Human Papillomavirus in Oral Squamous Cell Carcinoma: An Institutional Study

Background: Human papillomavirus (HPV) is associated with the etiology of oropharyngeal squamous cell carcinomas. Despite the high proportion of oral squamous cell carcinomas (OSCC) in India, there only a few studies on the HPV status. The present study evaluated the HPV status of OSCC and its association with age, site, and tobacco habits. Methods: A total of 60 formalin-fixed paraffin-embedded tissues were included in the study, of which 30 were cases with OSCC and 30 formed the control group. The study group consisted of 30 subjects with primary, untreated, histologically confirmed cases of OSCC. The tissues were evaluated for the presence of HPV DNA using conventional polymerase chain reaction. Tissues which tested positive for HPV were further tested for HPV 16 and HPV 18. Results: In the study group, 83% were males and 17% were females with an average age of 58 years. The commonest sites of OSCC were the alveolus, alveologingival sulcus, and tongue. All subjects except one had tobacco habit. Among OSCC cases, 16.7% tested positive for HPV and controls were positive in 3.3% samples. HPV 16 was the most common HPV type detected in 60% of HPV-positive OSCC cases, while HPV 18 was present in 20%. Tobacco habits were present in 80% of the HPV-positive cases, while no habit history was reported in 20% of cases. Conclusion: Tobacco habits such as smoking and use of smokeless tobacco are found predominantly in OSCC and are the most common etiological factors. The present study found a prevalence of 16.7% of HPV-associated OSCC, with most cases also having tobacco habits. Thus, HPV as an etiological factor in OSCC is confounded by the presence of tobacco-associated risk factors.