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Epstein-Barr 病毒在复发性呼吸道乳头状瘤病严重程度中的作用。

Role of epstein-barr virus in the severity of recurrent respiratory papillomatosis.

机构信息

Department of Biosciences and Oral Diagnosis, Institute of Science and Technology, São Paulo State University (Unesp), São José dos Campos, São Paulo, Brazil.

Department of Stomatology, Collective Health and Legal Dentistry, Ribeirão Preto School of Dentistry, São Paulo, Brazil.

出版信息

Laryngoscope. 2020 Nov;130(11):E611-E618. doi: 10.1002/lary.28465. Epub 2019 Dec 20.

Abstract

OBJECTIVE

The objective was to investigate the prevalence of the Epstein-Barr virus (EBV) and its association with human papilloma virus (HPV) detection, clinicopathological features, and the severity of recurrent respiratory papillomatosis (RRP).

METHODS

Cases of juvenile recurrent respiratory papillomatosis (JRRP) (n = 36) and adult recurrent respiratory papillomatosis (ARRP) (n = 44) were collected retrospectively and subdivided into low- and high-risk severity groups based on the Derkay score. We performed HPV detection and genotyping using a reverse hybridization protocol and investigated the presence of EBV by polymerase chain reaction (PCR) and in situ hybridization. CD21 levels were accessed by immunohistochemistry.

RESULTS

All samples were HPV-positive, including 49 cases of HPV 6, 26 cases of HPV 11, four cases of HPV 6 and 11 coinfections, and one case of HPV 16. EBV-DNA was detected in nine samples by PCR, although none of the cases were positive by means of in situ hybridization. CD21 immunoexpression was not statistically associated with any of the variables analyzed. HPV 6 detection was significantly higher in ARRP cases (P = 0.03), whereas HPV 11 was more prevalent in JRRP cases (P = 0.02) and was even more prevalent in JRRP cases of greater severity (Derkay laryngoscopic scale ≥20) (P = 0.04).

CONCLUSION

The presence of EBV does not seem to play an important role in the progression/severity of RRP.

LEVEL OF EVIDENCE

4 Laryngoscope, 130:E611-E618, 2020.

摘要

目的

本研究旨在调查 Epstein-Barr 病毒(EBV)的流行情况及其与人类乳头瘤病毒(HPV)检测、临床病理特征以及复发性呼吸道乳头状瘤病(RRP)严重程度的相关性。

方法

本研究回顾性收集了青少年复发性呼吸道乳头状瘤病(JRRP)(n=36)和成人复发性呼吸道乳头状瘤病(ARRP)(n=44)病例,并根据 Derkay 评分将其分为低危和高危严重程度亚组。我们采用反向杂交技术进行 HPV 检测和基因分型,并通过聚合酶链反应(PCR)和原位杂交技术检测 EBV 的存在。通过免疫组织化学检测 CD21 水平。

结果

所有样本均为 HPV 阳性,其中 49 例为 HPV 6,26 例为 HPV 11,4 例为 HPV 6 和 11 混合感染,1 例为 HPV 16。PCR 检测到 9 例样本中存在 EBV-DNA,但原位杂交技术均未检测到阳性。CD21 免疫表达与分析的任何变量均无统计学相关性。ARRP 病例中 HPV 6 的检出率明显更高(P=0.03),而 JRRP 病例中 HPV 11 的检出率更高(P=0.02),且在更严重的 JRRP 病例(Derkay 喉镜分级≥20)中更为常见(P=0.04)。

结论

EBV 的存在似乎在 RRP 的进展/严重程度中不起重要作用。

证据等级

4 Laryngoscope, 130:E611-E618, 2020.

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