Oral and maxillofacial pathology
p16INK4 Expression is not associated with human papillomavirus in oral lichen planus

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Objective

Frequencies as high as 60% of overexpressed p16INK4 were recently reported in lichen planus (LP). Because p16INK4 overexpression may be a feature of human papilloma virus (HPV)–induced cancer, it has been postulated that LP may be somehow related to HPV. The present study is the first to evaluate both high p16INK4 expression and HPV in patients with LP.

Study Design

Thirty-five consecutive biopsy specimens from patients with LP constituted the basis of the present study. Level of p16INK4A expression was evaluated in each sample by immunohistochemical analysis, and the presence of HPV DNA was tested by real-time polymerase chain reaction (PCR).

Results

p16INK4 expression was detected in 26 specimens, whereas HPV was found in 4 lesions: 3 low-risk HPV and 1 high-risk HPV. All HPV-positive lesions also indicated p16INK4A overexpression, whereas 22 cases of overexpressed p16INK4A were HPV negative (Chi square 2.6; ns).

Conclusions

p16INK4 overexpression is not correlated with HPV in patients with LP.

Section snippets

Study population

Forty-seven consecutive biopsy specimens from patients with LP who presented to the section of Oral Sciences, Department of Neuromotor and Biomedical Sciences, of the University of Bologna, Italy, during the period January 1, 2001 to December 31, 2011 constituted the basis of the present study.

Samples were fixed in 4% formalin and paraffin-embedded according to a routine protocol. Serial 2-μm sections were obtained from each block and stained with hematoxylin and eosin for histologic evaluation.

Results

HPV DNA could not be amplified in 12 cases; thus the final population consisted of 35 patients (11 men and 24 women aged 28-81, mean 56.6 ± 12.2). p16INK4 expression (positive cells >5%) was detected in 26 (74%) specimens. Among them, 15 were collected from reticular LP and 11 from atrophic/erosive LP, indicating that p16INK4 was not associated with lesion morphology (Fisher's exact test .61; ns).

High-risk HPV DNA was found in a single specimen positive for HPV type 16. Consensus primers

Discussion

The specific role of HPVs in the development of premalignant and oral squamous cell carcinoma remains controversial.23, 63

In humans, HPVs have been classified as high-risk (HR) types (e.g., 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68, 73, 82), probable high-risk types (26, 53, 66), or low-risk (LR) types (e.g., 2,4, 6, 11, 13, 32, 40, 42, 43, 44, 54, 61, 70, 72, 81, CP6108) based on the affinity for tumor suppressor proteins and their association with cervical carcinoma.64 HPV proteins,

Conclusions

In conclusion, the present results suggest that no correlation exists between p16INK4 overexpression and the presence of HPV DNA in LP. They also offer further evidence that elevated p16INK4A expression in LP cannot serve as a useful marker to predict lesions at risk of malignant transformation.

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