral disorders (PMOD) and correlated HPV positivity with cytological changes in oral smears.
This descriptive cross-sectional study was conducted at University of Health Sciences Lahore, Pakistan from April 2020 to April 2021. Oral smears from N=162 patients with PMODs were taken by the Cytobrush and Manual Liquid Based Cytology was performed followed by p16 antibody detection on immunohistochemistry and HPV-DNA detection by conventional polymerase chain reaction (PCR). The cytological changes were categorized according to the updated Bethesda Classification system 2014. SPSS was used to analyze data and p-Value of <0.05 was considered as statistically significant.
Out of total N = 162 patients, the most prevalent lesion [39% (n=63)] was lichen planus. Fifty six percent (n=90) of the patients were habitual chewers and 43% (n=70) were smokers. Pap staining of oral smears revealed atypical squamous cells of undetermined significance (ASCUS) in 45% (n=69) cases and in 2 % (n=4) of the samples diagnosis of atypical squamous cells-cannot exclude high-grade squamous intraepithelial lesion (ASC-H) was made. A total of 37% cases showed HPV positivity by polymerase chain reaction (PCR) while positive p16 expression was observed in 24% of the cases. ASC-H and ASCUS category showed significant association with HPV positivity (p=0.003).
Early detection of PMODs by adopting minimally invasive cytological techniques and screening for HPV infection in local population is pivotal to reduce the morbidity and mortality associated with the advanced disease and carcinoma.
本拟进行的研究旨在筛查潜在恶性口腔疾病（PMOD）中的人乳头瘤病毒（HPV）状态，并将HPV阳性与口腔涂片的细胞学变化相关联。
本描述性横断面研究于2020年4月至2021年4月在巴基斯坦拉合尔健康科学大学开展。使用细胞刷采集了N = 162例PMOD患者的口腔涂片，进行了手工液基细胞学检查，随后进行免疫组织化学p16抗体检测以及通过常规聚合酶链反应（PCR）检测HPV-DNA。根据2014年更新的贝塞斯达分类系统对细胞学变化进行分类。使用SPSS分析数据，p值<0.05被认为具有统计学意义。
在总共N = 162例患者中，最常见的病变[39%（n = 63）]是扁平苔藓。56%（n = 90）的患者有咀嚼习惯，43%（n = 70）的患者吸烟。口腔涂片的巴氏染色显示，45%（n = 69）的病例中有意义不明确的非典型鳞状细胞（ASCUS），2%（n = 4）的样本诊断为非典型鳞状细胞 - 不能排除高级别鳞状上皮内病变（ASC-H）。总共37%的病例通过聚合酶链反应（PCR）显示HPV阳性，而24%的病例观察到p16表达阳性。ASC-H和ASCUS类别与HPV阳性显示出显著关联（p = 0.003）。
采用微创细胞学技术早期检测PMOD并对当地人群进行HPV感染筛查对于降低与晚期疾病和癌症相关的发病率和死亡率至关重要。
