人类乳头瘤病毒在鼻息肉和上颌窦后鼻孔息肉中的分布及临床意义

Human papillomavirus(HPV)prevalence and its clinical significance in nasal and antrochoanal polyps

目的探讨人类乳头瘤病毒在鼻息肉和上颌窦后鼻孔息肉中的分布及临床意义。方法采用3种聚合酶链式反应(PCR)扩增方法检测257例标本的人类乳头瘤病毒(HPV)表达情况:GP5+/6+扩增法(使用GP5+/6+通用引物对)主要用于新鲜冷冻和石蜡包埋标本HPV检测、短PCR片段(SPF)扩增法(使用扩增HPV L1基因片段的通用引物对)。此外,免疫组化检测HPV16表达,免疫组化和蛋白质免疫印迹检测HPV诱导肿瘤的生物标志物p16表达情况。结果后鼻息肉、鼻息肉及正常鼻甲中HPV-DNA的检出率分别为53.8%、15.1%及5.8%。HPV16是主要表达亚型,鼻息肉和后鼻息肉中的检出率分别为76%和62%。HPV阳性组织标本中HPV16抗原和p16主要表达于上皮细胞层。蛋白质免疫印迹检测显示后鼻息肉、鼻息肉及正常鼻甲中p16表达差异无统计学意义。HPV状态与性别、年龄、吸烟等无相关性。结论高危型HPV16在上颌窦后鼻孔息肉中呈高频率分布。

【Objective】To elucidate HPV frequency and its clinical significance in nasal polyps and antrochoanal polyps.【Methods】Genomic DNA from 257 tissue specimens(166 nasal polyps,39 antrochoanal polyps and 52 nasal turbinates)were subjected to three different established HPV-polymerase chain reaction assays,testing for 37 low-and high-risk HPV.In addition,immunohistochemical analyses for HPV16 were carried out,as well as immunohistochemistry and western blots of p16,a biomarker for HPV induced cancer.【Results】HPV-DNA was detected in 53.8%of antrochoanal polyps,15.1%of nasal polyps,and 5.8%of nasal turbinates.HPV16 was the predominant type with a detection rate of 76%in nasal polyps and 62%in antrochoanal polyps.Immunohistochemically,HPV positive tissues stained positive for HPV16 antigens and p16 in epithelial cell layers.No significant p16 overexpression was traceable in antrochoanal polyps,nasal polyps and nasal turbinates by western blot.There was no correlation of HPV-status with sex,age,smoking,alcohol consumption or allergic background.【Conclusion】The present study shows a significant frequency of high-risk type HPV16 in antrochoanal polyps.Absence of oncogenic transformation or correlation of the HPV-status with clinical data suggests a latent superinfection,possibly because of anatomical proximity to the oropharynx.