infectious agents and oral cancer Flashcards
which subtype of HPV affects the oral mucosa?
beta
what is the most common tumour from HPV?
benign papilloma’s
caused by direct contact
mostly asymptomatic unless large
what are the higher risk types of HPV associated with mouth cancer?
HPV 16
HPV 18
what types of HPV are not associated with malignancy?
low risk types
oncogenic property of HPV
? binds to ? and marks it for destruction by the ?
? binds and inactivates tumour suppressor gene product, ?
Means cells continue to ?
E6
p53
ubiquitin pathway
E7
retinoblastoma protein pRB
proliferate
HPV infection
HPV molecule binds to ??? on cell surface
it is ? becoming an ? then ??
Virus ? and ?? complexed with ? is released
??? traffics through the cytoplasm and enters the nucleus
Whole process takes ?
Once in nucleus it complexes with ? and ? begins
heparin suphate proteoglycan
endocytosed
endosome
late endosome
uncoats
viral genome
L2
L2 genome complex
24hrs
ND10
RNA transcription
name 2 benign oral HPV lesions (low risk HPV types)
papilloma
condylomata
what is a common location for a papilloma?
soft palate caused by sexual contact
what is the treatment for a papilloma?
excision
condylomata tends to be seen clinically in what?
multiples
condylomata is spread through what?
sexual contact
what is the treatment for condylomata?
excision
what is the type of cancer associated with high risk types of HPV?
squamous cell carcinoma
what are the symptoms of a squamous cell carcinoma?
generally asymptomatic
what is a high risk site in the mouth for squamous cell carcinoma?
Lingual gutter as saliva naturally pools here so carcinogens can sit in direct contact with the mucosa
define exophytic
tumour grows outwards
define endophytic
tumour invading the underlying structures
if a tumour is described as indurated, what does this mean?
tumour feels hard and rubbery to touch
name 2 risk factors for HPV
Number of sexual partners
Weakened immune system
how is HPV detected?
Incisional biopsy with either P16 staining (dark brown) or in-situ hybridisation
Three vaccines that cover different HPV types, 2 doses 6-12months apart. but them in order from the one that covers the least types to the most types
quadrivalen gardasil
bivalent cervarix
nonvalent gardasil
bivalent cervarix (least)
quadrivalent gardasil
nonvalent gardasil (most)
the HPV vaccines are available on the NHS to whom?
all girls <26
gay men
name the cancer associated with EBV
Burkitt’s lymphoma
what is EBV associated with? Non-malignant
infectious mononucleosis
what is Burkitt’s lymphoma?
B cell lymphoma of the nasopharynx
how does HIV link to cancer?
Weakens the immune system so body is less able to fight off infections that cause cancer
what is the treatment for HIV?
combination of antiviral drugs
Potential cure with stem cell transplant
what malignant lesions are linked to HIV?
Kaposi sarcoma
lymphomas
name 6 oral symptoms of HIV
candidiasis (fungal infection)
hairy leukoplakia
accelerated periodontal disease
Kaposi’s sarcoma
salivary gland disease
oral ulcers
other than malignant lesions what other oral condition is common in HIV?
Pseudomembranous candidiasis - thrush
Pseudomembranous candidiasis - thrush is common in what kind of patients?
immunocompromised
describe the appearance of Pseudomembranous candidiasis - thrush
Can wipe off the white stuff leaving a red angry appearance underneath
Kaposi’s sarcoma is caused by what Herpes virus?
Herpes virus 8
what are the first symptoms of Kaposi’s sarcoma?
red, pruple or brown patches, plaques or nodules on the skin
