Oral and Maxillofacial Surgery

, Volume 18, Issue 2, pp 165–172

The role of human papillomavirus in oral squamous cell carcinoma: myth and reality

Review Article



As the traditional risk factors for oral squamous cell carcinoma, especially tobacco, decline, new potential causative agents become the focus of research. Since the discovery of human papillomavirus (HPV) and its importance in carcinogenesis in cervical cancer, a lot of research has been undertaken to define its role in different types of cancer. In the present study, we evaluate the role of high-risk HPV types in initiation and progression of oral squamous cell carcinoma (OSCC) using a systematic review of the current literature.

Material and methods

A literature research with the search term “HPV oral squamous cell carcinoma” was performed via PubMed. Results were screened systematically for relevance and classified into the following categories: molecular biology, genetics, clinical aspects, and prevalence. Articles were then further analyzed to assess quality.


The literature research led to 527 results, with an overall HPV prevalence of 30.1 % in OSCCs. The most frequently identified subtypes were HPV-16 and HPV-18 (25.4 and 18.1 %, respectively). Prognostic relevance of HPV was discussed controversially. HPV detection via polymerase chain reaction is the most established method today. Molecular changes according to carcinogenic pathways described for cervix carcinoma were not routinely found in OSCC. In general, no definite role of high-risk HPV is currently deducible from the literature.


High-risk subtypes 16 and 18 are present in the genome in approximately one third of OSCC. Its role as a causative agent is less clear than the role in oropharyngeal tumors. The infection might not be the cause of carcinogenesis in a significant number of patients but may become proportionally more important with the decrease of the classical risk factors of tobacco and alcohol.


Human papillomavirus OSCC Oral squamous cell carcinoma Head and neck cancer 


  1. 1.
    Jemal A, Bray F, Center MM, Ferlay J, Ward E, Forman D (2011) Global cancer statistics. CA Cancer J Clin 61(2):69–90. doi:10.3322/caac.20107 PubMedCrossRefGoogle Scholar
  2. 2.
    Patel SC, Carpenter WR, Tyree S, Couch ME, Weissler M, Hackman T, Hayes DN, Shores C, Chera BS (2011) Increasing incidence of oral tongue squamous cell carcinoma in young white women, age 18 to 44 years. J Clin Oncol 29(11):1488–1494. doi:10.1200/JCO.2010.31.7883 PubMedCrossRefGoogle Scholar
  3. 3.
    Dürst M, Gissmann L, Ikenberg H, zur Hausen H (1983) A papillomavirus DNA from a cervical carcinoma and its prevalence in cancer biopsy samples from different geographic regions. Proc Natl Acad Sci U S A 80(12):3812–3815PubMedCentralPubMedCrossRefGoogle Scholar
  4. 4.
    Gillison ML, Koch WM, Capone RB, Spafford M, Westra WH, Wu L, Zahurak ML, Daniel RW, Viglione M, Symer DE, Shah KV, Sidransky D (2000) Evidence for a causal association between human papillomavirus and a subset of head and neck cancers. J Natl Cancer Inst 92(9):709–720PubMedCrossRefGoogle Scholar
  5. 5.
    zur Hausen H (2002) Papillomaviruses and cancer: from basic studies to clinical application. Nat Rev Cancer 2(5):342–350. doi:10.1038/nrc798 PubMedCrossRefGoogle Scholar
  6. 6.
    Stanley M (2010) Pathology and epidemiology of HPV infection in females. Gynecol Oncol 117(Suppl 2):S5–S10. doi:10.1016/j.ygyno.2010.01.024 PubMedCrossRefGoogle Scholar
  7. 7.
    Marur S, D’Souza G, Westra WH, Forastiere AA (2010) HPV-associated head and neck cancer: a virus-related cancer epidemic. Lancet Oncol 11(8):781–789. doi:10.1016/S1470-2045(10)70017-6 PubMedCrossRefGoogle Scholar
  8. 8.
    Chaturvedi AK, Engels EA, Anderson WF, Gillison ML (2008) Incidence trends for human papillomavirus-related and -unrelated oral squamous cell carcinomas in the United States. J Clin Oncol 26(4):612–619. doi:10.1200/JCO.2007.14.1713 PubMedCrossRefGoogle Scholar
  9. 9.
    Gillison ML, Broutian T, Pickard RK, Tong ZY, Xiao W, Kahle L, Graubard BI, Chaturvedi AK (2012) Prevalence of oral HPV infection in the United States, 2009–2010. JAMA 307(7):693–703. doi:10.1001/jama.2012.101 PubMedCrossRefGoogle Scholar
  10. 10.
    Pickard RK, Xiao W, Broutian TR, He X, Gillison ML (2012) The prevalence and incidence of oral human papillomavirus infection among young men and women, aged 18–30 years. Sex Transm Dis 39(7):559–566. doi:10.1097/OLQ.0b013e31824f1c65 PubMedCrossRefGoogle Scholar
  11. 11.
    Montaldo C, Mastinu A, Zorco S, Santini N, Pisano E, Piras V, Denotti G, Peluffo C, Erriu M, Garau V, Orru G (2010) Distribution of human papillomavirus genotypes in Sardinian patients with oral squamous cell carcinoma. Open Virol J 4:163–168. doi:10.2174/1874357901004010163 PubMedCentralPubMedCrossRefGoogle Scholar
  12. 12.
    Seraj JM, Yazdani N, Ashtiani ZO, Seraj SM, Hasheminasab SM, Memar B, Mirashrafi F, Borghei H, Yazdani J, Mostaan LV (2011) TP53 gene expression in HPV-positive oral tongue SCC and its correlation with nodal metastasis. Pathol Res Pract 207(12):758–761. doi:10.1016/j.prp.2011.09.013 PubMedCrossRefGoogle Scholar
  13. 13.
    Lee LA, Huang CG, Liao CT, Lee LY, Hsueh C, Chen TC, Lin CY, Fan KH, Wang HM, Huang SF, Chen IH, Kang CJ, Ng SH, Yang SL, Tsao KC, Chang YL, Yen TC (2012) Human papillomavirus-16 infection in advanced oral cavity cancer patients is related to an increased risk of distant metastases and poor survival. PLoS One 7(7):e40767. doi:10.1371/journal.pone.0040767 PubMedCentralPubMedCrossRefGoogle Scholar
  14. 14.
    Huang SF, Li HF, Liao CT, Wang HM, Chen IH, Chang JC, Chen YJ, Cheng AJ (2012) Association of HPV infections with second primary tumors in early-staged oral cavity cancer. Oral Dis 18(8):809–815. doi:10.1111/j.1601-0825.2012.01950.x PubMedCrossRefGoogle Scholar
  15. 15.
    Marques-Silva L, Farias LC, Fraga CA, de Oliveira MV, Cardos CM, Fonseca-Silva T, Gomes CC, De-Paula AM, Gomez RS, Guimaraes AL (2012) HPV-16/18 detection does not affect the prognosis of head and neck squamous cell carcinoma in younger and older patients. Oncol Lett 3(4):945–949. doi:10.3892/ol.2012.588 PubMedCentralPubMedGoogle Scholar
  16. 16.
    Duray A, Descamps G, Decaestecker C, Remmelink M, Sirtaine N, Lechien J, Ernoux-Neufcoeur P, Bletard N, Somja J, Depuydt CE, Delvenne P, Saussez S (2012) Human papillomavirus DNA strongly correlates with a poorer prognosis in oral cavity carcinoma. Laryngoscope 122(7):1558–1565. doi:10.1002/lary.23298 PubMedCrossRefGoogle Scholar
  17. 17.
    Chen YW, Kao SY, Yang MH (2012) Analysis of p16(INK4A) expression of oral squamous cell carcinomas in Taiwan: prognostic correlation without relevance to betel quid consumption. J Surg Oncol 106(2):149–154. doi:10.1002/jso.23067 PubMedCrossRefGoogle Scholar
  18. 18.
    Kozomara R, Jovic N, Magic Z, Brankovic-Magic M, Minic V (2005) p53 mutations and human papillomavirus infection in oral squamous cell carcinomas: correlation with overall survival. J Craniomaxillofac Surg 33(5):342–348. doi:10.1016/j.jcms.2005.05.004 PubMedCrossRefGoogle Scholar
  19. 19.
    Chuang AY, Chuang TC, Chang S, Zhou S, Begum S, Westra WH, Ha PK, Koch WM, Califano JA (2008) Presence of HPV DNA in convalescent salivary rinses is an adverse prognostic marker in head and neck squamous cell carcinoma. Oral Oncol 44(10):915–919. doi:10.1016/j.oraloncology.2008.01.001 PubMedCentralPubMedCrossRefGoogle Scholar
  20. 20.
    Sharma A, Mendez E, Yueh B, Lohavanichbutr P, Houck J, Doody DR, Futran ND, Upton MP, Schwartz SM, Chen C (2012) Human papillomavirus-positive oral cavity and oropharyngeal cancer patients do not have better quality-of-life trajectories. Otolaryngol Head Neck Surg 146(5):739–745. doi:10.1177/0194599811434707 PubMedCentralPubMedCrossRefGoogle Scholar
  21. 21.
    Elango KJ, Suresh A, Erode EM, Subhadradevi L, Ravindran HK, Iyer SK, Kuriakose MA (2011) Role of human papilloma virus in oral tongue squamous cell carcinoma. Asian Pac J Cancer Prev APJCP 12(4):889–896Google Scholar
  22. 22.
    Rades D, Seibold ND, Gebhard MP, Noack F, Schild SE, Thorns C (2011) Prognostic factors (including HPV status) for irradiation of locally advanced squamous cell carcinoma of the head and neck (SCCHN). Strahlenther Onkol 187(10):626–632. doi:10.1007/s00066-011-1139-8 PubMedCrossRefGoogle Scholar
  23. 23.
    Snietura M, Piglowski W, Jaworska M, Mucha-Malecka A, Wozniak G, Lange D, Suwinski R (2011) Impact of HPV infection on the clinical outcome of p-CAIR trial in head and neck cancer. Eur Arch Otorhinolaryngol 268(5):721–726. doi:10.1007/s00405-010-1396-7 PubMedCentralPubMedCrossRefGoogle Scholar
  24. 24.
    Zhao D, Xu QG, Chen XM, Fan MW (2009) Human papillomavirus as an independent predictor in oral squamous cell cancer. Int J Oral Sci 1(3):119–125. doi:10.4248/IJOS.09015 PubMedCentralPubMedCrossRefGoogle Scholar
  25. 25.
    Schwartz SR, Yueh B, McDougall JK, Daling JR, Schwartz SM (2001) Human papillomavirus infection and survival in oral squamous cell cancer: a population-based study. Otolaryngol Head Neck Surg 125(1):1–9. doi:10.1067/mhn.2001.116979 PubMedCrossRefGoogle Scholar
  26. 26.
    Laco J, Nekvindova J, Novakova V, Celakovsky P, Dolezalova H, Tucek L, Vosmikova H, Vosmik M, Neskudlova T, Cermakova E, Hacova M, Sobande FA, Ryska A (2012) Biologic importance and prognostic significance of selected clinicopathological parameters in patients with oral and oropharyngeal squamous cell carcinoma, with emphasis on smoking, protein p16(INK4a) expression, and HPV status. Neoplasma 59(4):398–408. doi:10.4149/neo_2012_052 PubMedCrossRefGoogle Scholar
  27. 27.
    Simonato LE, Garcia JF, Sundefeld ML, Mattar NJ, Veronese LA, Miyahara GI (2008) Detection of HPV in mouth floor squamous cell carcinoma and its correlation with clinicopathologic variables, risk factors and survival. J Oral Pathol Med Off Publ Int Assoc Oral Pathol Am Acad Oral Pathol 37(10):593–598. doi:10.1111/j.1600-0714.2008.00704.x Google Scholar
  28. 28.
    Oliveira LR, Ribeiro-Silva A, Ramalho LN, Simoes AL, Zucoloto S (2008) HPV infection in Brazilian oral squamous cell carcinoma patients and its correlation with clinicopathological outcomes. Mol Med Report 1(1):123–129Google Scholar
  29. 29.
    D’Souza G, Zhang HH, D’Souza WD, Meyer RR, Gillison ML (2010) Moderate predictive value of demographic and behavioral characteristics for a diagnosis of HPV16-positive and HPV16-negative head and neck cancer. Oral Oncol 46(2):100–104. doi:10.1016/j.oraloncology.2009.11.004 PubMedCentralPubMedCrossRefGoogle Scholar
  30. 30.
    Campisi G, Giovannelli L, Calvino F, Matranga D, Colella G, Di Liberto C, Capra G, Leao JC, Lo Muzio L, Capogreco M, D’Angelo M (2006) HPV infection in relation to OSCC histological grading and TNM stage. Evaluation by traditional statistics and fuzzy logic model. Oral Oncol 42(6):638–645. doi:10.1016/j.oraloncology.2005.11.007 PubMedCrossRefGoogle Scholar
  31. 31.
    Woods KV, Shillitoe EJ, Spitz MR, Schantz SP, Adler-Storthz K (1993) Analysis of human papillomavirus DNA in oral squamous cell carcinomas. J Oral Pathol Med Off Publ Int Assoc Oral Pathol Am Acad Oral Pathol 22(3):101–108Google Scholar
  32. 32.
    Ye D, Wei K, Zhang L, Jiang Q, Zhou X, Zhao Q, Zhong L, Zhang Z (2012) Inhibitory effect of the HPV-16mE6Delta/mE7/TBhsp70Delta vaccine on oral squamous cell carcinoma. Am J Med Sci. doi:10.1097/MAJ.0b013e3182574831
  33. 33.
    Ostwald C, Rutsatz K, Schweder J, Schmidt W, Gundlach K, Barten M (2003) Human papillomavirus 6/11, 16 and 18 in oral carcinomas and benign oral lesions. Med Microbiol Immunol 192(3):145–148. doi:10.1007/s00430-002-0161-y PubMedCrossRefGoogle Scholar
  34. 34.
    Gonzalez JV, Gutierrez RA, Keszler A, Colacino Mdel C, Alonio LV, Teyssie AR, Picconi MA (2007) Human papillomavirus in oral lesions. Medicina 67(4):363–368PubMedGoogle Scholar
  35. 35.
    Acay R, Rezende N, Fontes A, Aburad A, Nunes F, Sousa S (2008) Human papillomavirus as a risk factor in oral carcinogenesis: a study using in situ hybridization with signal amplification. Oral Microbiol Immunol 23(4):271–274. doi:10.1111/j.1399-302X.2007.00422.x PubMedCrossRefGoogle Scholar
  36. 36.
    Szarka K, Tar I, Feher E, Gall T, Kis A, Toth ED, Boda R, Marton I, Gergely L (2009) Progressive increase of human papillomavirus carriage rates in potentially malignant and malignant oral disorders with increasing malignant potential. Oral Microbiol Immunol 24(4):314–318. doi:10.1111/j.1399-302X.2009.00516.x PubMedCrossRefGoogle Scholar
  37. 37.
    Angiero F, Gatta LB, Seramondi R, Berenzi A, Benetti A, Magistro S, Ordesi P, Grigolato P, Dessy E (2010) Frequency and role of HPV in the progression of epithelial dysplasia to oral cancer. Anticancer Res 30(9):3435–3440PubMedGoogle Scholar
  38. 38.
    Sand L, Wallstrom M, Jalouli J, Larsson PA, Hirsch JM (2000) Epstein–Barr virus and human papillomavirus in snuff-induced lesions of the oral mucosa. Acta Otolaryngol 120(7):880–884PubMedCrossRefGoogle Scholar
  39. 39.
    Llamas-Martinez S, Esparza-Gomez G, Campo-Trapero J, Cancela-Rodriguez P, Bascones-Martinez A, Moreno-Lopez LA, Garcia-Nunez JA, Cerero-Lapiedra R (2008) Genotypic determination by PCR-RFLP of human papillomavirus in normal oral mucosa, oral leukoplakia and oral squamous cell carcinoma samples in Madrid (Spain). Anticancer Res 28(6A):3733–3741PubMedGoogle Scholar
  40. 40.
    Sugiyama M, Bhawal UK, Dohmen T, Ono S, Miyauchi M, Ishikawa T (2003) Detection of human papillomavirus-16 and HPV-18 DNA in normal, dysplastic, and malignant oral epithelium. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 95(5):594–600. doi:10.1067/moe.2003.36 PubMedCrossRefGoogle Scholar
  41. 41.
    Smith JF, Brownlow M, Brown M, Kowalski R, Esser MT, Ruiz W, Barr E, Brown DR, Bryan JT (2007) Antibodies from women immunized with Gardasil cross-neutralize HPV 45 pseudovirions. Hum Vaccin 3(4):109–115PubMedCrossRefGoogle Scholar
  42. 42.
    Castillo A, Koriyama C, Higashi M, Anwar M, Bukhari MH, Carrascal E, Mancilla L, Okumura H, Matsumoto M, Sugihara K, Natsugoe S, Eizuru Y, Akiba S (2011) Human papillomavirus in upper digestive tract tumors from three countries. World J Gastroenterol 17(48):5295–5304. doi:10.3748/wjg.v17.i48.5295 PubMedCentralPubMedCrossRefGoogle Scholar
  43. 43.
    Harris SL, Thorne LB, Seaman WT, Hayes DN, Couch ME, Kimple RJ (2011) Association of p16(INK4a) overexpression with improved outcomes in young patients with squamous cell cancers of the oral tongue. Head Neck 33(11):1622–1627. doi:10.1002/hed.21650 PubMedCrossRefGoogle Scholar
  44. 44.
    Lim KP, Hamid S, Lau SH, Teo SH, Cheong SC (2007) HPV infection and the alterations of the pRB pathway in oral carcinogenesis. Oncol Rep 17(6):1321–1326PubMedGoogle Scholar
  45. 45.
    Ishibashi M, Kishino M, Sato S, Morii E, Ogawa Y, Aozasa K, Kogo M, Toyosawa S (2011) The prevalence of human papillomavirus in oral premalignant lesions and squamous cell carcinoma in comparison to cervical lesions used as a positive control. Int J Clin Oncol Jpn Soc Clin Oncol 16(6):646–653. doi:10.1007/s10147-011-0236-0 CrossRefGoogle Scholar
  46. 46.
    Mukhopadhyay D, Chatterjee R, Chakraborty RN (1994) Association of p53 expression with cytokinetics and HPV capsid antigen prevalence in oral carcinomas. Cancer Lett 87(1):99–105PubMedCrossRefGoogle Scholar
  47. 47.
    Saini R, Tang TH, Zain RB, Cheong SC, Musa KI, Saini D, Ismail AR, Abraham MT, Mustafa WM, Santhanam J (2011) Significant association of high-risk human papillomavirus (HPV) but not of p53 polymorphisms with oral squamous cell carcinomas in Malaysia. J Cancer Res Clin Oncol 137(2):311–320. doi:10.1007/s00432-010-0886-8 PubMedCrossRefGoogle Scholar
  48. 48.
    Shin KH, Park KH, Hong HJ, Kim JM, Oh JE, Choung PH, Min BM (2002) Prevalence of microsatellite instability, inactivation of mismatch repair genes, p53 mutation, and human papillomavirus infection in Korean oral cancer patients. Int J Oncol 21(2):297–302PubMedGoogle Scholar
  49. 49.
    Cristina Mazon R, Rovigatti Gerbelli T, Benatti Neto C, de Oliveira MR, Antonio Donadi E, Guimaraes Goncalves MA, Garcia Soares E, Patricia Klay C, Tersariol I, Aparecida Pinhal M, Resende L, Pienna Soares C (2011) Abnormal cell-cycle expression of the proteins p27, mdm2 and cathepsin B in oral squamous-cell carcinoma infected with human papillomavirus. Acta Histochem 113(2):109–116. doi:10.1016/j.acthis.2009.08.008 PubMedCrossRefGoogle Scholar
  50. 50.
    Bhawal UK, Sugiyama M, Nomura Y, Kuniyasu H, Tsukinoki K (2008) Loss of 14-3-3 sigma protein expression and presence of human papillomavirus type 16 E6 in oral squamous cell carcinoma. Arch Otolaryngol Head Neck Surg 134(10):1055–1059. doi:10.1001/archotol.134.10.1055 PubMedCrossRefGoogle Scholar
  51. 51.
    Gonzalez-Moles MA, Rodriguez-Archilla A, Ruiz-Avila I, Gonzalez-Moles S, Marfil-Alvarez R (1996) Increase of proliferating cell nuclear antigen (PCNA) expression in HPV-18 positive oral squamous cell carcinomas. Acta Stomatol Belg 93(3):113–118PubMedGoogle Scholar
  52. 52.
    Boy S, Van Rensburg EJ, Engelbrecht S, Dreyer L, van Heerden M, van Heerden W (2006) HPV detection in primary intra-oral squamous cell carcinomas—commensal, aetiological agent or contamination? J Oral Pathol Med Off Publ Int Assoc Oral Pathol Am Acad Oral Pathol 35(2):86–90. doi:10.1111/j.1600-0714.2006.00385.x Google Scholar
  53. 53.
    Thomas J, Primeaux T (2012) Is p16 immunohistochemistry a more cost-effective method for identification of human papilloma virus-associated head and neck squamous cell carcinoma? Ann Diagn Pathol 16(2):91–99. doi:10.1016/j.anndiagpath.2011.09.002 PubMedCrossRefGoogle Scholar
  54. 54.
    Kingma DW, Allen RA, Caughron SK, Melby M, Moore WE, Gillies EM, Marlar RA, Dunn TS (2010) Comparison of molecular methods for detection of HPV in oral and oropharyngeal squamous cell carcinoma. Diagn Mol Pathol 19(4):218–223. doi:10.1097/PDM.0b013e3181d0cd35 PubMedCrossRefGoogle Scholar
  55. 55.
    Chaudhary AK, Pandya S, Mehrotra R, Bharti AC, Singh M (2010) Comparative study between the Hybrid Capture II test and PCR based assay for the detection of human papillomavirus DNA in oral submucous fibrosis and oral squamous cell carcinoma. Virol J 7:253. doi:10.1186/1743-422X-7-253 PubMedCentralPubMedCrossRefGoogle Scholar
  56. 56.
    Chang F, Syrjanen S, Nuutinen J, Karja J, Syrjanen K (1990) Detection of human papillomavirus (HPV) DNA in oral squamous cell carcinomas by in situ hybridization and polymerase chain reaction. Arch Dermatol Res 282(8):493–497PubMedCrossRefGoogle Scholar
  57. 57.
    Shroyer KR, Greer RO Jr (1991) Detection of human papillomavirus DNA by in situ DNA hybridization and polymerase chain reaction in premalignant and malignant oral lesions. Oral Surg Oral Med Oral Pathol 71(6):708–713PubMedCrossRefGoogle Scholar
  58. 58.
    Zeuss MS, Miller CS, White DK (1991) In situ hybridization analysis of human papillomavirus DNA in oral mucosal lesions. Oral Surg Oral Med Oral Pathol 71(6):714–720PubMedCrossRefGoogle Scholar
  59. 59.
    Miller CS, Zeuss MS, White DK (1994) Detection of HPV DNA in oral carcinoma using polymerase chain reaction together with in situ hybridization. Oral Surg Oral Med Oral Pathol 77(5):480–486PubMedCrossRefGoogle Scholar
  60. 60.
    Gillison ML, D’Souza G, Westra W, Sugar E, Xiao W, Begum S, Viscidi R (2008) Distinct risk factor profiles for human papillomavirus type 16-positive and human papillomavirus type 16-negative head and neck cancers. J Natl Cancer Inst 100(6):407–420. doi:10.1093/jnci/djn025 PubMedCrossRefGoogle Scholar
  61. 61.
    Andrews E, Seaman WT, Webster-Cyriaque J (2009) Oropharyngeal carcinoma in non-smokers and non-drinkers: a role for HPV. Oral Oncol 45(6):486–491. doi:10.1016/j.oraloncology.2008.07.008 PubMedCrossRefGoogle Scholar
  62. 62.
    Pannone G, Santoro A, Papagerakis S, Lo Muzio L, De Rosa G, Bufo P (2011) The role of human papillomavirus in the pathogenesis of head & neck squamous cell carcinoma: an overview. Infect Agent Cancer 6:4. doi:10.1186/1750-9378-6-4 PubMedCentralPubMedCrossRefGoogle Scholar
  63. 63.
    Anderson JA, Irish JC, McLachlin CM, Ngan BY (1994) H-ras oncogene mutation and human papillomavirus infection in oral carcinomas. Arch Otolaryngol Head Neck Surg 120(7):755–760PubMedCrossRefGoogle Scholar
  64. 64.
    da Silva CE, da Silva ID, Cerri A, Weckx LL (2007) Prevalence of human papillomavirus in squamous cell carcinoma of the tongue. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 104(4):497–500. doi:10.1016/j.tripleo.2007.04.028 PubMedCrossRefGoogle Scholar
  65. 65.
    Zhao R, Zhang WY, Wu MH, Zhang SW, Pan J, Zhu L, Zhang YP, Li H, Gu YS, Liu XZ (2009) Human papillomavirus infection in Beijing, People’s Republic of China: a population-based study. Br J Cancer 101(9):1635–1640. doi:10.1038/sj.bjc.6605351 PubMedCentralPubMedCrossRefGoogle Scholar
  66. 66.
    Jalouli J, Jalouli MM, Sapkota D, Ibrahim SO, Larsson PA, Sand L (2012) Human papilloma virus, herpes simplex virus and Epstein–Barr virus in oral squamous cell carcinoma from eight different countries. Anticancer Res 32(2):571–580PubMedGoogle Scholar
  67. 67.
    Williams HK (2000) Molecular pathogenesis of oral squamous carcinoma. Mol Pathol MP 53(4):165–172CrossRefGoogle Scholar
  68. 68.
    Ang KK, Harris J, Wheeler R, Weber R, Rosenthal DI, Nguyen-Tan PF, Westra WH, Chung CH, Jordan RC, Lu C, Kim H, Axelrod R, Silverman CC, Redmond KP, Gillison ML (2010) Human papillomavirus and survival of patients with oropharyngeal cancer. N Engl J Med 363(1):24–35. doi:10.1056/NEJMoa0912217 PubMedCentralPubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2012

Authors and Affiliations

  1. 1.Department of Oral and Maxillofacial SurgeryHeidelberg University HospitalHeidelbergGermany

Personalised recommendations