人乳头状瘤病毒与鼻内翻性乳头状瘤的关系

为探讨人乳头状瘤病毒（ＨＰＶ）感染与鼻内翻性乳头状瘤（ＩＰ）发病及其恶变的关系，研究选取组织病理确认为ＩＰ（３６例）和ＩＰ癌变（１６例）的石蜡包埋标本，采用多聚酶链反应（ＰＣＲ）方法对标本进行ＨＰＶ相关ＤＮＡ序列扩增。结果显示：３６例ＩＰ组织有２１例（５８．３％）为ＨＰＶ阳性；１６例ＩＰ癌变组织中有１１例（６８．８％）阳性。经统计学处理，二者间无显著性差异（Ｐ〉０．０５）．提示ＨＰＶ感染在ＩＰ的发     

血管内皮生长因子在鼻内翻性乳头状瘤中的表达

目的：明确血管内皮生长因子（ＶＥＧＦ）及其受体在鼻内翻性乳头状瘤（ＮＩＰ）组织中的探讨其在ＮＩＰ发病中的作用。方法：采用免疫组化ＳＰ法,对１１例ＮＩＰ标本及６例慢性单纯性鼻炎患者的下鼻甲标本,检测ＶＥＧＦ及其胎肝激酶受体,以图像分析仪半定量测定ＶＥＧＦ和ｆｌｋ－１的表达强度。     

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。     

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。     

鼻内翻性乳头状瘤误诊为鼻息肉的分析

我科於1978年至1993年收治15例鼻腔及鼻窦内翻性乳头状瘤，均曾在本院或外院误诊为鼻息内，现报告如下。临床资料本组15例中，男11例，女4例。发病年龄48～62岁。左鼻腔4例，右鼻腔6例。病程最短为1年6个月，最长20年。病史表现为不同程度鼻塞及流粘脓涕，1例涕中带血。检查鼻腔均可见灰白色或紫红色息肉样新生物，有的表面欠光滑，呈颗粒状，触之易出血。1例X线显示右眼眶内侧壁骨质破坏。全部病例均有“鼻息肉”手术史2～5次，其中1例曾取右鼻腔部分新生物活检，病理报告为鼻息肉。后因“鼻息肉”术后复发频繁，乃将鼻腔手术标本全部送检…     

人乳头状瘤病毒57感染与鼻内翻性乳头状瘤发生的相关性

目的:研究人乳头状瘤病毒(HPV)感染与鼻内翻性乳头状瘤(IP)发生的相关性,进一步明确HPV57在IP发生中的作用。方法:随机收集经病理确诊的IP病变组织石蜡包埋标本60个,分别采用HPVL1通用引物MY09/11和HPV57型特异性引物进行多聚酶链反应(PCR),对标本的HPV相关DNA序列扩增,计算其阳性率;另取10个慢性鼻窦炎病变组织标本作为对照,采用HPVL1通用引物MY09/11及HPV57型特异性引物进行PCR扩增。结果:60个鼻内翻性乳头状瘤组织标本经HPVL1通用引物MY09/11扩增后,均为阴性。经HPV57型特异性引物扩增后有47个(78.3%)为阳性。10个慢性鼻窦炎标本DNA模板均未能扩增出DNA片断。结论:HPV57型感染可能在IP的发生中起重要作用。     

鼻内翻性乳头状瘤恶变与人乳头状瘤病毒相关性

鼻内翻性乳头状瘤（sinonasal inverted papilloma,SNIP）是鼻腔及鼻窦较常见的良性肿瘤,但具有侵袭破坏性、易复发性以及恶变倾向,严重危害患者的健康。人乳头状瘤病毒（human papillomavirus, HPV）感染在SNIP的发生、发展及转归过程中发挥着重要作用,尤其是逐步认识到某些亚型HPV感染可能与SNIP恶变存在相关性。因此对HPV生物学特性及临床特性的深入研究认识有助于提高对SNIP的诊断、治疗及预防水平。本文就HPV与SNIP恶变的相关性研究进展做一综述。     

鼻内翻性乳头状瘤的临床分期与术式选择

目的；探讨鼻内翻性乳头状瘤的临床分期和手术方式选择，以降低复发率。方法：对41例鼻内翻性乳头状瘤，根据病变的 特征将其分期为T1、T2、T3、T4期，据此，19例行鼻内镜手术，20例行鼻侧切开手术，2例行上颌骨部分或全截除术。结果：鼻内镜手术后复发率为10.5％，鼻侧切开术后复发率为15.0％。结论：鼻内翻性乳头状瘤根据CT检查和病变的特征进行临床分期，按分期选择手术方式，可以彻底切除肿瘤，降低术后复发率。     

鼻内窥镜在鼻内翻性乳头状瘤手术中的价值

目的 :探讨鼻内窥镜在鼻内翻性乳头状瘤手术中的价值。方法 :鼻内翻性乳头状瘤患者 2 9例中 ,采用鼻内窥镜手术者 15例 (鼻内窥镜组 ) ,经鼻侧切开手术者 14例 (鼻侧切开组 ) ,并将两种手术结果进行比较。结果 :随访 1.8年。并发症 :鼻内窥镜组 (1例 )明显低于鼻侧切开组 (5例 ) ,P <0 .0 1;住院时间 :鼻内窥镜组 (13.1d)明显短于鼻侧切开组 (2 0 .4d) ,P <0 .0 1;术中出血量 (Ⅰ～Ⅱ级 ) :鼻内窥镜组 (175ml)亦明显少于鼻侧切开组 (5 2 5ml) ,P <0 .0 1。结论 :鼻内窥镜术是治疗Ⅰ～Ⅱ级鼻内翻性乳头状瘤一种较好的方法 ,其主要优点是避免了面部切口 ;对Ⅲ～Ⅳ级病例 ,使用鼻内窥镜术应持谨慎态度 ,鼻侧切开术仍不失为安全、可靠的治疗方法     

鼻内镜手术治疗鼻腔鼻窦内翻性乳头状瘤

对于鼻腔鼻窦内翻性乳头状瘤(NIP)的治疗，传统的手术方法为鼻侧切开术。随着鼻内镜手术的广泛开展，现多采用鼻内镜手术治疗。我们对经鼻内镜手术治疗的50例NIP患者的临床资料进行回顾性分析，探讨其手术疗效。     

VEGF及其受体的表达对鼻内翻性乳头状瘤恶变倾向预测的意义

目的:探讨血管内皮生长因子(VEGF)及其胎肝激酶受体(flk-1)在鼻内翻性乳头状瘤(NIP)恶变前不同阶段中的表达情况。方法:应用免疫组织化学LSAB法检测NIP、非典型增生的不同阶段及恶变组织中VEGF及其受体flk-1的表达情况。应用图像分析仪对染色结果进行定量分析。结果:VEGF、flk-1阳性染色随着不典型增生程度的加重,其在上皮组织和间质结缔组织中的表达强度和范围也增加。轻度不典型增生与NIP比较,中-重度不典型增生与轻度不典型增生比较,VEGF、flk-1表达差异均有统计学意义(均P<0.01)。中-重度不典型增生组织的表达强度与鳞状细胞癌组织接近。结论:VEGF参与了NIP的病理过程,VEGF及其受体flk-1的表达随肿瘤异型程度的增加其表达强度增加,其表达水平可以作为衡量NIP恶变倾向的指标之一。     

鼻内镜手术治疗鼻腔及鼻窦内翻性乳头状瘤的疗效观察

目的：观察鼻内镜手术治疗鼻腔及鼻窦内翻性乳头状瘤的疗效。方法：病理和临床诊断为鼻腔及鼻窦内翻性乳头状瘤16例,术前做鼻内镜检查及鼻窦CT扫描,全身麻醉鼻内镜下行鼻腔及鼻窦内翻性乳头状瘤切除术。结果：术后随访1～2年,16例患者术后复发2例。结论：鼻内镜手术是治疗Krouse Ⅰ～Ⅱ级鼻腔及鼻窦内翻性乳头状瘤的一种较好的方法,此方法的优点为视野清楚、创伤少、出血量少、复发率低、避免了面部切口。     

Prevalence of human papillomavirus in inverted nasal papillomas

Human papillomaviruses (HPVs) have been associated with both benign and malignant neoplasms of the head and neck. To determine the prevalence and types of HPVs in this neoplasm, we examined fixed tissue from 21 patients by in situ hybridization. Human papillomavirus types 6b and 11 probes were used, and hybridization was positive to both types in lesions from 16 (76%) of 21 patients. Hybridization to the HPV-11 probe resulted in the most intense nuclear staining throughout the epithelium, probably indicating a high copy number. The high incidence of viral DNA sequences found in this tumor suggests a potential etiologic role. Therapeutic implications are briefly discussed.     

Radiation therapy in inverted papillomas of the nasal cavity and paranasal sinuses

PURPOSE: Between December 1969 and September 1989, a total of 10 patients with advanced and/or recurrent inverted or cylindrical cell papillomas were treated with irradiation at the University of Florida in Gainesville. MATERIALS AND METHODS: Nine of 10 patients had 1 or more recurrences before they received radiation therapy. Three patients were treated with irradiation alone, and 7 patients received surgery and irradiation (preoperatively in 1 patient and postoperatively in 6 patients). Eight patients had inverted papillomas (3 with concomitant squamous cell carcinoma), and 2 patients had cylindrical cell papillomas. Results: Local recurrence developed in 4 patients at 1.5, 6.5, 12, and 13 years after treatment. No evidence of recurrence was observed in 6 patients at 7, 8.5, 8.5, 9, 9, and 20.5 years after treatment. Four patients died of intercurrent disease. No patient developed a malignant transformation. Significant complications of treatment included, in 1 patient, an area of bone exposure in the orbit that necessitated debridement. CONCLUSION: Surgery is the primary treatment of this entity. Radiation therapy should be considered in patients with incompletely resectable lesions, multiply recurrent tumors, and tumors associated with malignancy.     

Expression and localization of hepatocyte growth factor and its receptor c-Met in inverted papillomas

Abstract

Conclusions. The results suggest that elevated c-Met expression in combination with the co-expression of hepatocyte growth factor (HGF) in the epithelial cells of inverted papilloma may proliferate the epithelial cells of inverted papilloma. Objectives. HGF and its receptor, c-Met, have been identified in a variety of neoplastic and normal tissue types, implicating these factors in tissue regeneration and tumor progression. We investigated the expression and distribution of HGF and c-Met in normal nasal mucosa and inverted papilloma, to evaluate the possible influence of HGF and c-Met on the development of inverted papilloma. Materials and methods. Normal inferior turbinate mucosa and inverted papilloma were examined for expression of HGF and c-Met using RT-PCR, immunohistochemistry and Western blot analysis. Results. Using immunohistochemistry, moderate to high levels of HGF and c-Met protein were localized in epithelial cells in inverted papillomas tested in the present study. In normal turbinate mucosa immunopositive HGF was detected in the submucosal glands where faint staining was found. However, c-Met was noted in the epithelial cells and submucosal glands of normal turbinate mucosa. RT-PCR and Western blot analysis showed that the expression levels of HGF and c-Met were increased in inverted papilloma in comparison with the normal turbinate mucosa.     

Expression and localization of hepatocyte growth factor and its receptor c-Met in inverted papillomas

CONCLUSIONS: The results suggest that elevated c-Met expression in combination with the co-expression of hepatocyte growth factor (HGF) in the epithelial cells of inverted papilloma may proliferate the epithelial cells of inverted papilloma. OBJECTIVES: HGF and its receptor, c-Met, have been identified in a variety of neoplastic and normal tissue types, implicating these factors in tissue regeneration and tumor progression. We investigated the expression and distribution of HGF and c-Met in normal nasal mucosa and inverted papilloma, to evaluate the possible influence of HGF and c-Met on the development of inverted papilloma. MATERIALS AND METHODS: Normal inferior turbinate mucosa and inverted papilloma were examined for expression of HGF and c-Met using RT-PCR, immunohistochemistry and Western blot analysis. RESULTS: Using immunohistochemistry, moderate to high levels of HGF and c-Met protein were localized in epithelial cells in inverted papillomas tested in the present study. In normal turbinate mucosa immunopositive HGF was detected in the submucosal glands where faint staining was found. However, c-Met was noted in the epithelial cells and submucosal glands of normal turbinate mucosa. RT-PCR and Western blot analysis showed that the expression levels of HGF and c-Met were increased in inverted papilloma in comparison with the normal turbinate mucosa.     

鼻内镜下联合低温等离子刀切除鼻腔鼻窦内翻性乳头状瘤37例

目的 回顾性分析鼻腔鼻窦内翻性乳头状瘤的临床特点,探讨鼻内镜下联合低温等离子刀切除鼻腔鼻窦内翻性乳头状瘤的可行性.方法 在鼻内镜下使用低温等离子刀切除37例鼻腔鼻窦内翻性乳头状瘤,根据Krouse分级标准:T1期8例,T2期18例,T3期11例.术后鼻内镜下随访4～10年.结果 37例均在鼻内镜下成功使用低温等离子刀切...