Current aspects of the clinic, diagnosis and treatment of HPV-related benign oral lesions

Abstract

Human papillomavirus (HPV) exhibits specific tropism for squamous epithelium and therefore contributes to the development of many benign, potentially malignant, and malignant epithelial lesions. The benign HPV-related lesions of the oral cavity comprise verruca vulgaris, squamous papilloma, condyloma acuminatum and multifocal epithelial hyperplasia. Oral squamous papilloma is most common in people of various ages.

Purpose: To determine the structure, clinical features and morphological signs of oral squamous papilloma in patients of different sex and age.

Materials and methods. For the period of 2020-2023, 18 people with oral papilloma (papillomatosis) aged 15 to 70 years were examined. In 12 patients, papilloma was removed by conventional surgery, in 6 patients – using a high power diode laser. Pathohistological evaluation of excisional biopsy and identification/genotyping of HPV DNA by REAL TIME PCR was carried out.

Results. Squamous papilloma dominates in the structure of HPV-related benign oral lesions (88.8%). Among patients with papilloma, the majority are women (72.2%) with an average age of 29.3±4.0 years. The average age of men with papilloma is 52.2±5.8 years. By localization in the oral cavity, papillomas are most often found on the gingiva (43.75%), as well as on the tongue (25%), on the soft palate (18.75%), on the mucous membrane of the upper lip (6.25%) and cheek (6.25%). The average papilloma size by diameter was 0.71±0.06 cm. Pathomorphological confirmation of the impact of HPV on the development of oral squamous papilloma, namely the presence of coylocytes, was obtained in 31.3% of excision biopsies. Hyperkeratosis of the covering epithelium was found in 5 patients (27.7%), and this condition is defined as  “keratopapiloma.” In 6 women (33.3%), the presence of various types of HPV was detected by PCR, including high oncogenic risk (HPV-16, 18, 66, 68).

Conclusion. Oral squamous papilloma, associated with high oncogenic risk HPV, as well as keratopapilloma in heavy smokers, should be considered a precancerous disease of the oral mucosa with a high risk of malignancy.