Immunohistochemical Expression of Epstein-Bar Virus in Biopsies Bearing Oral Squamous Cell Carcinoma

Abstract

Background: Oral Squamous cell carcinoma is the sixth most common cancer across the world. In Pakistan oral squamous cell carcinoma ranks second among all cancer in both men and women. Several risk factors of oral squamous cell carcinoma have been established which includes; smoking, alcohol, betel quid and Human Papilloma Virus infection. Epstein-Bar virus has been recently linked with development of oral squamous cell carcinoma in multiple studies. We therefore, attempt to investigate the expression of Epstein-Bar virus in oral squamous cell carcinoma biopsy samples using immunohistochemistry. Methods: A total of 150 biopsy proven oral squamous cell carcinoma cases were investigated for expression of Epstein-Bar virus protein using immunohistochemistry. The data were then compared for association with age, gender and biological behavior of oral squamous cell carcinoma. Results: 34 out of 150 samples were positive for Epstein-Bar virus infection. Most of the positive cases were males and predominantly affected buccal mucosa for neoplastic lesions. Most well known risk factors of the disease was significantly associated with EBV. Uniform distribution of EBV and different morphological patterns of oral squamous cell carcinoma was also observed. Conclusion: Epstein-Bar virus may be considered as a risk factor in etiopathogenesis of all forms of oral squamous cell carcinoma. We suggest that oncogenic effect of EBV may be enhanced by other chemical carcinogens; although more investigation is needed on a large series of cohort to confirm these findings.