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Oral Path 2, Exam 4 > HPV-Related Cancers > Flashcards

HPV-Related Cancers Flashcards

1
Q

True/False: All HPV types are sexually transmitted

A

False - HPV 6, 11 (squamous papilloma) and HPV 2 (non-genital warts) are not sexually transmitted

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2
Q

True/False: All HPV types are low risk for cancer

A

False - some types are low risk and some are high

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3
Q

Which HPV types are high risk for cancer?

A

HPV 16, 18

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4
Q

Which HPV types are sexually transmitted

A

HPV 6, 11

HPV 16, 18

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5
Q

Most common soft tissue mass arising from the soft palate

A

Squamous papilloma

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6
Q

Lesion that is exophytic with fingerlike projections giving a “cauliflower” or “wart-like” appearance

A

Squamous papilloma

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7
Q

Sessile

A

Base is the widest part of the lesion

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8
Q

Pedunculated

A

Base is narrower than the widest part of the lesion

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9
Q

Squamous papilloma has ___ (high/low) infectivity and ____ (high/low) virulence

A

Low, Low

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10
Q

What determines the color of squamous papilloma?

A

The amount of keratin

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11
Q

Treatment for squamous papilloma

A

Conservative excision

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12
Q

Prognosis for squamous papilloma

A

Recurrence is unlikely and spontaneous remission is possible

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13
Q

Dermatologic term for common wart

A

Verruca vulgaris

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14
Q

True/False: Verruca vulgaris is contagious

A

True

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15
Q

Verruca vulgaris is extremely common on the ___, especially the ____

A

Skin

Hand

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16
Q

Where are oral lesions of verruca vulgaris typically seen?

A

Vermilion border, labial mucosa, anterior tongue

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17
Q

Treatment for verruca vulgaris skin lesions

A

Topical therapies, surgery

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18
Q

Treatment for verruca vulgaris oral lesions

A

Surgery, laser, cryotherapy, electrosurgery

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19
Q

Prognosis for verruca vulgaris

A

May recur, spontaneous remission possible

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20
Q

Most common sexually transmitted infection in the US

A

HPV

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21
Q

HPV ___ and ___ are high risk and implicated in cancers

A

16 and 18

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22
Q

Low risk sexually transmitted infection

A

Condyloma acuminatum

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23
Q

Venereal warts

A

Condyloma acuminatum

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24
Q

Venereal warts are larger than ____ (~1 cm but up to 3cm) and there are often ____

A

Papillomas

Multiple

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25
Q

Treatment for venereal warts

A

Excision, cryotherapy, laser, (topical agent for anogenital lesions)

26
Q

Anogenital condylomata infected with HPV 16, 18 have a higher risk for…

A

Malignant transformation to SCC

27
Q

45% of American adults have ____ HPV

28
Q

What is an HPV infection?

A

HPV enters epithelial cells and infects the basal cells

29
Q

What is an HPV infection?

A

Terminal differentiation of infected keratinocytes

30
Q

What do mutations lead to?

A

Pre-cancerous and then cancerous transformation

31
Q

Are most HPV infections symptomatic or asymptomaticc?

A

Asymptomatic

32
Q

T/F: Over 90% of HPV infections are cleared by the body within 2-3 years

33
Q

T/F: Some HPV infected cells never remain latent

A

False: Some remain latent for decades

34
Q

HPV latent infections have ____ (high/low) replication, _____ (high/minimal) viral protein expression, lack of immune clearance, and persistent _____ up to 20 yrs.

A

Low
Minimal
Persistent

35
Q

High-risk HPV types make what 4 proteins?

A

E6, E7, L1, L2

36
Q

Which 2 proteins allow the cell to grow in an uncontrolled manner and avoid cell death

37
Q

Which 2 proteins compromise the virus capsid (shell) required for virus transmission, spread and survival

38
Q

Which 2 proteins are involved in early HPV protein production? Late?

A

Early - E6, E7

Late - L1, L2

39
Q

What cancer is the most highly caused by HPV? Second most?

A

Most - Anal cancer (95%)

2nd most - Oropharyngeal and Cervical cancer (~70%)

40
Q

How do you differentiate between oral and oropharyngeal cancer?

A

Based on anatomic location

41
Q

Where are oral cancers located?

A

Anterior to the tonsillar pillars

42
Q

T/F: HPV is a risk factor for Oral Squamous Cell Carcinoma

A

False - there is no evidence to support this

43
Q

Where are oropharyngeal cancers located?

A

Base of the tongue, soft palate, palatine tonsils, and the pharyngeal wall

44
Q

Both Oral and Oropharyngeal Squamous Cell Carcinoma have a ____ predilection

45
Q

What is the etiology of OSCC? What about OPSCC?

A

OSCC - Smoking, alcohol

OPSCC - More sexual partners (some HPV+)

46
Q

Most patients with OPSCC have sexual partners with HPV. What form?

47
Q

Clinical presentation for OSCC? OPSCC?

A

OSCC - Leuko/Erythro/Erythroleukoplakia

OPSCC - Enlarged lymph node in neck, dysphagia, initially asymptomatic

48
Q

Is the incidence of OSCC increasing or decreasing? OPSCC?

A

OSCC - Decreasing

OPSCC - Increasing

49
Q

Which has a better survival rate? OSCC or OPSCC?

50
Q

Why did the incidence of HPV+ oropharyngeal cancers increase, but the HPV- oropharyngeal cancers decreased (smoking)?

A

Increase in oral sexual behavior

Decrease in tobacco use

51
Q

T/F: HPV-16 infection is not characterized by the presence of HPV-16 alone

52
Q

What 2 other qualifications characterize an HPV-16 infection?

A
  1. E6, E7 in the tumor cells expressed AND

2. Serum presence of E6, E7 antibodies

53
Q

Treatment for early HPV + OPSCC? Late?

A

Early: Platinum-based chemoradiotherapy and surgery
Late: Surgery, chemotherapy, radiation

54
Q

What is the prognosis for HPV + OPSCC?

A

Good - comorbidities have negative effects

55
Q

From best to worst, rank the prognosis for HPV + and - in smokers and non-smokers

A

HPV+, non-smoker
HPV+, smoker
HPV-, non-smoker
HPV-, smoker

56
Q

Why is HPV testing important in oropharyngeal squamous cell carcinoma?

A

To ID patients that should have treatment de-escalated

57
Q

HPV+ in OPSCC has a ___ (improved/worsened) survival, ___ (better/fewer) genetic alterations, and ___ (better/worse) response to therapy

A

Improved
Fewer
Better

58
Q

2 things that vaccines prevent in both males and females?

A
  1. Genital warts

2. Epithelial dysplasia and anal cancer

59
Q

T/F: Vaccines provide protection against diseases due to all HPV types

60
Q

Do HPV vaccines protect patients that have already been exposed?

61
Q

Are vaccines a treatment for genital warts or HPV-related cancer?

Oral Path 2, Exam 4 (6 decks)

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