PAPILLOMAVIRUS INFECTIONS AND PRECANCEROUS LESIONS IN THE ORAL CAVITY NLM AIDSLINE Important note: Information in this article was accurate in 1992. The state of the art may have changed since the publication date.

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PAPILLOMAVIRUS INFECTIONS AND PRECANCEROUS LESIONS IN THE ORAL CAVITY

Serono Symp Publ Raven; 78:365-77 1990. Unique Identifier : AIDSLINE ICDB/92678085
Kuffer R; Dept. of Pathology, Saint Louis Hosp., 1 rue Claude Vellefaux,; 75010 Paris, France

Abstract: The incidence of oral squamous cell carcinoma (OSC) shows great geographic variation, from 2.5 in southern England to 25/100,000 in certain parts of India, where it represents a major public health problem. Precancerous lesions of the oral cavity and the role of human papillomavirus (HPV) infection in these lesions are reviewed under the following headings: the need for more accurate terminology for 'leukoplakia;' low or high malignant potential of oral precancerous lesions; carcinogenic factors in oral malignancy; oral HPV-associated lesions (focal epithelial hyperplasia [FEH], oral papillomas, oral condyloma acuminatum, oral lesions resembling flat condyloma and vulvar Bowenoid papulosis, oral verrucous carcinoma, oral florid papillomatosis, oral hairy leukoplakia, OSC, and oral lichen planus); and whether HPVs cause oral premalignant and malignant lesions. The precancerous lesions of the oral mucosa, which may have a low or a high malignant potential, are characteristically flat or papillomatous exophytic lesions. Flat lesions may be either white patches ('leukoplakia') or (especially when malignant potential is high) red plaques ('erythroplakia') or more often white and red 'mosaic' pattern lesions ('speckled leukoplakia'). The word leukoplakia, which includes in a purely clinical sense different benign entities as well as dysplasias and even superficial carcinoma, should be replaced by adequate terms. A new classification of oral intraepithelial neoplasia (OIN) derived from the one currently in use for uterine cervix lesions is proposed: OIN 1 for mild dysplasia, OIN 2 for moderate dysplasia, and OIN 3 for severe dysplasia and intraepithelial carcinoma. Recent research has shown that either flat or papillomatous precancerous oral lesions are associated with HPV genotypes 2, 6, 11, 16, and 18. Types 16 and 11 are detected with a particular frequency in oral squamous cell carcinomas, dysplasias, and potential precursor keratosis. HPV types 13 and 32 are specific for FEH, a constantly benign lesion, and type 7 has been found in HIV-infected patients. HPV infection may cooperate with other classical carcinogenic factors (tobacco, alcohol, decayed teeth, and cicatricial atrophy) in oral carcinogenesis. (58 Refs)
Keywords: Carcinoma, Squamous Cell/*PATHOLOGY Cell Transformation, Neoplastic/PATHOLOGY Cocarcinogenesis Human Leukoplakia, Oral/PATHOLOGY Mouth Mucosa/PATHOLOGY Mouth Neoplasms/*PATHOLOGY Papillomavirus Precancerous Conditions/*PATHOLOGY Risk Factors Tumor Virus Infections/*PATHOLOGY MONOGRAPH REVIEWKWDcarcinoma,squamouscell/KWDpathologycelltransformation,neoplastic/pathologycocarcinogenesishumanleukoplakia,oral/pathologymouthmucosa/pathologymouthneoplasms/KWDpathologypapillomavirusprecancerousconditions/KWDpathologyriskfactorstumorvirusinfections/KWDpathologymonographreview
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Copyright © 1992 - National Library of Medicine. Reproduced under license with the National Library of Medicine, Bethesda, MD.

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