咽喉上皮增生性病变和HPV感染相关性的研究

对５１例咽喉上皮增生性病变进行病理组织学观察，并应用免疫组化及ＰＣＲ方法检测人类乳头瘤病毒。其中３７例咽喉部乳头状瘤样病变分为尖锐湿疣样病变、不典型尖锐湿疣样病变、鳞状上皮乳头状瘤３组。免疫组化检测ＨＰＶ－Ａｇ：第１组阳性率３３％，后２组全部阴性。ＰＣＲ检测ＨＰＶ－ＤＮＡ：前２组全部阳性，后１组阳性率１０％。１４例喉鳞状细胞癌分为鳞状细胞疣状癌（４例）、高分化鳞状细胞癌（１０例）２组。免疫组化检测ＨＰＶ－Ａｇ：前组阴性，后组阳性率１０％；ＰＣＲ检测ＨＰＶ－ＤＮＡ：前组阳性率５０％，后组阳性率３０％。结果表明：部分咽喉上皮增生性病变的发生与ＨＰＶ感染有关。

Study on the Correlation between HPV Infection and Laryngopharyngeal Epithelial Hyperplastic Lesions

We assayed HPV-Ag and HPVDNA using immunohistochemical stain and PCR amplification respectively in 51 laryngopharyngeal epithelial hyperplastic lesions and correlated these findinfg with histological changes. The group consists of 37 laryngopharyngeal papillomatous lesions, 14 squamous carcinoma of the larynx. We reclassfied into 3 subgroups : 9 cases of condyloma acuminata like lesion, 18 cases of notype condyloma acuminata like lesion,and 10 cases of squamous cell papillomas. In the subgroup of condyloma acuminata like lesion, the incidence of HPV-Ag positive immunohistochemical stain was 33% while ,it is 0% in the other two subgroups. In the first two subgroups the HPV-DNA by PCR amplification was manifested in 100% cases, but it was detected only in 10% in the third subgroup. 14 squamous carcinoma of the larynx was composed of 4 verrucous carcinoma and 10 well differentiated squamous cell carcinoma. The HPVAg was detected immunohistochemically in 10%(1/10) of well differentiated squamous cell carcinoma while it was 0% in verrucous carcinoma.In addition to this findings. HPV-DNA was detected in 50% (2/4) of verrucous carcinoma and 30% (3/10) of well differentiated squamous cell carcinoma. Our results suggestedthat the development of some subgroups of the laryngopharyngeal epithelial hyperplastic lesions was related to the infection of HPV. We put foward of the condyloma acuminate of the larynx is a pathological entity. We believe PCR amplification is the most sensitive technique for detection of HPV.