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Observational Study
. 2021 Oct;7(5):914-923.
doi: 10.1002/cre2.435. Epub 2021 Jun 8.

Human papillomavirus, Epstein-Barr virus, and Candida albicans co-infection in oral leukoplakia with different degrees of dysplasia

Alveiro T Erira  1 , Andrea Fernanda Romo Navarro  1 , Dabeiba Adriana García Robayo  2
Affiliations
Observational Study

Human papillomavirus, Epstein-Barr virus, and Candida albicans co-infection in oral leukoplakia with different degrees of dysplasia

Alveiro T Erira et al. Clin Exp Dent Res. 2021 Oct.

Abstract

Objectives: To identify human papillomavirus (HPV), Epstein-Barr virus (EBV), and Candida albicans in oral leukoplakia with different degrees of dysplasia.

Materials and methods: An observational, cross-sectional, descriptive study was performed using 30 formalin-fixed and paraffin-embedded tissues from patients with clinical suspicion of leukoplakia and confirmed diagnosis of oral dysplasia. Histological analyses were performed by two pathologists (interobserver) and dysplasias were classified as mild, moderate, or severe. Conventional PCR was used to detect HPV and EBV viruses and C. albicans. To determine the association between each microorganism with different degrees of dysplasia a Chi-square test was employed.

Results: The tongue was the most common site for leukoplakias (71.4%) in females with a mean age of 50 years (ranging between 30 to 50 years old; 57.1%). EBV was the most frequently detected (73.3%), followed by HPV (43.3%), mainly of type 16 (40%), and C. albicans (23.3%). Significant differences were observed between degrees of dysplasia and HPV presence (p = 0.005). In lesions positive for HPV, EBV, and C. albicans the most frequent histological changes were hyperkeratosis, irregular interpapillary ridges, and loss of basal stratum cell polarity.

Conclusion: Co-infection with human papillomavirus, Epstein Barr virus, and Candida albicans in oral leukoplakia could be associated with dysplastic changes.

Keywords: Candida albicans; Epstein-Barr virus; Human papillomavirus; dysplasia; leukoplakia.

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Conflict of interest statement

The authors declare there is no conflict of interest.

Figures

FIGURE 1
FIGURE 1
Irregular ridges (drop‐shaped rete ridges) H&E 10×, severe dysplasia
FIGURE 2
FIGURE 2
Cells with koilocytic appearance. H&E 40×, moderate grade dysplasia
FIGURE 3
FIGURE 3
(a) Severe loss of epithelial adhesion and islets of connective tissue in the epithelium; (b) keratin pearls within rete pegs. H&E 10×, moderate grade dysplasia
FIGURE 4
FIGURE 4
(a) Acanthosis; (b) hyperkeratosis. H&E 10×, moderate grade dysplasia
FIGURE 5
FIGURE 5
(a) Cellular and nuclear pleomorphism. (b) Loss of polarity of basal cells. (c) Nuclear hyperchromatism. H&E 10×, moderate grade dysplasia
See this image and copyright information in PMC

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