title: [Usefulness of Toki's morphological criteria for the diagnosis of oral lesions caused by human papillomavirus].
abstract: BACKGROUND
  Oral lesions caused by human papillomavirus (HPV), share morphological features which may complicate their diagnosis.
  
  
  OBJECTIVE
  To analyze the usefulness of Toki's morphological criteria for the diagnosis of HPV lesions in cervix, in the diagnosis of oral lesions.
  
  
  METHODS
  Retrospective study of 355 oral lesions by HPV. The pathologic evaluation was carried out three times by the same examiner with a Kappa coefficient of 0.780 (p = 0.01). Toki's criteria scored the presence of acanthosis as 1, dyskeratosis as 1, koilocytosis as 4, basilar hyperplasia as 1, bi or multinucleated cells as 2 and papillomatosis as 1. The information was analyzed using χ² and binary logistic regression.
  
  
  RESULTS
  Fifty eight percent of cases (207) corresponded to Verruca Vulgaris (VV), 23% (80) to Multifocal Epithelial Hyperplasia (MEH), and 19% (68) to Condyloma Acuminatum (CA). According to Toki's criteria, 76/80 MEH lesions, 195/207 of VV and 67/68 of CA, had a score equal or greater than six. A logistic regression showed that dyskeratosis suggests the presence of MEH. The presence of acanthosis and dyskeratosis in HPV oral lesions are not useful criteria for the diagnosis of VV. No significant associations with CA were found.
  
  
  CONCLUSIONS
  The morphological criteria studied do not predict their possible viral etiology and do not allow a differential diagnosis of the lesions. Therefore, polymerase chain reaction studies are required to identify high-risk HPVs or sexually transmitted viral lesions.
authors.affiliation: Facultad de Medicina, Universidad Autónoma del Estado de México, Toluca, México. josuer84@hotmail.com
authors.forename: Josué R
authors.initials: JR
authors.lastname: Bermeo E
authors.forename: Blanca S
authors.initials: BS
authors.lastname: González L
authors.forename: Eva
authors.initials: E
authors.lastname: Ramón G
authors.forename: Hugo
authors.initials: H
authors.lastname: Mendieta Z
mesh_terms: D003218:Condylomata Acuminata / Q000473:pathology* / Q000821:virology; D003937:Diagnosis, Differential; D005260:Female; D017573:Focal Epithelial Hyperplasia / Q000473:pathology* / Q000821:virology; D006801:Humans; D016015:Logistic Models; D008297:Male; D009061:Mouth Mucosa / Q000473:pathology* / Q000821:virology; D030361:Papillomavirus Infections / Q000821:virology; D012189:Retrospective Studies; D012737:Sex Factors