الفهرس 
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Abstract
Abstract : Background: Human papilloma virus (HPV) is a cause for oropharyngeal cancer, but the role of HPV in the oral squamous cell carcinoma (OSCC) remains controversial. The purpose of the present study is to detect the localization of HPV-16 virus in OSCC and to correlate HPV-16 positivity and p16 protein expression with the clinical and pathological features of OSCC. Methods: The archives of Oral Pathology at University of Florida, College of Dentistry were accessed for demographic, clinical, histopathological data, and slides of 114 consecutive cases of OSCC. The following information was obtained for each case: age, gender, oral site of SCC, smoking, alcohol consumption, and the degree of OSCC differentiation. The samples were categorized into well differentiated, moderately differentiated, and poorly differentiated. HPV-16 infection positivity of OSCC was evaluated by p16 immunohistochemistry (IHC) and HPV-16 E6/E7mRNA by in situ hybridization (ISH). Results: Out of 114 OSCC patients, 16 (14%) showed positivity for p16 by IHC, 14 (12%) showed HPV-16 E6/E7mRNA ISH positivity with the predominance of females and patients older than 60 years. The HPV status showed significant correlation with the patients’ age, alcohol consumption, and the degree of OSSC differentiation (p<0.05). The palate showed the highest proportion of p16 positivity detected by IHC (38%) as well as HPV-16 E6/E7 mRNA ISH (36%) followed by the tongue. p16 IHC revealed a high sensitivity (87.5%) and specificity (98.04%) with accuracy of (96.61%) for HPV-16 E6/E7mRNA expression in OSCC. Conclusion: We support that p16 IHC is an accepted surrogate diagnostic biomarker for HPV status for OSCC. However, for detection of HPV-16 subtype, we recommend incorporation of HPV-16 E6/E7mRNA ISH in addition to p16 IHC. This approach is very practical and should be readily implemented in most diagnostic pathology laboratories. Our results showed that HPV-16 might be involved in oral carcinogenesis which necessitates HPV screening of patient at risk for better prognosis and earlier treatment while it showed higher correlation with older age patients, alcoholism and the higher degree of OSCC differentiation.