Library Subscription: Guest
Critical Reviews™ in Oncogenesis

Published 4 issues per year

ISSN Print: 0893-9675

ISSN Online: 2162-6448

SJR: 0.395 SNIP: 0.322 CiteScore™:: 2.5 H-Index: 54

Indexed in

Association between Epstein-Barr Virus and Oral Carcinoma: A Systematic Review with Meta-Analysis

Volume 24, Issue 4, 2019, pp. 349-368
DOI: 10.1615/CritRevOncog.2019031897
Get accessGet access

ABSTRACT

The purpose of this meta-analysis is to evaluate the association of Epstein-Barr virus (EBV) with oral squamous cell carcinoma (OSCC). We searched the electronic scientific databases of PubMed and Scopus and included a total of 53 studies that were published from 1990 to 2019. The analysis yielded a 45.37% (95% confidence interval [CI]: 38.90-51.84; p < 0.001) overall pooled prevalence of EBV. Studies that used the applied methods of in situ hybridization, polymerase chain reaction, immunology, or RNA microarray showed the following pooled prevalence: 46.08%, 40.32, 54.97%, and 74.89%, respectively. EBV-infected individuals have a 2.5 higher risk for developing OSCC (odds ratio: 2.57; 95% CI: 1.23% to 5.36%; p < 0.001). The present meta-analysis supports the hypothesis of EBV association with OSCC, pointing to this virus as a risk factor for neoplasia. Our findings also suggest that EBV latent transcripts (latent membrane protein 1, EBV nuclear antigen 1 and 2, and EBV-encoded small RNAs) have an important role in this process. Furthermore, novel advancements could arise from large and standardized studies that are constructed to probe for other latent gene expression, eliminate confounding factors (tobacco, alcohol, and high-risk human papillomavirus infection), and define the relationship between EBV and oral carcinomas.

REFERENCES
  1. Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018;68(6):394-424.

  2. Rosebush MS, Rao SK, Samant S, Gu W, Handorf CR, Pfeffer LM, Nosrat CA. Oral cancer: Enduring characteristics and emerging trends. J Tenn Dent Assoc. 2011;91(2):24-7; quiz 28-9.

  3. Yang YY, Koh LW, Tsai JH, Tsai CH, Wong EF, Lin SJ, Yang CC. Involvement of viral and chemical factors with oral cancer in Taiwan. Jpn J Clin Oncol. 2004;34(4):176-83.

  4. Iype EM, Pandey M, Mathew A, Thomas G, Sebastian P, Nair MK. Oral cancer among patients under the age of 35 years. J Postgrad Med. 2001;47(3):171-6.

  5. Murray PG, Young LS. Epstein-Barr virus infection: Basis of malignancy and potential for therapy. Expert Rev Mol Med. 2001;3(28):1-20.

  6. World Health Organization. Epstein-Barr virus and Kaposi's sarcoma herpesvirus/human herpesvirus 8. Lyon, France/Geneva, Switzerland: IARC Press; 1997. p. 524.

  7. Callaghan DJ, Conner BR, Strauss M. Epstein-Barr virus antibody titers in cancer of the head and neck. Arch Otolaryngol. 1983;109(12):781-4.

  8. Harris R, Bradburn M, Deeks J, Harbord R, Altman D, Sterne J. Metan: Fixed- and random-effects meta-analysis. Stata J. 2008;8(1):3-28.

  9. Newcombe RG. Two-sided confidence intervals for the single proportion: Comparison of seven methods. Stat Med. 1998;17(8):857-72.

  10. DerSimonian R, Laird N. Meta-analysis in clinical trials. Control Clin Trials. 1986;7(3):177-88.

  11. Talacko AA, Teo CG, Griffin BE, Johnson NW. Epstein-Barr virus receptors but not viral DNA are present in normal and malignant oral epithelium. J Oral Pathol Med. 1991;20(1):20-5.

  12. Cruz I, Van den Brule AJ, Steenbergen RD, Snijders PJ, Meijer CJ, Walboomers JM, Snow GB, Van der Waal I. Prevalence of Epstein-Barr virus in oral squamous cell carcinomas, premalignant lesions and normal mucosa-A study using the polymerase chain reaction. Oral Oncol. 1997;33(3):182-8.

  13. Kis A, Feher E, Gall T, Tar I, Boda R, Toth ED, Mehes G, Gergely L, Szarka K. Epstein-Barr virus prevalence in oral squamous cell cancer and in potentially malignant oral disorders in an eastern Hungarian population. Eur J Oral Sci. 2009;117(5):536-40.

  14. Saravani S, Miri-Moghaddam E, Sanadgol N, Kadeh H, Nazeri MR. Human herpesvirus-6 and Epstein-Barr virus infections at different histopathological grades of oral squamous cell carcinomas. Int J Prev Med. 2014;5(10):1231-8.

  15. Tsuhako K, Nakazato I, Miyagi J, Iwamasa T, Arasaki A, Hiratsuka H, Sunakawa H, Kohama G, Abo T. Comparative study of oral squamous cell carcinoma in Okinawa, Southern Japan and Sapporo in Hokkaido, Northern Japan; with special reference to human papillomavirus and Epstein-Barr virus infection. J Oral Pathol Med. 2000;29(2):70-9.

  16. Turunen A, Rautava J, Grenman R, Syrjanen K, Syrjanen S. Epstein-Barr virus (EBV)-encoded small RNAs (EBERs) associated with poor prognosis of head and neck carcinomas. Oncotarget. 2017;8(16):27328-38.

  17. Goldenberg D, Benoit NE, Begum S, Westra WH, Cohen Y, Koch WM, Sidransky D, Califano JA. Epstein-Barr virus in head and neck cancer assessed by quantitative polymerase chain reaction. Laryngoscope. 2004;114(6):1027-31.

  18. Zheng Y, Xia P, Zheng HC, Takahashi H, Masuda S, Takano Y. The screening of viral risk factors in tongue and pharyngolaryngeal squamous carcinoma. Anticancer Res. 2010;30(4):1233-8.

  19. Nasher AT, Al-Hebshi NN, Al-Moayad EE, Suleiman AM. Viral infection and oral habits as risk factors for oral squamous cell carcinoma in Yemen: A case-control study. Oral Surg Oral Med Oral Pathol Oral Radiol. 2014;118(5):566-72.e1.

  20. Ryan JL, Morgan DR, Dominguez RL, Thorne LB, Elmore SH, Mino-Kenudson M, Lauwers GY, Booker JK, Gulley ML. High levels of Epstein-Barr virus DNA in latently infected gastric adenocarcinoma. Lab Invest. 2009;89(1):80-90.

  21. Mao EJ, Smith CJ. Detection of Epstein-Barr virus (EBV) DNA by the polymerase chain reaction (PCR) in oral smears from healthy individuals and patients with squamous cell carcinoma. J Oral Pathol Med. 1993;22(1): 12-7.

  22. Bagan L, Ocete-Monchon MD, Leopoldo-Rodado M, Murillo-Cortes J, Diaz-Fernandez JM, Medina-Gonzalez R, Gimeno-Cardona C, Bagan JV. Prevalence of salivary Epstein-Barr virus in potentially malignant oral disorders and oral squamous cell carcinoma. Med Oral Patol Oral Cir Bucal. 2016;21(2):e157-60.

  23. Cruz I, Van Den Brule AJ, Brink AA, Snijders PJ, Walboomers JM, Van Der Waal I, Meijer CJ. No direct role for Epstein-Barr virus in oral carcinogenesis: A study at the DNA, RNA and protein levels. Int J Cancer. 2000;86(3):356-61.

  24. Flaitz CM, Nichols CM, Adler-Storthz K, Hicks MJ. Intraoral squamous cell carcinoma in human immunodeficiency virus infection. A clinicopathologic study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1995;80(1):55-62.

  25. McLemore MS, Haigentz M, Smith RV, Nuovo GJ, Alos L, Cardesa A, Brandwein-Gensler M. Head and neck squamous cell carcinomas in HIV-positive patients: A preliminary investigation of viral associations. Head Neck Pathol. 2010;4(2):97-105.

  26. Gonzalez-Moles MA, Gutierrez J, Rodriguez MJ, Ruiz-Avila I, Rodriguez-Archilla A. Epstein-Barr virus latent membrane protein-1 (LMP-1) expression in oral squamous cell carcinoma. Laryngoscope. 2002;112(3):482-7.

  27. Shimakage M, Horii K, Tempaku A, Kakudo K, Shirasaka T, Sasagawa T. Association of Epstein-Barr virus with oral cancers. Hum Pathol. 2002;33(6):608-14.

  28. Lambert R, Sauvaget C, de Camargo Cancela M, Sankaranarayanan R. Epidemiology of cancer from the oral cavity and oropharynx. Eur J Gastroenterol Hepatol. 2011;23(8):633-41.

  29. Higa M, Kinjo T, Kamiyama K, Iwamasa T, Hamada T, Iyama K. Epstein-Barr virus (EBV) subtype in EBV related oral squamous cell carcinoma in Okinawa, a subtropical island in southern Japan, compared with Kita-kyushu and Kumamoto in mainland Japan. J Clin Pathol. 2002;55(6):414-23.

  30. Horiuchi K, Mishima K, Ichijima K, Sugimura M, Ishida T, Kirita T. Epstein-Barr virus in the proliferative diseases of squamous epithelium in the oral cavity. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1995;79(1):57-63.

  31. Kikuchi K, Noguchi Y, de Rivera MW, Hoshino M, Sakashita H, Yamada T, Inoue H, Miyazaki Y, Nozaki T, Gonzalez-Lopez BS, Ide F, Kusama K. Detection of Epstein-Barr virus genome and latent infection gene expression in normal epithelia, epithelial dysplasia, and squamous cell carcinoma of the oral cavity. Tumour Biol. 2016;37(3):3389-404.

  32. Kobayashi I, Shima K, Saito I, Kiyoshima T, Matsuo K, Ozeki S, Ohishi M, Sakai H. Prevalence of Epstein-Barr virus in oral squamous cell carcinoma. J Pathol. 1999;189(1):34-9.

  33. Mahomed F, Grayson W. A rare case of lymphoepithelial carcinoma of the lip. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008;105(5):e49-52.

  34. Mizugaki Y, Sugawara Y, Shinozaki F, Takada K. Detection of Epstein-Barr virus in oral papilloma. Jpn J Cancer Res. 1998;89(6):604-7.

  35. Pegolo E, Parodi P, Francescon M, Di Loreto C. A rare case of undifferentiated nonkeratinizing carcinoma of the lip mucosa. J Oral Maxillofac Surg. 2014;72(6):1119-23.

  36. Reddy SS, Sharma S, Mysorekar V. Expression of Epstein-Barr virus among oral potentially malignant disorders and oral squamous cell carcinomas in the South Indian tobacco-chewing population. J Oral Pathol Med. 2017;46(6):454-9.

  37. Shamaa AA, Zyada MM, Wagner M, Awad SS, Osman MM, Abdel Azeem AA. The significance of Epstein Barr virus (EBV) and DNA topoisomerase II alpha (DNA-Topo II alpha) immunoreactivity in normal oral mucosa, oral epithelial dysplasia (OED) and oral squamous cell carcinoma (OSCC). Diagn Pathol. 2008;3:45.

  38. Budhy TI. Molecular grading of oral squamous cell carcinomas infected with EBV. Asian Pac J Cancer Prev. 2018;19(7):1793-6.

  39. Yen CY, Lu MC, Tzeng CC, Huang JY, Chang HW, Chen RS, Liu SY, Liu ST, Shieh B, Li C. Detection of EBV infection and gene expression in oral cancer from patients in Taiwan by microarray analysis. J Biomed Biotechnol. 2009;2009:904589.

  40. Frangou P, Buettner M, Niedobitek G. Epstein-Barr virus (EBV) infection in epithelial cells in vivo: Rare detection of EBV replication in tongue mucosa but not in salivary glands. J Infect Dis. 2005;191(2):238-42.

  41. Wilms T, Khan G, Coates PJ, Sgaramella N, Fahraeus R, Hassani A, Philip PS, Norberg Spaak L, Califano L, Colella G, Olofsson K, Loizou C, Franco R, Nylander K. No evidence for the presence of Epstein-Barr virus in squamous cell carcinoma of the mobile tongue. PLoS One. 2017;12(9):e0184201.

  42. Shillitoe EJ. The role of viruses in squamous cell carcinoma of the oropharyngeal mucosa. Oral Oncol. 2009;45(4-5):351-5.

  43. Nola-Fuchs P, Boras VV, Plecko V, Plestina S, Milenovic A, Susic M, Brailo V. The prevalence of human papilloma-virus 16 and Epstein-Barr virus in patients with oral squamous cell carcinoma. Acta Clin Croat. 2012;51(4):609-14.

  44. Venturi BD, Cabral MG, Lourenjo SD. Carcinoma de celulas escamosas oral-contribuijao de virus oncogenicos e alguns marcadores moleculares no desenvolvimento e prognostico da lesao: Uma revisao. Revista Brasileira Otorrinolaringologia. 2004;70:385-92.

  45. Jalouli J, Ibrahim SO, Sapkota D, Jalouli MM, Vasstrand EN, Hirsch JM, Larsson PA. Presence of human papilloma virus, herpes simplex virus and Epstein-Barr virus DNA in oral biopsies from Sudanese patients with regard to toombak use. J Oral Pathol Med. 2010;39(8):599-604.

  46. Lima MA, Ferreira MV, Barros MA, Pardini MI, Ferrasi AC, Mota RM, Rabenhorst SH. Relationship between EBV infection and expression of cellular proteins c-Myc, Bcl-2, and Bax in gastric carcinomas. Diagn Mol Pathol. 2008;17(2):82-9.

  47. Ambinder RF. Gamma herpes viruses and "hit-and-run" oncogenesis. Am J Pathol. 2000;156(1):1-3.

  48. Bonnet M, Guinebretiere JM, Kremmer E, Grunewald V, Benhamou E, Contesso G, Joab I. Detection of Epstein-Barr virus in invasive breast cancers. J Natl Cancer Inst. 1999;91(16):1376-81.

  49. Sugawara Y, Mizugaki Y, Uchida T, Torii T, Imai S, Makuuchi M, Takada K. Detection of Epstein-Barr virus (EBV) in hepatocellular carcinoma tissue: A novel EBV latency characterized by the absence of EBV-encoded small RNA expression. Virology. 1999;256(2):196-202.

  50. Al Moustafa AE, Chen D, Ghabreau L, Akil N. Association between human papillomavirus and Epstein-Barr virus infections in human oral carcinogenesis. Med Hypotheses. 2009;73(2):184-6.

  51. Drop B, Strycharz-Dudziak M, Kliszczewska E, Polz-Dacewicz M. Coinfection with Epstein-Barr virus (EBV), human papilloma virus (HPV) and polyoma BK virus (BKPyV) in laryngeal, oropharyngeal and oral cavity cancer. Int J Mol Sci. 2017;18(12):E2752.

  52. Hermann RM, Fuzesi L, Pradier O, Christiansen H, Schmidberger H. Presence of human papillomavirus-18 and Epstein-Barr virus in a squamous cell carcinoma of the tongue in a 20-year-old patient. Case report and review of the current literature. Cancer Radiother. 2004;8(4):262-5.

  53. Jalouli J, Ibrahim SO, Mehrotra R, Jalouli MM, Sapkota D, Larsson PA, Hirsch JM. Prevalence of viral (HPV, EBV, HSV) infections in oral submucous fibrosis and oral cancer from India. Acta Otolaryngol. 2010;130(11):1306-11.

  54. Guidry JT, Myers JE, Bienkowska-Haba M, Songock WK, Ma X, Shi M, Nathan CO, Bodily JM, Sapp MJ, Scott RS. Inhibition of Epstein-Barr virus replication in human papillomavirus-immortalized keratinocytes. J Virol. 2019;93(2):e01216-8.

  55. Acharya S, Ekalaksananan T, Vatanasapt P, Loyha K, Phusingha P, Promthet S, Kongyingyoes B, Pientong C. Association of Epstein-Barr virus infection with oral squamous cell carcinoma in a case-control study. J Oral Pathol Med. 2014;44(4):252-7.

  56. Sand LP, Jalouli J, Larsson PA, Hirsch JM. Prevalence of Epstein-Barr virus in oral squamous cell carcinoma, oral lichen planus, and normal oral mucosa. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2002;93(5):586-92.

  57. D'Costa J, Saranath D, Sanghvi V, Mehta AR. Epstein-Barr virus in tobacco-induced oral cancers and oral lesions in patients from India. J Oral Pathol Med. 1998;27(2):78-82.

  58. van Heerden WE, van Rensburg EJ, Engelbrecht S, Raubenheimer EJ. Prevalence of EBV in oral squamous cell carcinomas in young patients. Anticancer Res. 1995;15(5B):2335-9.

  59. She Y, Nong X, Zhang M, Wang M. Epstein-Barr virus infection and oral squamous cell carcinoma risk: A meta-analysis. PLoS One. 2017;12(10):e0186860.

  60. Ren Q, Zuo T, Lu H. Malignant transformation of a human oral squamous cell carcinoma cell strain OSC-19 by EBV encoded small RNAs. Lin Chuang Er Bi Yan Hou Ke Za Zhi. 2004;18(11):675-7, 80 (in Chinese).

  61. Birdwell CE, Queen KJ, Kilgore PC, Rollyson P, Trutschl M, Cvek U, Scott RS. Genome-wide DNA methylation as an epigenetic consequence of Epstein-Barr virus infection of immortalized keratinocytes. J Virol. 2014;88(19): 11442-58.

  62. Birdwell CE, Prasai K, Dykes S, Jia Y, Munroe TGC, Bienkowska-Haba M, Scott RS. Epstein-Barr virus stably confers an invasive phenotype to epithelial cells through reprogramming of the WNT pathway. Oncotarget. 2018;9(12):10417-35.

  63. Frisan T, Nagy N, Chioureas D, Terol M, Grasso F, Masucci MG. A bacterial genotoxin causes virus reactivation and genomic instability in Epstein-Barr virus infected epithelial cells pointing to a role of co-infection in viral oncogenesis. Int J Cancer. 2019;144(1):98-109.

  64. Burassakarn A, Pientong C, Sunthamala N, Chuerduangphui J, Vatanasapt P, Patarapadungkit N, Kongyingyoes B, Ekalaksananan T. Aberrant gene promoter methylation of E-cadherin, p16 INK4a, p14 ARF, and MGMT in Epstein-Barr virus-associated oral squamous cell carcinomas. Med Oncol. 2017;34(7):128.

  65. Maeda T, Hiranuma H, Matsumura S, Furukawa S, Fuchihata H. Epstein-Barr virus infection and response to radiotherapy in squamous cell carcinoma of the oral cavity. Cancer Lett. 1998;125(1-2):25-30.

  66. Tsang NM, Chang KP, Lin SY, Hao SP, Tseng CK, Kuo TT, Tsai MH, Chung TC. Detection of Epstein-Barr virus-derived latent membrane protein-1 gene in various head and neck cancers: Is it specific for nasopharyngeal carcinoma? Laryngoscope. 2003;113(6):1050-4.

  67. Iamaroon A, Khemaleelakul U, Pongsiriwet S, Pintong J. Co-expression of p53 and Ki67 and lack of EBV expression in oral squamous cell carcinoma. J Oral Pathol Med. 2004;33(1):30-6.

  68. Choe JY, Yun JY, Nam SJ, Kim JE. Expression of c-Met is different along the location and associated with lymph node metastasis of head and neck carcinoma. Korean J Pathol. 2012;46(6):515-22.

  69. Jang HS, Cho JO, Yoon CY, Kim HJ, Park JC. Demonstration of Epstein-Barr virus in odontogenic and nonodontogenic tumors by the polymerase chain reaction (PCR). J Oral Pathol Med. 2001;30(10):603-10.

  70. Anwar M, Koriyama C, Naveed IA, Hamid S, Ahmad M, Itoh T, Minakami Y, Eizuru Y, Akiba S. Epstein-Barr virus detection in tumors of upper gastrointestinal tract. An in situ hybridization study in Pakistan. J Exp Clin Cancer Res. 2005;24(3):379-85.

  71. Shahrabi-Farahani M, Karimi E, Mostaan LV, Saba S, Yazdani N, M Amoli M. Association between Epstein-Barr virus and tongue squamous cell carcinoma in Iranian patients. Pathol Res Pract. 2018 Jan;214(1): 130-3.

  72. Van Rensburg EJ, Engelbrecht S, Van Heerden W, Raubenheimer E, Schoub BD. Detection of EBV DNA in oral squamous cell carcinomas in a black African population sample. In Vivo. 1995;9(3):199-202.

  73. Broccolo F, Ciccarese G, Rossi A, Anselmi L, Drago F, Toniolo A. Human papillomavirus (HPV) and Epstein-Barr virus (EBV) in keratinizing versus non-keratinizing squamous cell carcinoma of the oropharynx. Infect Agent Cancer. 2018 Nov 9;13:32.

  74. Polz-Gruszka D, Morshed K, Stec A, Polz-Dacewicz M. Prevalence of human papillomavirus (HPV) and Epstein-Barr virus (EBV) in oral and oropharyngeal squamous cell carcinoma in Southeastern Poland. Infect Agent Cancer. 2015 Oct 12;10:37.

  75. Bagan JV, Jimenez Y, Murillo J, Poveda R, Diaz JM, Gavalda C, Margaix M, Scully C, Alberola TM, Torres Puente M, Perez Alonso M. Epstein-Barr virus in oral proliferative verrucous leukoplakia and squamous cell carcinoma: A preliminary study. Med Oral Patol Oral Cir Bucal. 2008;13(2):E110-3.

  76. Alnema MM, Aydin S, Ozkan Y, Dagli AF, Ozercan HI, Yildirim N, Sahin I, Karaoglu A, Kilic N, Yilmaz M, Ozercan MR, Donder E. Ghrelin and obestatin expression in oral squamous cell carcinoma: An immunohis-tochemical and biochemical study. Mol Cell Biochem. 2010;339(1-2):173-9.

  77. Jiang R, Gu X, Moore-Medlin TN, Nathan CA, Hutt-Fletcher LM. Oral dysplasia and squamous cell carcinoma: Correlation between increased expression of CD21, Epstein-Barr virus and CK19. Oral Oncol. 2012;48(9):836-41.

CITED BY
  1. Pyo Jung-Soo, Kim Nae-Yu, Kang Dong-Wook, Clinicopathological Significance of EBV-Infected Gastric Carcinomas: A Meta-Analysis, Medicina, 56, 7, 2020. Crossref

  2. Núñez-Acurio Daniela, Bravo Denisse, Aguayo Francisco, Epstein–Barr Virus—Oral Bacterial Link in the Development of Oral Squamous Cell Carcinoma, Pathogens, 9, 12, 2020. Crossref

  3. Aguayo Francisco, Boccardo Enrique, Corvalán Alejandro, Calaf Gloria M., Blanco Rancés, Interplay between Epstein-Barr virus infection and environmental xenobiotic exposure in cancer, Infectious Agents and Cancer, 16, 1, 2021. Crossref

  4. Blanco Rancés, Carrillo-Beltrán Diego, Corvalán Alejandro H., Aguayo Francisco, High-Risk Human Papillomavirus and Epstein–Barr Virus Coinfection: A Potential Role in Head and Neck Carcinogenesis, Biology, 10, 12, 2021. Crossref

  5. Sánchez-Ponce Yessica, Fuentes-Pananá Ezequiel M., The Role of Coinfections in the EBV–Host Broken Equilibrium, Viruses, 13, 7, 2021. Crossref

  6. Paula Dayrine Silveira, Nóbrega Malta Cássia Emanuella, Brito Wendy Honório, Mota Lemos José Vitor, Cetira Fillho Edson Luiz, Gurgel Costa Fábio Wildson, Nunes Alves Ana Paula Negreiros, Barros Silva Paulo Goberlânio, Prevalence of malignant neoplastic oral lesions among children and adolescents: A systematic review and meta‐analysis, International Journal of Paediatric Dentistry, 31, 4, 2021. Crossref

  7. de Lima Marcos Antonio Pereira, Silva Álife Diêgo Lima, do Nascimento Filho Antônio Carlos Silva, Cordeiro Thiago Lima, Bezerra João Pedro de Souza, Rocha Maria Aline Barroso, Pinheiro Sally de França Lacerda, Pinheiro Junior Roberto Flávio Fontenelle, Gadelha Maria do Socorro Vieira, da Silva Cláudio Gleidiston Lima, Epstein-Barr Virus-Associated Carcinoma of the Larynx: A Systematic Review with Meta-Analysis, Pathogens, 10, 11, 2021. Crossref

  8. Stasiewicz Mark, Karpiński Tomasz M., The oral microbiota and its role in carcinogenesis, Seminars in Cancer Biology, 2021. Crossref

  9. Aghiorghiesei Ovidiu, Zanoaga Oana, Nutu Andreea, Braicu Cornelia, Campian Radu Septimiu, Lucaciu Ondine, Berindan Neagoe Ioana, The World of Oral Cancer and Its Risk Factors Viewed from the Aspect of MicroRNA Expression Patterns, Genes, 13, 4, 2022. Crossref

  10. Nethan Suzanne Tanya, Gupta Shalini, Warnakulasuriya Saman, Risk Factors for Oral Squamous Cell Carcinoma in the Indian Population, in Microbes and Oral Squamous Cell Carcinoma, 2022. Crossref

  11. Lima Marcos Antonio Pereira, Cavalcante Roberta Barroso, Silva Cláudio Gleidiston Lima, Nogueira Renato Luiz Maia, Macedo Geamberg Einstein Cruz, Galiza Lara Eduardo, Pinheiro Juliana Viana, Maia Filho Pedro Hugo Bezerra, Santos Sarah Ferreira, Rabenhorst Silvia Helena Barem, Evaluation of HPV and EBV in OSCC and the expression of p53, p16, E‐cadherin, COX‐2, MYC, and MLH1, Oral Diseases, 28, 4, 2022. Crossref

Begell Digital Portal Begell Digital Library eBooks Journals References & Proceedings Research Collections Prices and Subscription Policies Begell House Contact Us Language English 中文 Русский Português German French Spain