呼吸道乳头状瘤HPV DNA定量检测与临床特征分析

Quantitative detection of HPV DNA in recurrent respiratory papillomatosis and its clinical significance

目的探讨幼年型呼吸道乳头状瘤病(juvenile onset recurrent respiratory papillomatosis,JORRP)的临床特点及病程的相关影响因素,研究JORRP瘤体中人乳头状瘤病毒(human papillomavirus,HPV)的基因含量及其临床意义。方法收集55例JORRP患儿的临床资料,应用荧光定量聚合酶链反应(polymerase chain reaction,PCR)法检测肿瘤组织中的HPV6/11含量,并进行临床随访观察复发情况。结果JORRP发病高峰在3～4岁,2～7岁组患儿的手术间隔时间小于大于7岁以上组患儿;行气管切开术的患儿的手术次数明显多于未行气管切开手术的患儿;55例JORRP标本经荧光定量PCR检测后35例(63.6%)为HPV6/11型阳性,其DNA中位拷贝数为2.2E+07,其拷贝数与JORRP病程无明显相关性。结论2～7岁为JORRP好发及易复发年龄段,气管切开会增加患儿手术次数与风险,JORRP患儿的病程变化与HPV6/11 DNA含量无明显相关。

OBJECTIVE To investigate the clinical features and the correlated factors of Juvenile onset recurrent respiratory papillomatosis（JORRP）,and to study the DNA contents of human papillomavirus（HPV） from the tissue of JORRP and its clinical significance. METHODS The clinical data of 55 cases with JORRP were collected,and the DNA contents of HPV6/11 using Fluorescence quantitative PCR（FQ-PCR）were measured.All the patients were followed up to observe the relapse.RESULTS The peak time of JORRP was at 3 to 4 years old.The interval time of the operations of the patients more than 7 years old was longer than that of the patients at 2 to 7 years old.The ones who had a tracheotomy offered more operations.Thirty five of 55 JORRP specimens were confirmed to be HPV DNA6/11 type positive（63.6 %）by FQ-PCR.The median copy numbers of DNA template in 6/11 type positive samples were 2.2E＋07.There was no significant correlation between DNA copy number and the course of JORRP. CONCLUSION JORRP is often occurrence at 2 to 7 years old children and recurrence is common in JORRP patients less than 7 years old.Tracheotomy can increase the frequency and risk of the operations,and there is no obvious correlation between the course of the disease and HPV DNA contents.