title: Do Human Papilloma Viruses Play Any Role in Oral Squamous Cell Carcinoma in North Indians?
abstract: BACKGROUND
  Oral squamous cell carcinoma (OSCC) is the most prevalent malignancy among males in India. While tobacco and alcohol are main aetiological factors, human papilloma virus (HPV) presence has surprisingly increased in head and neck Squamous Cell Carcinoma (HNSCC) in the past two decade but its frequency in OSCCS is still uncertain. We aim to explore the frequency of HPV and its major genotypes in North Indian patients and their association with clinicopathological and histopathological features and p16 expression pattern.
  
  
  METHODS
  The study group comprised 250 histologically proven cases of OSCC. HPV was detected by real time PCR in tumor biopsy specimens and confirmed by conventional PCR with PGMY09/ PGMY11 primers. Genotyping for high-risk types 16/ 18 was conducted by type specific PCR. p16 expression was assessed by immunohistochemsitry.
  
  
  RESULTS
  HPV presence was confirmed in 23/250 (9.2%) OSCC cases, of which 30.4% had HPV 16 infection, 17.4%were positive for HPV 18 and 26.1% had co-infections. HPV presence was significantly associated with male gender (p=0.02) and habit of pan masala chewing (p=0.01). HPV positive cases also had a history of tobacco consumption in 91.3% cases. p16 over expression was observed in 39.1% of HPV positive cases but this was not significantly different from negative cases (p=0.54).
  
  
  CONCLUSIONS
  The frequency of HPV in OSCC is low in North-India and majority of cases are associated with a tobacco habit. It appears that tobacco shows a confounding effect in HPV positive cases and use of p16 protein as a reliable marker to assess the potential etiological role of HPV in OSCC in our population is not suggested.
authors.affiliation: Department of Pathology, Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, UP, India E-mail : drnuzhathusain@hotmail.com.
authors.forename: Vineeta
authors.initials: V
authors.lastname: Singh
authors.forename: Nuzhat
authors.initials: N
authors.lastname: Husain
authors.forename: Naseem
authors.initials: N
authors.lastname: Akhtar
authors.forename: Vijay
authors.initials: V
authors.lastname: Kumar
authors.forename: Shikha
authors.initials: S
authors.lastname: Tewari
authors.forename: Sridhar
authors.initials: S
authors.lastname: Mishra
authors.forename: Sanjeev
authors.initials: S
authors.lastname: Misra
authors.forename: M Y
authors.initials: MY
authors.lastname: Khan
mesh_terms: D000328:Adult; D001114:Areca; D002294:Carcinoma, Squamous Cell / Q000737:chemistry / Q000453:epidemiology* / Q000821:virology; D060085:Coinfection / Q000821:virology; D019941:Cyclin-Dependent Kinase Inhibitor p16 / Q000032:analysis; D005260:Female; D005838:Genotype; D061809:Human Papillomavirus DNA Tests; D052162:Human papillomavirus 16 / Q000235:genetics / Q000302:isolation & purification*; D052161:Human papillomavirus 18 / Q000235:genetics / Q000302:isolation & purification*; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000737:chemistry / Q000453:epidemiology* / Q000821:virology; D030361:Papillomavirus Infections / Q000150:complications / Q000453:epidemiology*; D012307:Risk Factors; D012737:Sex Factors; D015996:Survival Rate; D064424:Tobacco Use / Q000009:adverse effects*
chemical_list: D019941:Cyclin-Dependent Kinase Inhibitor p16