不同类型鼻内乳头状瘤与HPV感染的关系

The relationship between different type of nasal papilloma and human papilloma virus infection

目的 :探讨不同类型的鼻内乳头状瘤与人乳头状瘤病毒 (HPV)感染的关系。方法 :按照 1991年WHO的上呼吸道肿瘤分类法 ,鼻内乳头状瘤病理标本 30例中 ,外生性乳头状瘤 7例 ,内翻性乳头状瘤 18例 ,柱状细胞乳头状瘤 5例。采用多聚酶链反应 (PCR)和免疫组化 (IH)法分别检测标本中与HPV相关的DNA和PV结构的抗原 ,并以 5例鼻息肉为对照。结果 :7例外生性乳头状瘤组织中 5例 (72 % )HPV阳性 ;18例内翻性乳头状瘤仅 1例 (5 .8% )阳性 ;5例柱状细胞乳头状瘤及对照组鼻息肉 5例中均未检出阳性。外生性乳头状瘤组中HPV的检出率与其他各组差异有显著性 (P <0 .0 5 )。结论 :HPV感染与外生性乳头状瘤的发生过程密切相关 ,与内翻性乳头状瘤和柱状细胞乳头状瘤的病因无明显相关性。对内翻性乳头状瘤的治疗目前采用干扰素及转移因子等药物治疗效果有待进一步探讨 ,以手术治疗为主较妥。

Objective:To study the relationship between human papilloma virus(HPV)infection and pathogenesis of nasal papilloma.Methods:According to the World Health Organization classification of nasal papilloma,thirty nasal papillomas were histopathologically classified.There were 7 cases of exophytic papilloma (EP),18 cases of inverted papilloma (IP) and 5 cases of columnar cell papilloma (CCP).Polymerase chain reaction (PCR)and immunohistochemistry (IH) were used to examine the prevalence of HPV in nasal papilloma.Results:HPV DNA and PV structural antigens in six cases were detected among twenty-eight cases of nasal papilloma.Five of seven cases of EP (5/7,72%) and one of seventeen cases of IP (1/17,5.8%),as well as none of the five cases of CCP and five cases of nasal polyps (control group)were detected positively.The difference of positive rates of HPV in EP and other groups were significant (P<0.05). Conclusion:HPV infection may play an important role in the pathogenesis of EP.In contrast,CCP is unassociated with HPV,whereas IP contain HPV in a minority of cases.It is also suggested that it is less useful of curing IP with interferon or transfer factor and so on,and operation on it may be the best therapy method.