Kao Patricia C, Vecchio James A, Schned Laura M, Blaszyk Hagen
Department of Internal Medicine, University of Vermont College of Medicine, Burlington, 05405, USA.
Eur J Gastroenterol Hepatol. 2005 Nov;17(11):1233-7. doi: 10.1097/00042737-200511000-00013.
Esophageal squamous papillomatosis is rare and has been associated with gastroesophageal reflux and recurrent respiratory papillomatosis. We report a case of extensive esophageal papillomatosis, no airway involvement and a slowly progressive clinical course with progressive strictures and ultimately fatal squamous cell carcinoma. In-situ hybridization performed on biopsy specimens was negative for high-risk human papilloma virus types. Due to the paucity of reported cases, little is conclusively known about the etiology, natural course and best clinical management of this disease. Human papilloma virus has been linked to some, but not all, cases, and the clinical course has been reported to vary from spontaneous regression to malignant transformation. Surveillance for malignancy by conventional endoscopic biopsies or computed tomography scan appears to have low sensitivity. This case illustrates the difficulties in clinical management and establishing a definite etiology in esophageal squamous papillomatosis.
食管鳞状乳头状瘤病较为罕见，与胃食管反流及复发性呼吸道乳头状瘤病相关。我们报告一例广泛性食管乳头状瘤病，未累及气道，临床病程呈缓慢进展，伴有进行性狭窄，最终发展为致命性鳞状细胞癌。对活检标本进行的原位杂交检测显示高危型人乳头瘤病毒呈阴性。由于报道的病例较少，关于该疾病的病因、自然病程及最佳临床管理知之甚少。人乳头瘤病毒与部分而非全部病例有关，据报道临床病程从自发消退到恶性转化不等。通过传统内镜活检或计算机断层扫描进行恶性肿瘤监测的敏感性似乎较低。该病例说明了食管鳞状乳头状瘤病临床管理及确定明确病因的困难。
