HPV detection in primary intra‐oral squamous cell carcinomas – commensal, aetiological agent or contamination?

Background: High-risk human papilloma viruses (HPV) are reported to be significant independent risk factors for oral squamous cell carcinoma (OSCC). The prevalence of HPV in OSCC in a South African population sample was evaluated comparing three different HPV detection methods. Methods: Tumour and adjacent morphologically normal oral mucosa of 59 resections of primary OSCC were evaluated for the presence of HPV using real-time polymerase chain reaction (PCR), conventional in situ hybridization (ISH), and a signal amplification ISH technique (Dako GenPoint TM ). Results: HPV18 DNA was detected in seven cases using real-time PCR. No positivity was found with the other two ISH techniques. Conclusions: We support the view that HPV is probably unimportant in the pathogenesis of OSCC and hypothesize HPV detection techniques as the main reason for the positive results in many studies. Realtime PCR was confirmed as the most sensitive technique, but researchers are urged to incorporate strict internal controls when using this detection method.