Human papillomavirus infection and premalignant lesions of the oral cavity: A cross-sectional study in Allahabad, North India


Dr Mamta Singh, Departmant of Pathology, M.L.N. Medical College, Allahabad 211001, India. Email:


Aim:  To assess the role of human papillomavirus (HPV) in premalignant lesions of the oral cavity using the second-generation Hybrid Capture assay kit (Digene Corporation) and to study the correlation between this technique and morphological changes (koilocytosis) on histopathology in those lesions.

Methods:  A hospital-based cross-sectional study was undertaken including 92 patients with premalignant lesions of the oral cavity (the study group) and a control group of 35 patients with no oral disease. All the participants were interviewed regarding possible risk factors. Oral exfoliated cells in the saliva were tested for HPV DNA using an HPV RNA probe of 13 high-risk HPV genotypes (16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59 and 68). Simultaneously biopsy specimens of the lesions were examined under a light microscope for evidence of koilocytosis, an empirical marker for HPV infection. Pearson's χ2 test using SPSS V.16 was applied for statistical analysis.

Results:  HPV DNA was detected in 44.6% of the study group (41 out of 92), and 14.3% of the controls (five out of 35). The association was independent of the influence of betel quid and tobacco chewing, two established causal factors for oral pre-cancers. Out of the total 92 participants in the study group there was evidence of koilocytosis on the histological sections of 42 individuals (45.6%).

Conclusion:  The results support a strong association between HPV infection and oral premalignant lesions, particularly oral lichen planus and squamous papilloma. Koilocytosis on histology is a good predictor of HPV infection.