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。

Relationship between prognosis of nasal inverted papilloma and human papillomavirus types

Objective To detecte HPV human papillomavirus DNA and HPV types in NIP nasal inverted papilloma, to inquire into the infection of HPV in the pathogenese of NIP, and the relationship of HPV with the prognosis of NIP. Methods Twenty-eight cases of NIP were divided into 3 groups: no recurrence group (group 1), recurrence group (group 2), squamous cell carcinoma (SCC) arising in NIP group (malignancy group, group 3). Ten cases of benign nasal polyps were used as control group. HPV-DNA types of 6, 11, 16, 18 and general type were detected by polymerase chain reaction (PCR). Results(Total ) positive rate of HPV in NIP was 75% (21/28). The positive rate of group 1 was 42%(5/12), all with single and low risk HPV type infection (4 with HPV6 and 1 with HPV11). Thirteen cases of recurrence and 3 cases of malignancy were discovered to have HPV-DNA, in group 2,the majority were HPV6 and HPV11, 4 cases with double infection;in group 3,the majority were HPV16 and HPV18, and 2 cases with double infection. Conclusions The occurrence of NIP was related with HPV infection. To detecte HPV and its subtypes can show the cases easily to have recurrence or malignant change. For the cases with HPV positive, double infection and infected with high risk types should be closely followed- up.