HPV感染与鼻内翻性乳头状瘤复发及恶变相关的Meta分析

 目的探讨人乳头状瘤病毒（HPV）与鼻腔鼻窦内翻性乳头状瘤（SNIP）发生、复发及恶变的关系。方法检索Pubmed、Web of science、 Embase、Cochrane Library、CNKI、维普、中国知网及万方等数据库,查找2000~2017年国内外公开发表的HPV与SNIP发生、复发及恶变相关的所有病例对照研究文献,应用RevMan 5.3统计软件对各研究原始数据进行统计分析。结果Meta分析示SNIP组HPV感染率明显高于对照组(P<0.01,OR=19.72,95%CI为7.91~49.18);复发组HPV感染率明显高于对照组(P<0.01,OR=3.10,95%CI为1.90~5.08);恶变组HPV感染率明显高于对照组（P<0.01,OR=2.09,95%CI为1.41~3.09）。结论HPV感染与SNIP的发生、复发及恶变密切相关。     

鼻腔鼻窦内翻性乳头状瘤发病及复发与人乳头状瘤病毒感染相关性Meta分析

目的综合评价人乳头状瘤病毒(humanpapillomavirus,HPV)感染与鼻腔鼻窦内翻性乳头状瘤(sinonasal inverted papillomas,SNIP)发病及复发的关系。方法纳入研究SNIP与HPV感染相关性并采用聚合酶链反应(PCR)法检测HPV的病例对照研究,对纳入研究的质量进行评价,采用Revman5.1软件进行Meta分析。结果①SNIP发病与HPV感染相关性(SNIP组与对照组比较):符合标准的文献15篇,总样本数1068,其中SNIP组664例,对照组404例,Meta分析示SNIP组HPV感染率明显高于对照组(P<0.00001),其合并OR是对照组的25.55倍(95%CI=12.71～51.37);②SNIP复发与HPV感染相关性(SNIP复发组与单纯SNIP组比较):符合标准的文献7篇,总样本数198,其中SNIP复发组57例,单纯SNIP组141例,Meta分析示SNIP复发组HPV感染率明显高于单纯SNIP组(P<0.00001),其合并优势比是对照组的8.11倍(95%CI=3.27～20.13)。结论 HPV感染可增加SNIP发病的危险性,并可能在SNIP复发中起到重要作用。     

鼻腔鼻窦内翻性乳头状瘤恶变的相关危险因素分析

目的:探讨预测鼻腔鼻窦内翻性乳头状瘤(SNIP)恶变的相关危险因素.提高术前诊断肿瘤恶变的准确性.方法:回顾性分析89例SNIP及内翻性乳头状瘤恶变(IP-SCC)患者的临床资料,其中SNIP组60例,IP-SCC组29例.选取长期吸烟史和长期感染史、内镜检查所见肿瘤特征、鼻窦CT和MRI示肿瘤特征等多种临床指标,对两...     

人乳头状瘤病毒感染与鼻内翻性乳头状瘤的发病及恶变关系的研究

目的:探讨人乳头状瘤病毒(HPV)感染与鼻内翻性乳头状瘤(NIP)的发病及恶变的关系。方法:将57例NIP患者分为不伴恶变组(45例)和伴恶变组(12例),应用PCR技术,检测其HPV6、11、16、18等4个型别的HPV-DNA,同时以30例鼻息肉患者为对照组。结果:57例NIP患者HPV-DNA总阳性率为64.9%(37/57)。不伴恶变组HPV-DNA阳性率为60%(27/45),均为单一的低危型HPV11型感染;伴恶变组HPV-DNA阳性率为83.3%(10/12),以检出HPV16、18型DNA为主,其中5例为双重感染(4例为HPV16、18型,1例为HPV11、16型),4例为单一型HPV16型感染,1例为单一型HPV11型感染。而30例鼻息肉患者均未检出HPV-DNA。结论:HPV在NIP的发病中有重要作用,而高危型HPV16、18型与NIP恶变可能密切相关。     

人类乳头状瘤病毒疫苗在复发性呼吸道乳头状瘤中的作用及进展

复发性呼吸道乳头状瘤（recurrent respiratorypapillomatosis,RRP）是指发生于上下呼吸道的乳头状瘤病,是一种具有高度复发性及侵袭性的疾病,与人类乳头状瘤病毒（human papillomavirus,HPV）感染有关。喉乳头状瘤的大量研究及累积的分子学和临床证据表明,HPV感染是RRP发病中的主要因素。手术治疗仍为RRP主要治疗手段,但不能根治,常需辅助治疗。本文对近几年有关HPV疫苗在RRP病例中应用研究做一综述。     

儿童喉乳头状瘤与人乳头状瘤病毒的相关性及其免疫综合治疗

对2002～2005年收治的60例儿童喉乳头状瘤（JLP）的病变组织进行人乳头状瘤病毒（HPV）分型及体液、细胞免疫检测，并对其临床资料进行回顾性分析，以探讨JLP患儿HPV感染类型、途径及细胞、体液免疫水平，提高对其临床特点的认识，探讨有效的治疗方法。     

复发性呼吸道乳头状瘤研究进展

人类乳头状瘤病毒 (HPV)是一类在脊椎动物中广泛存在的病毒 ,与人类肿瘤的发生密切相关。复发性呼吸道乳头状瘤是喉部常见的肿瘤 ,已知其与 HPV感染有极密切的关系 ,故本文就 HPV特性、研究手段以及与复发性呼吸道乳头状瘤的相关研究做一综述     

鼻内翻性乳头状瘤与人乳头状瘤病毒感染

鼻内翻性乳头状瘤是鼻腔鼻窦的良性病变,具有侵袭性、高复发率及易恶变的特性,引起了人们的广泛关注。近年来人乳头状瘤病毒感染与鼻内翻性乳头状瘤的发病、恶变及复发得到人们的普遍认可。本文对近几年来人乳头状瘤病毒感染与鼻内翻性乳头状瘤的发病、恶变及其预后关系的相关研究做一综述。     

儿童喉乳头状瘤研究进展[综述]

喉乳头状瘤是儿童最常见的呼吸道良性肿瘤,主要临床表现为声嘶、喘鸣和呼吸困难,严重者可出现完全性喉梗阻导致窒息。儿童喉乳头状瘤的病原体主要为人乳头状瘤病毒（human papilloma virus,HPV）,且主要为低危型HPV6、11型,HPV11型感染和发病年龄早更容易导致不良预后。目前认为幼儿HPV感染途径主要为宫内感染、经阴道接触感染,但母体感染HPV并不是终止妊娠和剖宫产指征。手术是目前主要的治疗方式,疫苗接种等辅助治疗日益发挥作用。     

复发性呼吸道乳头状瘤病

本文结合一组63例复发性乳头状瘤的基础及临床研究资料进行分析，其中16例的瘤组织以Slotblot和Southernblot杂交技术检测HPV－DNA，其阳性率：HPV6b为87.5％，HPV11为93．7％，HPV16为81．2％。本文就病因学、感染途径、复发部位与上皮组织特性及治疗选择进行讨论。     

鼻腔及鼻窦内翻性乳头状瘤与人乳头状瘤病毒感染及病毒亚型的关系

目的 采用多聚酶链反应(polymerase chain reaction，PCR)检测鼻腔及鼻窦内翻性乳头状瘤(nasal inverted papilloma，NIP)中人乳头状瘤病毒(human papilloma virus，HPV)DNA及其亚型，旨在探讨HPV在NIP发病中的作用及其与预后的关系。方法将28例鼻腔及鼻窦NIP分为无复发组、复发组、癌变组，用聚合酶链反应检测其HPV通用型、6、11、16及18型的感染情况，同时以10例慢性炎症鼻黏膜或炎症性鼻息肉病例为对照。结果28例NIP患者HPV-DNA总阳性率为75％(21例)。无复发组病例HPV-DNA阳性率为42％(5／12)，均为单一的低危型HPV感染(4例为HPV6型，1例为HPV11型)；复发组的13例和癌变组的3例中，均可检出HPV-DNA。复发者以检出HPV6、HPV11型DNA为主，4例具有双重感染。癌变者以检出HPV16、HPV18型DNA为主，其中2例为双重感染。结论NIP的发生与HPV感染密切相关。应用PCR检测HPV及各亚型感染情况有助于预测肿瘤的临床行为及预后，指导临床对高危患者进行重点监测。     

Human papillomavirus type 11 DNA in squamous cell carcinomas and pre-existing multiple laryngeal papillomas

The case histories of 4 patients are presented, who developed an invasive squamous cell carcinoma from pre-existing multiple laryngeal papillomatosis (two juvenile-onset and two adult-onset) during a long latency period. A series of 14 routinely processed, paraffin-embedded biopsies obtained from these patients (including both benign papillomas and carcinomas) were analysed using in situ DNA-hybridization technique with 35S-labelled Human papillomavirus (HPV) DNA probes of HPV types, 6, 11, 16, 18 and 30. The lesions were also assessed by indirect immunoperoxidase (IP-PAP) technique to demonstrate the expression of HPV structural proteins. On light microscopy, morphology was consistent with HPV infection in all 14 biopsies. HPV antigen expression could not be demonstrated in any of the papillomas or carcinomas, however. HPV 11 DNA was present in high copy numbers in both the benign and malignant lesions of 2 patients, both presenting with the juvenile-onset disease. The present findings provide support for the role of HPV as an etiological agent in laryngeal squamous cell carcinoma, most probably acting synergistically with chemical or physical carcinogens (one patient received irradiation and 2 others were smokers). It seems clear that an infection by the 'low risk' HPV types 6 and 11 by no means excludes the possibility of developing a laryngeal malignancy, so far ascribed to the 'high risk' type HPV 16 only.     

Integration of human papilloma virus type 26 in laryngeal cancer of a child

Squamous cell carcinoma (SCC) in larynx is rare with children and adolescents. Usually larynx cancer is common with male smokers in the 7th decade. Among patients with no history of tobacco and/or alcohol consumption several factors have can play a role in the outbreak of laryngeal cancer: such as individual predisposition, radiation, gastroesophageal reflux, viral infection, dietary factors and environmental influences. In literature only few cases of laryngeal cancer with children are reported. Recent studies show that the most frequent laryngeal malignancy is the embryonal rhabdomyosarcoma. Besides the recurrent respiratory papillomatosis (RRP) based on an infection with human papilloma virus (HPV) types 6 and 11 (low risk) and types 16 and 18 (high risk) is known for a possible malignant transformation towards a SCC. HPV type 26 is only reported as low risk type HPV associated with cervical cancer. Final diagnosis often takes a long time. Initial symptoms such as hoarseness, cough or shortness of breath are often referred to more typical pediatric diseases or laryngeal development.     

EMP1在鼻腔鼻窦内翻性乳头状瘤中表达及其与上皮化生的相关性

目的 探讨上皮细胞膜蛋白1（EMP1）在鼻腔鼻窦内翻性乳头状瘤中的表达及其在疾病发生中的意义。 方法 采用免疫组化和Quantitative PCR分别在25例鼻腔鼻窦内翻性乳头状瘤和15例正常下鼻甲黏膜标本中测定EMP1的表达。 结果 在鼻腔鼻窦内翻性乳头状瘤组织中,中度上皮化生（12/25 ,48 ％）是最常见的上皮重塑类型。与对照组相比, EMP1的蛋白及mRNA水平均有明显的降低。此外,EMP1的表达水平与上皮化生的严重程度呈负相关性。 结论 在鼻腔鼻窦内翻性乳头状瘤中,EMP1表达的下调与上皮化生的严重程度相关,可作为评估鼻腔鼻窦内翻性乳头状瘤上皮异常重塑的一个生物指标。     

Tracing human papillomavirus DNA in nasal polyps by polymerase chain reaction

Human papillomavirus (HPV) infections are related to the genesis of various benign and malignant human neoplasias. The HPV types 16 and 18 seem to be causally related to the development of most squamous cell carcinoma of the anogenital tract and a proportion of carcinomas of the upper aerodigestive tract. The near 100% positivity of the HPV types 6 and 11 in laryngeal papillomatosis is well established. We investigated whether HPV also plays a role in non-neoplastic mucosal entities such as sinunasal polyposis, the genesis of which has been discussed as being triggered by viral infections. On DNA from 39 sinunasal polyps (33 patients), polymerase chain reaction (PCR) was performed using beta-globin primers for demonstration of amplifiable DNA in the tissue extracts. Consensus primers for the detection of several different HPV types were applied to the beta-globin-positive samples. The results were confirmed by Southern blot hybridization using consensus probes. Cycle sequencing was performed on the positive cases. All 39 samples showed positive signals for beta-globin. HPV-DNA investigations showed a slight positive signal in only 1 of the 39 investigated cases (2.6%). Further molecular investigations of this sample, including cycle sequencing, could not confirm this result. All the other tissue samples remained HPV-DNA-negative. Therefore, those HPV types readily detectable with the PCR primers and probes used are not frequently associated with sinunasal polyposis. The data confirm the hypothesis that HPV is correlated to a lesser extent to infectious mucosal lesions than to proliferative lesions. Furthermore, the results emphasize that the presence of HPV in specific lesions does not occur by chance, but represents a specific infection of the mucosa leading to proliferation and even to malignancy.     

鼻内翻性乳头状瘤中Fascin的表达及与微血管密度的关系

目的:探讨Fascin在鼻腔鼻窦内翻性乳头状瘤中的表达及其与微血管密度(MVD)的关系。方法:采用免疫组织化学方法检测30例鼻腔鼻窦内翻性乳头状瘤、12例鼻腔鳞状细胞癌及10例正常下鼻甲黏膜标本中Fascin的表达水平,计数CD34标记的肿瘤MVD。结果:鼻腔鼻窦内翻性乳头状瘤和鼻腔鳞状细胞癌组织中Fascin的表达分别为56.6%和83.3%,均显著高于正常下鼻甲黏膜组织20.0%(均P<0.01)。CD34标记的MVD值在下鼻甲、鼻腔鼻窦内翻性乳头状瘤、鼻腔鳞状细胞癌分别为23.64±2.74、45.10±5.45、74.76±7.32,两两比较差异均有统计学意义(均P<0.01)。Fascin表达与MVD计数呈正相关(P<0.01)。结论:Fascin的高表达以及血管生成与鼻腔鼻窦内翻性乳头状瘤的生物学行为密切相关,Fascin在鼻腔鼻窦内翻性乳头状瘤和鼻腔鳞状细胞癌的发生、发展中起重要作用,Fascin可能与血管生成在鼻腔内翻性乳头状瘤的发展中起协同作用。     

鼻腔鼻窦内翻性乳头状瘤的临床分期及术式选择

鼻腔鼻窦内翻性乳头状瘤(sinonasal inverted papilloma,SNIP)是鼻腔最常见的良性肿瘤,三个特征使SNIP与其它鼻腔肿瘤有很大的不同:局部破坏性大,复发率较高,有癌变可能。SNIP分期至关重要,其在SNIP术式选择以及预后评估方面具有公认的价值,但目前还没有普遍接受的分期系统。手术是SNIP首选治疗方式,术式可分为鼻外入路、鼻内镜入路以及联合入路,但是切除SNIP的最佳术式仍然存在争议。本文对SNIP分期系统以及术式管理的最新进展进行综述。