HPV and oral lesions: preventive possibilities, vaccines and early diagnosis of malignant lesions

Abstract

SUMMARYThe importance of HPV in world healthy is high, in fact high-risk HPV types contribute significantly to viral associated neoplasms.In this article we will analyze vary expression of HPV in oral cavity both benign and malignant, their prevalence and the importance in early diagnosis and prevention. The classical oral lesions associated with human papillomavirus are squamous cell papilloma, condyloma acuminatum, verruca vulgaris and focal epithelial hyperplasia. Overall, HPV types 2, 4, 6, 11, 13 and 32 have been associated with benign oral lesions while HPV types 16 and 18 have been associated with malignant lesions, especially in cancers of the tonsils and elsewhere in the oropharynx. Transmission of the virus can occur with direct contact, genital contact, anal and oral sex; latest studies suggest a salivary transmission and from mother to child during delivery. The number of lifetime sexual partners is an important risk factor for the development of HPV-positive head-neck cancer. Oral/oropharyngeal cancer etiologically associated with HPV having an increased survival and a better prognostic (85%-90% to five years). There is no cure for the virus. There are two commercially available prophylactic vaccines against HPV today: the bivalent (16 and 18) Cervarix® and the tetravalent (6,11, 16 and 18) Gardasil® and new vaccine Gardasil 9 (6,11,16,18,31,33, 45, 52, 58) was approved in the United States. To be effective, such vaccination should start before "sexual puberty". The vaccine could be an important preventive strategy, in fact the scientific community is in agreement on hypothesis that blocking the contagion it may also limit the distance complications as the oropharyngeal cancer.

Oral squamous papilloma: a view under clinical, fluorescence and histopathological aspects

“…Oral lesions by HPV have been associated with an increased risk of developing oral cancer. (1)(2)(3)(4)(5)(6) Therefore, early diagnosis is fundamental for an adequate and less invasive treatment. (4) However, Shin et al, and Lane et al, reported the challenging of identifying and diagnosing the differential between oral lesions, especially in the early stages when they may present clinical similarity.…”

“…Oral squamous papilloma is a benign tumor and its pathogenesis has been associated with human papillomavirus (HPV) infection. (1)(2)(3)(4)(5) The HPV einstein (São Paulo). 2019;17(2):1-4 infection is one of the risk factors associated with the development of cervical, anogenital, pharynx, larynx and oral cavity carcinomas.…”

“…(2)(3)(4)(5)(6) Transmission of the virus can occur by direct contact with lesions, sexual intercourse or from mother to child during delivery. (1)(2)(3)(4)(5)(6) The classic clinical presentation of oral squamous papilloma can be described as an exophytic growth, with a rough surface that appears a cauliflower-like and, depending on the degree of keratinization, the lesion may be white, pink and/or red. (3,4) The lesion can affect any oral region, being more common on the tongue, lip, uvula and soft palate.…”

“…(1)(2)(3)(4)(5)(6) The classic clinical presentation of oral squamous papilloma can be described as an exophytic growth, with a rough surface that appears a cauliflower-like and, depending on the degree of keratinization, the lesion may be white, pink and/or red. (3,4) The lesion can affect any oral region, being more common on the tongue, lip, uvula and soft palate. (1,3) The diagnosis is clinical and histopathological.…”

“…(1,3) The diagnosis is clinical and histopathological. (1)(2)(3)(4) The treatment of choice for oral squamous papilloma is the surgical removal. (1)(2)(3) Otherwise, widefield optical fluorescence imaging devices have been developed for use as a complementary examination to the traditional clinical examination for screening of oral lesions.…”