Martins Regina Helena Garcia, Dias Norimar H, Gregório Elisa Aparecida, Marques Mariângela Alencar, Silva Márcia Guimarães da, Candeias João Manuel Grisi
Otorhinolaryngology Discipline, Botucatu Medical School-UNESP, Botucatu, SP.
Braz J Otorhinolaryngol. 2008 Jul-Aug;74(4):539-43. doi: 10.1016/s1808-8694(15)30600-5.
Laryngeal papillomatosis is the most frequent benign neoplasia in children. It is caused by HPV 6 and 11. The lesions are exophytic and highly recurrent, compromising the airway mucosa, mainly the larynx. Study design--clinical prospective.
To show morphologic alterations of the epithelium (light and electron microscopy) in the HPV-6 lesions.
Specimens of laryngeal lesions obtained during surgery of four children (1 male, 3 female) were submitted to HPV typing (PCR), light microscopy and electron microscopy.
In all specimens, HPV type 6 was found. Epithelial projections were found by electron microscopy with superficial cells in desquamation. Light microscopy showed exophytic projections of the keratinized stratified squamous epithelium overlying a fibrovascular core. Koilocytes (vacuolated cells), suggesting the viral infection by HPV, were identified. No alterations were seen in the basement membrane and corion. Ultraestrutural analysis showed vacuolated cells with clear cytoplasmic inclusions, intercellular injuries and widening intercellular spaces.
morphologic alterations of the epithelium in the HPV-6 lesions are superficial, and additional studies including the others HPV types are needed to show the more aggressive and extensive aspect of the disease.
喉乳头状瘤病是儿童最常见的良性肿瘤。它由人乳头瘤病毒6型和11型引起。病变为外生性且极易复发，累及气道黏膜，主要是喉部。研究设计——临床前瞻性研究。
展示人乳头瘤病毒6型病变中上皮的形态学改变（光镜和电镜观察）。
对4名儿童（1名男性，3名女性）手术中获取的喉部病变标本进行人乳头瘤病毒分型（聚合酶链反应）、光镜和电镜观察。
所有标本均检测出人乳头瘤病毒6型。电镜观察发现上皮突起，表层细胞有脱屑现象。光镜显示角化复层鳞状上皮的外生性突起覆盖在纤维血管核心之上。发现了空泡细胞（挖空细胞），提示为人乳头瘤病毒感染。基底膜和绒毛膜未见改变。超微结构分析显示有空泡细胞，胞质内有清晰包涵体，细胞间损伤及细胞间隙增宽。
人乳头瘤病毒6型病变中上皮的形态学改变较为表浅，需要开展包括其他型别人乳头瘤病毒的进一步研究，以揭示该疾病更具侵袭性和广泛性的特征。
