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目的 :探讨不同类型的鼻内乳头状瘤与人乳头状瘤病毒 (HPV)感染的关系。方法 :按照 1991年WHO的上呼吸道肿瘤分类法 ,鼻内乳头状瘤病理标本 30例中 ,外生性乳头状瘤 7例 ,内翻性乳头状瘤 18例 ,柱状细胞乳头状瘤 5例。采用多聚酶链反应 (PCR)和免疫组化 (IH)法分别检测标本中与HPV相关的DNA和PV结构的抗原 ,并以 5例鼻息肉为对照。结果 :7例外生性乳头状瘤组织中 5例 (72 % )HPV阳性 ;18例内翻性乳头状瘤仅 1例 (5 .8% )阳性 ;5例柱状细胞乳头状瘤及对照组鼻息肉 5例中均未检出阳性。外生性乳头状瘤组中HPV的检出率与其他各组差异有显著性 (P <0 .0 5 )。结论 :HPV感染与外生性乳头状瘤的发生过程密切相关 ,与内翻性乳头状瘤和柱状细胞乳头状瘤的病因无明显相关性。对内翻性乳头状瘤的治疗目前采用干扰素及转移因子等药物治疗效果有待进一步探讨 ,以手术治疗为主较妥。
Objective: To investigate the relationship between different types of intranasal papilloma and human papillomavirus (HPV) infection. Methods: According to WHO classification of upper respiratory tract in 1991, among 30 cases of pathological specimens of nasal papilloma, 7 cases were exogenous papilloma, 18 cases were inverted papilloma and 5 cases were papillary thyroid. Polymerase chain reaction (PCR) and immunohistochemistry (IH) were used to detect the DNA and PV structure-associated antigens in the specimens respectively. Five cases of nasal polyps were used as controls. Results: HPV was positive in 5 cases (72%) of 7 cases of exogenous papilloma tissues; in 18 cases of inverted papilloma was only 1 case (5. 8%) positive; 5 cases of papillary thyroid tumor and control group of nasal polyps 5 cases were not detected positive. The detection rate of HPV in the exogenous papilloma group was significantly different from other groups (P <0.05). CONCLUSION: HPV infection is closely related to the pathogenesis of exogenous papilloma, but not to the cause of inverted papilloma and columnar papilloma. The treatment of inverted papilloma currently used interferon and transfer factor and other drug treatment needs further study, mainly to surgical treatment.