Human papillomavirus infection in oral squamous cell carcinomas: Correlation with histologic variables and survival outcome in a high risk population

Aim: Cancer of the oral cavity is extremely prevalent in Pakistan. Human papillomavirus (HPV) has been shown to play a role in the development of oral squamous cell carcinoma (OSCC) and may even improve overall and disease-free survival. The purpose of this study was to determine prevalence and types of HPV in a high risk population and its correlation with overall and disease-free survival, chewing habits and histologic variables. Material and methods: A total of 140 patients of OSCC, having a long-term follow-up, were included in this study. HPV-general and type-specific 16 and 18 infection were investigated by means of polymerase chain reaction. Results: Out of 140 patients, HPV was detected in 95 (68%) patients, out of whom, 85 (90%) contained HPV16. HPV positive patients had comparatively prolonged overall survival when compared with HPV-negative patients, but this difference was not statistically significant (P = 0.97). HPV presence was also not found to correlate significantly with disease-free survival (P = 0.58). The male were significantly correlated [odds ratio (OR) = 2.34; 95% confidence interval (CI) = 1.13-4.84] with the HPV infection. Betel quid chewer were comparatively more prone to HPV positivity (OR = 2; 95% CI = 1.1-4.31). Conclusion: Our study found a high prevalence of HPV16 in OSCC of Pakistani patients with male sex showing significant correlation with HPV infection. However, we did not find a statistically significant favourable association between HPV, survival and histologic variables. Borderline significance of HPV positivity was also seen with betel quid chewing (P = 0.049).