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The presence of human papillomavirus (HPV) in two groups of oral squamous cell carcinoma (OSCC) from Sri Lanka were analyzed by PCR and direct cycle sequencing using consensus GP5+/6+ primers. The two groups of OSCC specimens analyzed were 68 formalin-fixed paraffinembedded surgical specimens and 34 formalin-fixed unembedded biopsies. Twenty-five patients from the latter group were habitual betel quid chewers. The HPV prevalence of the overall sample was 38/102 (37.2%). However, HPV was detected in significantly higher rate from formalin-fixed unembedded biopsies (61.7%) compared to paraffin embedded surgical specimens (25%) (p<0.0003). Upon sequencing, high-risk HPV types, 16,18, 45 and 66 were detected in 65% of the HPV infected tumors. Moreover, HPV was detected at significantly higher rates from small primary tumors (T1&T2) (75%) compared to large primary tumors (T3&T4) (30%) (p<0.025). However, no correlation existed between other clinico-pathological variables such as age, gender, sites, habits or histological differentiation and HPV detection when analyzed statistically using Pearson's chi-square test (at 5% level of significance). In conclusion, high prevalence of HPV in formalin fixed-unembedded OSCC biopsies from Sri Lanka indicate that, in addition to betel quid, viral infection may play a role in oral carcinogenesis and support the multi-factor model for oral cancer causation.

Human Papillomavirus in Oral Cancer from Sri Lanka: Prevalence and relationship with clinico-pathological parameters.