Objective
The aim of this study was to determine the utility of surrogate markers of human papillomavirus
(HPV) infection in the diagnosis of HPV-associated oral epithelial dysplasia (OED).
Study Design
Twelve cases of oral dysplasia with histologic features of HPV infection were stained
with surrogate markers for HPV (p16, Ki-67, and ProExC) on immunohistochemistry. A
second group of 12 cases of oral dysplasia without histologic features of HPV infection
was used for comparison. Reverse transcriptase polymerase chain reaction (RT-PCR)
was used to confirm the presence of high-risk HPV (HR HPV) in p16-positive cases.
Results
All of the surrogate markers showed a statistically significant association with HPV-positive
OED (P < .001). The agreement between p16 and HPV positivity was the strongest (κ = 1.00),
whereas Ki-67 showed very good association with HPV (κ = 0.83), and ProExC showed
good association (κ = 0.75). In each case, the agreement was statistically significant
(P < .001). Overall, each of the 3 markers showed good sensitivity; however, ProExC
showed the lowest specificity.
Conclusions
The clinicopathologic features of 12 cases of HPV OED are reported. Diffuse p16 positivity
is an accurate and reliable method for predicting HR HPV infection in both high and
low grade cases of epithelial dysplasia with histopathologic features of HPV OED.
The use of Ki-67 and ProExC did not demonstrate any additional diagnostic benefit
in the diagnosis HPV OED.
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Article info
Publication history
Published online: October 14, 2019
Accepted:
September 29,
2019
Received in revised form:
August 28,
2019
Received:
June 16,
2019
Footnotes
This project was funded internally by the Department of Pathology and Laboratory Medicine, and by the Schulich Dentistry Research Opportunity Program, Western University (London, Ontario, Canada).
A portion of this data was presented at the 2019 Canadian Dental Association Convention as part of the CDA/Dentsply Sirona Student Clinician Research Program.
Identification
Copyright
© 2019 Elsevier Inc. All rights reserved.
