Thavaraj Selvam, Henley-Smith Rhonda, Gregson-Williams Harry, Yogarajah Sangeetha, Odell Edward W, Sathasivam Hans
Department of Oral and Maxillofacial Clinical Sciences, Faculty of Dentistry, University of Malaya, 50603 Kuala Lumpur, Malaysia; Head and Neck Pathology, King's College London and Guy's and St Thomas' NHS Foundation Trust, 4th Floor Tower Wing, Guy's Hospital, Great Maze Pond, London SE1 9RT, United Kingdom.
Head and Neck Cancer Biobank, Guy's and St Thomas' NHS Foundation Trust, 4th Floor Tower Wing, Guy's Hospital, Great Maze Pond, London SE1 9RT, United Kingdom.
Oral Oncol. 2025 Mar;162:107182. doi: 10.1016/j.oraloncology.2025.107182. Epub 2025 Jan 27.
Human papillomavirus-associated oral epithelial dysplasia (HPV-OED) has been recently recognised by the World Health Organisation (WHO) as a distinct type of oral epithelial dysplasia. The rarity of HPV-OED, together with gaps in the current understanding of risk factors and clinical behaviour raise the risk of under-recognition and misdiagnosis. To address this, we describe the clinico-pathological features of a consecutive series of HPV-OED from a single institution to provide additional insight into the presentation and behaviour of this disease.
Consecutive cases of HPV-OED were identified over a 20-year period from the pathology routine diagnostic archives of a single centre. Cases with features of viral cytopathic changes in a background of OED underwent HPV-specific testing in addition to p16 immunohistochemistry to confirm HPV positivity.
Fifty-three consecutive patients with HPV-OED were identified. The mean age at diagnosis was 55 years-old and there was a strong male predilection (83 %). Most patients were smokers or former smokers, and almost a fifth of individuals were Human Immunodeficiency Virus (HIV)-positive. The latero-ventral tongue was the most common index site. Twenty-eight percent of cases were associated with invasive oral squamous cell carcinoma. There was a statistically significant association between with patient's HIV status and malignant transformation (p = 0.022).
Findings from our cohort of HPV-OED patients suggests that malignant transformation is relatively frequent and associated with the HIV status of patients.
人乳头瘤病毒相关口腔上皮发育异常（HPV-OED）最近被世界卫生组织（WHO）认定为一种独特类型的口腔上皮发育异常。HPV-OED病例罕见，加上目前对风险因素和临床行为的认识存在差距，增加了漏诊和误诊的风险。为解决这一问题，我们描述了来自单一机构的一系列连续HPV-OED病例的临床病理特征，以进一步了解该疾病的表现和行为。
从单一中心的病理常规诊断档案中，在20年期间确定连续的HPV-OED病例。在发育异常背景下具有病毒细胞病变特征的病例，除进行p16免疫组织化学检测外，还进行HPV特异性检测以确认HPV阳性。
共确定了53例连续的HPV-OED患者。诊断时的平均年龄为55岁，男性明显居多（83%）。大多数患者为吸烟者或曾经吸烟者，近五分之一的个体为人类免疫缺陷病毒（HIV）阳性。舌腹外侧是最常见的起始部位。28%的病例与侵袭性口腔鳞状细胞癌相关。患者的HIV状态与恶性转化之间存在统计学上的显著关联（p = 0.022）。
我们的HPV-OED患者队列研究结果表明，恶性转化相对常见，且与患者的HIV状态相关。
