复发性呼吸道乳头状瘤患儿乳头状瘤病毒的感染情况

Human Papillomavirus Infection in Juvenile Onset Recurrent Respiratory Papillomatosis in Children

目的研究复发性呼吸道乳头状瘤(RRP)病患儿乳头状瘤病毒(HPV)的感染情况以及HPV型别与疾病严重程度的相关性。方法收集2000年5月-2009年7月北京儿童医院82例RRP患儿的92份瘤体石蜡标本和20例扁桃体腺样体肿大患儿的20份石蜡标本(对照组)作为实验对象。采用通用引物PCR检测RRP患儿瘤体石蜡标本与对照组石蜡标本中的HPV DNA,通过HPVE6/E7巢氏多重PCR及测序确定具体型别。根据Doyle定义将RRP患儿分为侵袭组与非侵袭组,并分析HPV型别与临床过程的关系。结果 82例RRP患儿石蜡标本的HPV DNA感染率为68.3%(56/82例),对照组石蜡标本中均未检出HPV DNA,通用引物阳性的56例患儿中共30例确定HPV具体型别(34份标本),其中HPV11型占70.0%(21/30例),HPV6型占30.0%(9/30例),同一患儿不同时期及同一时期不同部位的瘤体标本均未发现HPV型别改变。HPV11感染患儿侵袭性改变发生率为42.9%(9/21例),HPV6感染患儿侵袭性改变发生率为22.2%(2/9例),二者比较差异无统计学意义(P=0.379)。结论 HPV是引起儿童RRP的主要病原体,具体型别为HPV11型及HPV6型,其中以HPV11型为主。

Objective To investigate the genotypes of human papillomavirus（HPV） in recurrent respiratory papillomatosis（RRP） in children and explore the relationship between HPV type and the aggressiveness of the disease.Methods Ninety-two paraffin-embedded specimens from 82 children with RRP diagnosed histologically from May.2000 to Jul.2009 in Beijing Children′s Hospital Affiliated to Capital Medical University were collected,and the control group included 20 paraffin-embedded specimens from 20 patients with adenoid hyperpla-sia.HPV general primers was used to detect HPV DNA in all specimens.HPVE6/E7 nested multiplex polymerase chain reaction and DNA sequencing were used to analyze the genotypes of HPV.RRP children were grouped as having an aggressive or non-aggressive disease accor-ding to the methods used by Doyle.The relationship between HPV genotypes and clinical courses was evaluated.Results The positive rate of HPV infection in the RRP group was 68.3%（56/82 cases）,and no HPV DNA was found in the control group.HPV genotypes of 30 patients were identified in all HPV positive cases.The specific types were HPV11 and HPV 6.The percentage of HPV11 was 70.0%（21/30 cases）,and HPV6 was 30.0%（9/30 cases） respectively.There was no significant difference in HPV genotypes at different periods of disease or di-fferent sites of tissue in one patient.The incidence of RRP with aggressiveness in patients with HPV11 infection was 42.9%（9/21 cases）,and HPV6 was 22.2%（2/9 cases）,respectively.There was no significant difference in the incidence of RRP with aggressiveness between HPV11 infection and HPV 6 infection（P=0.379）.Conclusions HPV is the main aetiological agents in most juvenile onset RRP patients.The specific types are HPV11 and HPV6,of which the majority was HPV11.