Department of Neurosciences, Section of Otolaryngology, University of Padova, Padova, Italy.
International Agency for Research On Cancer, Lyon, France.
Eur Arch Otorhinolaryngol. 2022 Jan;279(1):285-292. doi: 10.1007/s00405-021-07040-9. Epub 2021 Aug 28.
The aim of our study was to evaluate the prevalence of different HPV genera-alpha, beta and gamma-in Juvenile onset Recurrent Respiratory Papillomatosis (JoRRP) and examine the association of type and genus-specific viral features with the clinical outcome of disease.
This retrospective observational study included consecutive patients with JoRRP who were treated in a referral centre between October 2000 and October 2020. All patients underwent cold excision and laser vaporisation of papillomatous lesions. Samples were analysed for the presence of 120 viral genotypes (22 alpha-HPV, 46 beta-HPV, 52 gamma-HPV) using a highly sensitive multiplex genotyping assay.
Twenty patients with JoRRP, aged 0.3-11 years, were included, with a median follow-up of 13.5 years. All samples were HPV DNA positive: 20 (100%) for alpha-HPV DNA; 7 (35%) for beta-HPV DNA; 0 for gamma-HPV DNA. Three groups were defined according to the number of infections: seven cases (35%) with HPV mono-infection; ten cases (50%) with HPV double-infection; three cases (15%) with ≥ 3 HPV infections. At diagnosis, patients with ≥ 3 HPV infections reported higher median Derkay's score than those with mono-infection (21 vs 14, P = 0.018). Number of HPV infections was also associated with clinical outcomes, with an average of 0.5 surgical procedures/year in patients with mono-infection, 1.2 for double-infection, 2.6 for ≥ 3 infections (P = 0.006).
Despite the small sample size, these preliminary data support an association between the number of different alpha and beta HPV co-infections and the clinical severity of the disease.
本研究旨在评估青少年复发性呼吸道乳头瘤病（JoRRP）中不同 HPV 属-α、β和γ的流行情况，并研究病毒类型和属特异性特征与疾病临床结局的相关性。
本回顾性观察性研究纳入了 2000 年 10 月至 2020 年 10 月期间在一家转诊中心接受治疗的连续 JoRRP 患者。所有患者均接受冷切除和激光汽化乳头状病变。使用高度敏感的多重基因分型检测方法，对 120 种病毒基因型（22 种α-HPV、46 种β-HPV、52 种γ-HPV）的存在情况进行分析。
共纳入 20 例年龄 0.3-11 岁的 JoRRP 患者，中位随访时间为 13.5 年。所有样本均为 HPV DNA 阳性：20 例（100%）为α-HPV DNA；7 例（35%）为β-HPV DNA；0 例为γ-HPV DNA。根据感染数量，将患者分为三组：7 例（35%）为 HPV 单一感染；10 例（50%）为 HPV 双重感染；3 例（15%）为≥3 种 HPV 感染。在诊断时，感染≥3 种 HPV 的患者的 Derkay 评分中位数高于单一感染的患者（21 与 14，P=0.018）。HPV 感染数量也与临床结局相关，单一感染患者的平均每年手术次数为 0.5 次，双重感染为 1.2 次，≥3 种感染为 2.6 次（P=0.006）。
尽管样本量较小，但这些初步数据支持不同的α和β HPV 共感染数量与疾病严重程度之间存在相关性。
