Surrogate Markers for High Risk Human Papillomavirus Infection in Oral Epithelial Dysplasia: A Comparison of p16, Ki-67 and ProExC

Objective To determine the utility of surrogate markers of human papillomavirus (HPV) infection in the diagnosis of HPV associated oral epithelial dysplasia (OED). Study design Twelve cases of oral dysplasia with histologic features of HPV infection were stained with surrogate markers for HPV (p16, Ki-67 and ProExC) by immunohistochemistry. A second group of twelve cases of oral dysplasia without histologic features of HPV infection was used for comparison. Reverse transcriptase polymerase chain reaction (PCR) was used to confirm the presence of high risk HPV in p16 positive cases. Results All of the surrogate markers showed a statistically significant association with HPV positive OED (p Conclusions The clinicopathologic features of 12 additional cases of HPV OED are reported. Diffuse p16 positivity is an accurate and reliable method for predicting HR HPV infection in both high and low grade cases of epithelial dysplasia with histopathologic features of HPV OED. The use of Ki-67 and ProExC did not demonstrate any additional diagnostic benefit in the diagnosis HPV OED.