Association of Epstein-Barr virus infection with oral squamous cell carcinoma in a case-control study

J Oral Pathol Med. 2015 Apr;44(4):252-7. doi: 10.1111/jop.12231. Epub 2014 Aug 28.

Abstract

Background: Besides the well-known risk factors, Epstein-Barr virus (EBV) might play a significant role in oral squamous cell carcinoma (OSCC). To explore the role of EBV in OSCC, the prevalence of EBV infection in oral exfoliated cells of OSCC cases and controls in northeastern Thailand was investigated, and the association of EBV in tumor lesion cells was further confirmed.

Methods: Oral exfoliated cells were collected from OSCC cases and non-cancer controls. Cells from tumor lesions were taken from OSCC patients for further strong confirmation of the association of EBV with OSCC. EBV DNA was detected by polymerase chain reaction (PCR) using primers specific for EBV DNA polymerase. The EBV DNA positive samples were confirmed further by nested PCR.

Results: Epstein-Barr virus was detected in the oral exfoliated cells of 45.05% of OSCC patients and 18.08% of the non-cancer control (P < 0.001). Similarly, EBV was detected in 32.5% of the tumor lesions. Betel quid chewing was statistically significantly associated with EBV prevalence (OR = 2.08), whereas no association with tobacco smoking and alcohol consumption. Alcohol consumption and betel quid chewing were significantly associated with OSCC (OR = 3.05 and OR = 5.05, respectively), but tobacco smoking was not associated. Interestingly, EBV was significantly associated with OSCC (OR = 3.76).

Conclusions: Epstein-Barr virus prevalence is associated with OSCC and seems to be enhanced by betel quid chewing, suggesting that EBV may, together with betel quid chewing, act as an important etiological risk factor of OSCC.

Keywords: Epstein-Barr virus; oral squamous cell carcinoma; risk factors.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Alcohol Drinking / epidemiology
  • Areca
  • Carcinoma, Squamous Cell / epidemiology*
  • Carcinoma, Squamous Cell / virology*
  • Case-Control Studies
  • DNA, Viral / analysis
  • DNA, Viral / genetics
  • Epstein-Barr Virus Infections / epidemiology*
  • Epstein-Barr Virus Infections / pathology
  • Female
  • Head and Neck Neoplasms / epidemiology*
  • Head and Neck Neoplasms / virology*
  • Herpesvirus 4, Human / genetics
  • Herpesvirus 4, Human / isolation & purification*
  • Humans
  • Male
  • Middle Aged
  • Mouth Neoplasms / epidemiology*
  • Mouth Neoplasms / virology*
  • Odds Ratio
  • Polymerase Chain Reaction
  • Prevalence
  • Risk Factors
  • Smoking / epidemiology
  • Squamous Cell Carcinoma of Head and Neck
  • Thailand / epidemiology

Substances

  • DNA, Viral