title: The prevalence and distribution of human papillomavirus genotypes in oral epithelial hyperplasia: proposal of a concept.
abstract: BACKGROUND
  Evidence is accumulating for the aetiological role of human papillomavirus (HPV) in the pathogenesis of potentially malignant oral mucosal lesions and squamous cell carcinomas.
  
  
  METHODS
  Paraffin tissue sections from 49 patients with 'white patches' of the oral mucosa were investigated histologically, by broad-spectrum PCR followed by genotyping and chromogenic in situ hybridisation (CISH).
  
  
  RESULTS
  Histologically, 33 flat hyperplasias and 16 papillary hyperplasias were diagnosed. Twenty-two of 28 samples studied (78.6%) were positive for HPV DNA by PCR and six were negative. The following HPV types were detected in decreasing order of prevalence: HPV 35, HPV 6, HPV16, HPV 53, HPV 18, HPV 51 and HPV 55. Seventeen samples (60.7%) contained high-risk HPV DNA. Using CISH, >or= 1 HPV signals were detected at least in a few epithelial cells in 95% of cases studied. All but one case were positive with the high-risk HPV probe and all HPV infections contained low viral load. Concordant positive results both by PCR and CISH were detected in 14 of 19 cases (73.7%) analysed.
  
  
  CONCLUSIONS
  The high prevalence of HPV infection in hyperplastic 'white patches' of the oral mucosa supports the putative role of HPV at an early stage of oral carcinogenesis. These results further indicate that the majority of white oral mucosal lesions - flat, exophytic, wart-like or papillary proliferations - could be considered as the clinical manifestations of oral HPV infection. This finding has clinical relevance regarding therapy and patient management and may help in elucidating the role of HPV infection in oral carcinogenesis.
authors.affiliation: Institute of Pathology, Bonn-Duisdorf, Bonn, Germany.
authors.forename: Alinda Dalma
authors.initials: AD
authors.lastname: Varnai
authors.forename: Magdolna
authors.initials: M
authors.lastname: Bollmann
authors.forename: Agnes
authors.initials: A
authors.lastname: Bankfalvi
authors.forename: Krisztina
authors.initials: K
authors.lastname: Kovacs
authors.forename: Hildegard
authors.initials: H
authors.lastname: Heller
authors.forename: Christoph
authors.initials: C
authors.lastname: Schmitt
authors.forename: Jan
authors.initials: J
authors.lastname: Volek
authors.forename: Marianna
authors.initials: M
authors.lastname: Szendy
authors.forename: Reinhard
authors.initials: R
authors.lastname: Bollmann
authors.forename: Ralf
authors.initials: R
authors.lastname: Hildenbrand
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D052685:Alphapapillomavirus / Q000145:classification / Q000235:genetics* / Q000472:pathogenicity; D002863:Chromogenic Compounds; D004279:DNA, Viral / Q000032:analysis; D004847:Epithelial Cells / Q000821:virology; D005260:Female; D005838:Genotype; D006801:Humans; D006965:Hyperplasia / Q000821:virology; D017403:In Situ Hybridization / Q000379:methods; D007972:Leukoplakia, Oral / Q000473:pathology / Q000821:virology*; D008297:Male; D008875:Middle Aged; D009061:Mouth Mucosa / Q000473:pathology / Q000821:virology*; D009062:Mouth Neoplasms / Q000821:virology*; D030361:Papillomavirus Infections / Q000235:genetics*; D016133:Polymerase Chain Reaction; D011230:Precancerous Conditions / Q000821:virology*; D055815:Young Adult
chemical_list: D002863:Chromogenic Compounds; D004279:DNA, Viral