幼年型复发性呼吸道乳头状瘤病不同人乳头状瘤病毒亚型感染与临床病变侵袭性的关系
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摘要
目的分析比较不同人乳头状瘤病毒(HPV亚型感染与幼年型复发性呼吸道乳头状瘤病(juvenileonset recurrent respiratory papillomatosis,JORRP)患儿临床病变侵袭性之间的关系。方法研究组随机纳入55例患儿,包括7例喉标本重复测定者在内共计62例喉部活检标本。对患者既往临床资料进行回顾性分析,将病程分为侵袭性与非侵袭性。采用实时荧光定量PCR技术测定62例JORRP患儿喉活检标本HPVDNA检测,特异性引物包括HPV6和HPV11。结果 98.4%(61/62)喉标本存在HPVDNA的扩增。HPV11阳性率为52.7%(29/55),HPV6和HPV11双重感染的阳性率为36.3%(20/55),HPV6阳性率为9.1%,仅1例未检测出。单一HPV11亚型者初次手术年龄[(2.16±1.17)岁]较双重HPV6/11亚型感染者[(3.77±3.07)岁]小(P=0.033),临床病变侵袭性较双重HPV6/11亚型感染者强(P=0.015)。将7例JORRP患儿喉标本进行HPV DNA重复测定,发现相同个体不同时间HPV亚型感染一致率为57.1%(4/7)。结论与双重HPV6/11亚型感染者相比,单一低危型HPV11亚型感染者初次手术年龄较小,临床病变侵袭性更强;相同个体不同时间段感染HPV亚型检出率及亚型可发生改变。
OBJECTIVE To analyze the relationship between different HPV subtypes infection and their invasiveness in children with juvenile-onset recurrent respiratory papillomatosis(JORRP). METHODS A number of 55 children were randomly enrolled, and there were totally62 laryngeal biopsy specimens including 7 repeated ones. The clinical data of the patients were retrospectively analyzed,and the course of the disease was divided into the invasive and non-invasive groups. Real-time fluorescent quantitative PCR was used to detect HPV DNA in 62 laryngeal biopsy specimens of JORRP, with specific primers HPV 6 and 11.RESULTS HPV DNA amplification was found in 98.4%(61/62) laryngeal specimens. The positive rate of HPV11 was52.7%(29/55), the double infection rate of HPV6 and HPV11 was 36.3%(20/55), and the positive rate of HPV6 was 9.1%.Only one case was undetected. The age of initial operation in patients with single HPV11 subtype [(2.16±1.17) years]was younger than that in patients with double HPV6/11 subtype [(3.77±3.07) years](P =0.033), and the invasiveness of clinical lesions was stronger than that in patients with double HPV6/11 subtype(P =0.015). The HPV DNA of laryngeal specimens from 7 children with JORRP was repeated and the coincidence rate of HPV subtype infection in the same individual at different time was 57.1%(4/7). CONCLUSION The patients with single low-risk HPV11 subtype are younger in initial operation and more invasive than patients with double HPV6/11 subtype. The detection rate and subtype of HPV infection in the same individual at different time periods may be changed.
OBJECTIVE To analyze the relationship between different HPV subtypes infection and their invasiveness in children with juvenile-onset recurrent respiratory papillomatosis(JORRP). METHODS A number of 55 children were randomly enrolled, and there were totally62 laryngeal biopsy specimens including 7 repeated ones. The clinical data of the patients were retrospectively analyzed,and the course of the disease was divided into the invasive and non-invasive groups. Real-time fluorescent quantitative PCR was used to detect HPV DNA in 62 laryngeal biopsy specimens of JORRP, with specific primers HPV 6 and 11.RESULTS HPV DNA amplification was found in 98.4%(61/62) laryngeal specimens. The positive rate of HPV11 was52.7%(29/55), the double infection rate of HPV6 and HPV11 was 36.3%(20/55), and the positive rate of HPV6 was 9.1%.Only one case was undetected. The age of initial operation in patients with single HPV11 subtype [(2.16±1.17) years]was younger than that in patients with double HPV6/11 subtype [(3.77±3.07) years](P =0.033), and the invasiveness of clinical lesions was stronger than that in patients with double HPV6/11 subtype(P =0.015). The HPV DNA of laryngeal specimens from 7 children with JORRP was repeated and the coincidence rate of HPV subtype infection in the same individual at different time was 57.1%(4/7). CONCLUSION The patients with single low-risk HPV11 subtype are younger in initial operation and more invasive than patients with double HPV6/11 subtype. The detection rate and subtype of HPV infection in the same individual at different time periods may be changed.
引文
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[2]Buchinsky FJ,Donfack J,Derkay CS,et al.Age of child,more than HPV type,is associated with clinical course in recurrent respiratory papillomatosis.PloS One,2008,3(5):1-8.
[3]Zur Hausen H.Papillomaviruses and cancer:from basic studies to clinical application.Nat Rev Cancer,2002,2(5):342-350.
[4]Gabbott M,Cossart YE,Kan A,et al.Human papillomavirus and host variables as predictors of clinical course in patients with juvenile-onset recurrent respiratory papillomatosis.J Clin Microbiol,1997,35(12):3098-3103.
[5]Rimell Fl,Shoemaker DL,Pou AM,et al.Pediatric respiratory papillomatosis:prognostic role of viral typing and cofactors.Laryngoscope,1997,107(7):915-918.
[6]王乐.HPV多重感染与宫颈癌及高度鳞状上皮内病变的相关性.中国妇幼保健,2017,32(16):3753-3756.
[7]Back JO,Seo JW,Kwon O,el a1.Production of human papillomavirus type 33 L1 major capsid protein and virus-like particles from Bacillus subtilis to develop a prophylactic vaccine against cervical cancer.Enzyme Mierob Technol,2012,50(3):173-180.
[2]Buchinsky FJ,Donfack J,Derkay CS,et al.Age of child,more than HPV type,is associated with clinical course in recurrent respiratory papillomatosis.PloS One,2008,3(5):1-8.
[3]Zur Hausen H.Papillomaviruses and cancer:from basic studies to clinical application.Nat Rev Cancer,2002,2(5):342-350.
[4]Gabbott M,Cossart YE,Kan A,et al.Human papillomavirus and host variables as predictors of clinical course in patients with juvenile-onset recurrent respiratory papillomatosis.J Clin Microbiol,1997,35(12):3098-3103.
[5]Rimell Fl,Shoemaker DL,Pou AM,et al.Pediatric respiratory papillomatosis:prognostic role of viral typing and cofactors.Laryngoscope,1997,107(7):915-918.
[6]王乐.HPV多重感染与宫颈癌及高度鳞状上皮内病变的相关性.中国妇幼保健,2017,32(16):3753-3756.
[7]Back JO,Seo JW,Kwon O,el a1.Production of human papillomavirus type 33 L1 major capsid protein and virus-like particles from Bacillus subtilis to develop a prophylactic vaccine against cervical cancer.Enzyme Mierob Technol,2012,50(3):173-180.