Department of Otorhinolaryngology and Cervicofacial Surgery, University Medical Center, Ljubljana, Slovenia.
Virchows Arch. 2011 Nov;459(5):529-38. doi: 10.1007/s00428-011-1139-1. Epub 2011 Sep 9.
Inverted papillomas (IPs) are the most frequent type of sinonasal papillomas. These benign but destructive lesions are known for their high recurrence rate, probably due to incomplete excision. Our aim was to investigate the frequency of human papillomavirus (HPV) infection in patients with IPs and in IPs associated with squamous cell carcinoma (IPsSCC) and to compare it with the frequency of HPV infections in the control group. The influence of HPV infection on the malignant alteration and recurrence rate of IPs was also evaluated. Paraffin-embedded tissue samples from 68 patients with sinonasal IPs and 5 patients with IPsSCC were analyzed in this retrospective study. The control group consisted of 47 patients who had undergone septoplasty or mucotomy of the inferior turbinate. PCR amplification with consensus primer sets was performed to detect alpha-HPVs, and direct sequencing of the PCR products with the same primers was used to determine the HPV genotypes in the samples. We detected HPV DNA in 20 (30.3%) patients with IPs, in 3 (60%) patients with IPsSCC, and in 6 (13%) patients from the control group. The frequency of HPV infection in the study group was statistically significantly higher (p = 0.032) than in the control group. The presence of HPV DNA was not a statistically significant predictor of the recurrence of IPs (p = 0.745) nor was it a statistically significant risk factor for associated SCC (p = 0.32). Since HPV type 11 was the predominant genotype in the IPs, IPsSCC, and in the control cases, we presume that HPV infection may represent incidental colonization rather than being an important etiological factor of IPs.
倒置性乳头状瘤（IP）是最常见的鼻腔鼻窦乳头状瘤类型。这些良性但具有破坏性的病变以高复发率而闻名，这可能是由于不完全切除。我们的目的是研究 IP 患者、IP 合并鳞状细胞癌（IPsSCC）患者中人类乳头瘤病毒（HPV）感染的频率，并与对照组进行比较。还评估了 HPV 感染对 IP 恶性改变和复发率的影响。在这项回顾性研究中，分析了 68 例鼻腔鼻窦 IP 患者和 5 例 IPsSCC 患者的石蜡包埋组织样本。对照组由 47 例接受鼻中隔成形术或下鼻甲粘骨膜切除术的患者组成。使用共识引物组进行 PCR 扩增以检测α-HPV，并用相同的引物对 PCR 产物进行直接测序以确定样品中的 HPV 基因型。我们在 20 例（30.3%）IP 患者、3 例（60%）IPsSCC 患者和对照组的 6 例（13%）患者中检测到 HPV DNA。研究组 HPV 感染的频率明显高于对照组（p=0.032）。HPV DNA 的存在不是 IP 复发的统计学显著预测因子（p=0.745），也不是与 SCC 相关的统计学显著危险因素（p=0.32）。由于 HPV 型 11 是 IP、IPsSCC 和对照组中主要的基因型，我们推测 HPV 感染可能代表偶然定植，而不是 IP 的重要病因。
