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Clinico-pathological characterisation of human papillomavirus-associated oral epithelial dysplasia

Thavaraj S, Henley-Smith R, Gregson-Williams H, Yogarajah S, Odell EW, Sathasivam H

Oral Oncol, 2025 Jan 27;162:107182.
PMID: 39874724 DOI: 10.1016/j.oraloncology.2025.107182

BACKGROUND: Human papillomavirus-associated oral epithelial dysplasia (HPV-OED) has been recently recognised by the World Health Organisation (WHO) as a distinct type of oral epithelial dysplasia. The rarity of HPV-OED, together with gaps in the current understanding of risk factors and clinical behaviour raise the risk of under-recognition and misdiagnosis. To address this, we describe the clinico-pathological features of a consecutive series of HPV-OED from a single institution to provide additional insight into the presentation and behaviour of this disease.
METHODS: Consecutive cases of HPV-OED were identified over a 20-year period from the pathology routine diagnostic archives of a single centre. Cases with features of viral cytopathic changes in a background of OED underwent HPV-specific testing in addition to p16 immunohistochemistry to confirm HPV positivity.
RESULTS: Fifty-three consecutive patients with HPV-OED were identified. The mean age at diagnosis was 55 years-old and there was a strong male predilection (83 %). Most patients were smokers or former smokers, and almost a fifth of individuals were Human Immunodeficiency Virus (HIV)-positive. The latero-ventral tongue was the most common index site. Twenty-eight percent of cases were associated with invasive oral squamous cell carcinoma. There was a statistically significant association between with patient's HIV status and malignant transformation (p = 0.022).
CONCLUSIONS: Findings from our cohort of HPV-OED patients suggests that malignant transformation is relatively frequent and associated with the HIV status of patients.

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