Saumet L, Damay A, Jeziorski E, Cartier C, Rouleau C, Margueritte G, Rodière M, Segondy M
Hôpital Arnaud-de-Villeneuve, centre hospitalier universitaire, pôle Enfant, 34295 Montpellier, France.
Arch Pediatr. 2011 Jul;18(7):754-7. doi: 10.1016/j.arcped.2011.04.013. Epub 2011 May 18.
Malignant transformation of juvenile-onset recurrent respiratory papillomatosis (RRP) is a rare event and the cases reported have been mainly observed in adults. We report the case of a 15-year-old girl with a history of severe RRP who died of a HPV 11-associated bronchopulmonary squamous cell carcinoma with pericardial invasion. HPV 11 was identified in nasopharyngeal and tracheal papillomas, as well as in the pericardial fluid. HPV 11 isolate was further analyzed by amplification and sequencing of the E1, E2, E4, E6, and E7 genes. Only one amino acid substitution in E4 due to natural polymorphism was observed. Exons 5-9 of the patient's tumor protein 53 (TP53) gene were sequenced and no mutations were identified. This observation confirms that malignant conversion of juvenile-onset RRP associated with HPV 11 to squamous cell carcinoma may arise in children. HPV 11-induced carcinogenesis needs to be further investigated.
青少年复发性呼吸道乳头状瘤病(RRP)的恶性转化是一种罕见事件,且已报道的病例主要见于成年人。我们报告了一名15岁患有严重RRP病史的女孩,她死于伴心包侵犯的HPV 11相关支气管肺鳞状细胞癌。在鼻咽和气管乳头状瘤以及心包积液中鉴定出HPV 11。通过对E1、E2、E4、E6和E7基因进行扩增和测序,进一步分析了HPV 11分离株。仅观察到由于自然多态性导致的E4中一个氨基酸替代。对患者肿瘤蛋白53(TP53)基因的第5 - 9外显子进行测序,未发现突变。这一观察结果证实,与HPV 11相关的青少年RRP向鳞状细胞癌的恶性转化可能发生在儿童中。HPV 11诱导的致癌作用需要进一步研究。