A Retrospective 20-Year Analysis of Proliferative Verrucous Leukoplakia and Its Progression to Malignancy and Associatio
- PDF / 1,771,017 Bytes
- 11 Pages / 595.276 x 790.866 pts Page_size
- 23 Downloads / 148 Views
ORIGINAL PAPER
A Retrospective 20-Year Analysis of Proliferative Verrucous Leukoplakia and Its Progression to Malignancy and Association with High-risk Human Papillomavirus Jasbir D. Upadhyaya1 · Sarah G. Fitzpatrick1 · Mohammed N. Islam1 · Indraneel Bhattacharyya1 · Donald M. Cohen1 Received: 10 November 2017 / Accepted: 5 February 2018 © Springer Science+Business Media, LLC, part of Springer Nature 2018
Abstract Proliferative verrucous leukoplakia (PVL) is defined as an aggressive, relentless and recalcitrant form of leukoplakia that has a high propensity for malignant transformation. The aim of this study was to evaluate the malignant potential of PVL and determine its possible association with high-risk human papillomavirus (HPV). Twenty cases with a clinical and biopsy proven diagnosis of PVL were collected from the University of Florida Oral Medicine clinic database. Immunohistochemistry was performed to evaluate the expression of p 16INK4A and p53 genes in the PVL lesions. The lesions were also tested for high-risk HPV by DNA in-situ hybridization. The average age of the patients at the time of first biopsy was 62.7 years. Most patients had multiple sites of involvement, gingiva being the most common location. The lesions progressed to malignancy in approximately 50% of patients. The expression of p16INK4A gene was considered negative, with at least a 50–65% immunoreactivity observed in only three cases that progressed to malignancy. No expression of high-risk HPV was detected, whereas p53 staining was positive in less than 25% of the cells demonstrating gene expression. No definite association between PVL and high-risk HPV infection could be established. Due to the high transformation potential of PVL, early recognition with aggressive treatment, including multiple biopsies, and continued close clinical follow-up, remain the mainstay of favorable management of this condition. Keywords Proliferative verrucous leukoplakia · Verrucous hyperplasia · Verrucous carcinoma · Squamous cell carcinoma · P16INK4A · Human papillomavirus
Introduction Proliferative verrucous leukoplakia (PVL) is an aggressive form of leukoplakia which has a higher propensity for malignant transformation [1], thus warranting special attention. PVL was first introduced into the literature by Hansen et al. in 1985 [1]. The World Health Organization (WHO) defined PVL as “a distinct and aggressive form of oral leukoplakia that potentially is a malignant disorder” exhibiting This study was presented at the American Academy of Oral and Maxillofacial Pathology (AAOMP) annual meeting in April 2017 at Newport, Rhode Island. * Jasbir D. Upadhyaya [email protected] 1
Department of Oral and Maxillofacial Diagnostic Sciences, University of Florida College of Dentistry, 1395 Center Drive, Gainesville, FL 32610, USA
high recurrence and malignant transformation rates [2]. Initially, it presents as a focal flat white lesion, which gradually spreads to become multifocal and diffuse. Over varying periods of time, the lesions become exophyt
Data Loading...
