title: Chronic periodontitis-human papillomavirus synergy in base of tongue cancers.
abstract: OBJECTIVE
  To assess whether chronic periodontitis history predicts human papillomavirus (HPV) status in patients with base of tongue cancers.
  
  
  METHODS
  Case-control study using existing patient data.
  
  
  METHODS
  Roswell Park Cancer Institute.
  
  
  METHODS
  Thirty patients newly diagnosed with base of tongue squamous cell carcinoma between 1999 and 2005 for whom both tumor samples and periodontal records were available. Patients younger than 21 years, edentulous, immunocompromised, and those with a history of cancer were excluded. Periodontitis history was assessed on the basis of alveolar bone loss (in millimeters) from panoramic radiographs by one examiner who was blinded to cancer status.
  
  
  METHODS
  HPV-16 and HPV-18 DNA were identified on paraffin-embedded tumor samples by polymerase chain reaction. Multiple logistic regression was used to estimate odds ratios and 95% confidence intervals.
  
  
  RESULTS
  The prevalence of tumors positive for HPV-16 DNA was 21 of 30 (70%). None of the samples were positive for HPV-18 DNA. Compared with participants with HPV-negative tumors, patients with HPV-positive tumors had significantly higher mean alveolar bone loss (3.90 mm vs 2.85 mm, P = .01). After adjustment for age at diagnosis, sex, race/ethnicity, alcohol use, smoking status, and number of missing teeth, every millimeter of alveolar bone loss was associated with an approximately 4-fold (odds ratio, 3.96; 95% confidence interval, 1.18-13.36) increased risk of HPV-positive tumor status. Number of missing teeth was not associated with tumor HPV status (odds ratio, 0.95; 95% confidence interval, 0.74-1.21).
  
  
  CONCLUSIONS
  Chronic periodontitis may be a significant factor in the natural history of HPV infection in patients with base of tongue cancers. Additional confirmation in larger studies is required.
authors.affiliation: Department of Oral Diagnostic Sciences, State University of New York at Buffalo, 355 Squire Hall, Buffalo, NY 14214, USA. mtezal@buffalo.edu
authors.forename: Mine
authors.initials: M
authors.lastname: Tezal
authors.forename: Maureen
authors.initials: M
authors.lastname: Sullivan Nasca
authors.forename: Daniel L
authors.initials: DL
authors.lastname: Stoler
authors.forename: Thomas
authors.initials: T
authors.lastname: Melendy
authors.forename: Andrew
authors.initials: A
authors.lastname: Hyland
authors.forename: Philip J
authors.initials: PJ
authors.lastname: Smaldino
authors.forename: Nestor R
authors.initials: NR
authors.lastname: Rigual
authors.forename: Thom R
authors.initials: TR
authors.lastname: Loree
mesh_terms: D000428:Alcohol Drinking / Q000453:epidemiology; D016301:Alveolar Bone Loss / Q000453:epidemiology; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology / Q000821:virology*; D016022:Case-Control Studies; D055113:Chronic Periodontitis / Q000453:epidemiology*; D004279:DNA, Viral / Q000032:analysis; D005260:Female; D052162:Human papillomavirus 16 / Q000235:genetics / Q000302:isolation & purification*; D052161:Human papillomavirus 18 / Q000235:genetics / Q000302:isolation & purification*; D006801:Humans; D008297:Male; D008875:Middle Aged; D030361:Papillomavirus Infections / Q000453:epidemiology; D016133:Polymerase Chain Reaction; D012907:Smoking / Q000453:epidemiology; D014062:Tongue Neoplasms / Q000453:epidemiology / Q000821:virology*
chemical_list: D004279:DNA, Viral