Kajal Smile, Kakkar Aanchal, Naz Farhat, Tanwar P Pranay, Khandakar Hena, Gupta Anurag, Thakar Alok, Verma Hitesh
Department of Otorhinolaryngology and Head-Neck Surgery, All India Institute of Medical Sciences (AIIMS), New Delhi, India.
Department of Pathology, AIIMS, New Delhi, India.
Indian J Otolaryngol Head Neck Surg. 2024 Feb;76(1):596-603. doi: 10.1007/s12070-023-04220-3. Epub 2023 Sep 12.
Various clinico-pathological factors play role in the papilloma proliferation and pathogenesis of Recurrent respiratory papillomatosis (RRP). However, it is not known if they are directly responsible for malignant transformation of these papillomas or not. We did this study to elucidate any such association. The most recent debrided tissue of RRP in 20 patients was evaluated for p16 expression, VEGF estimation (tissue expression and serum levels), and tissue HPV DNA concentration. The final histopathology results were then correlated with these pathological factors and with clinical factors like duration of illness, age of onset of symptoms, extent of disease, etc. Squamous papilloma was seen in 60%, dysplasia in 25%, and squamous cell carcinoma (SCC) in 15% of the patients. Positive immunostaining for p16 (staining in ≥70% of tumor cells) was seen only in one case, which was SCC. There was no statistically significant difference between p16 expression, tissue VEGF expression, serum VEGF levels, and tissue HPV DNA in any of the histological groups. The mean age of disease onset was significantly higher in patients with SCC (p = 0.03). A significantly higher number of patients with dysplasia had tracheobronchial involvement (p = 0.022). We concluded that no single pathological factor is solely responsible for development of malignancy in RRP, whereas clinical factors like tracheobronchial involvement and age of onset may contribute to development of dysplasia or carcinoma.
多种临床病理因素在复发性呼吸道乳头状瘤病（RRP）的乳头状瘤增殖和发病机制中发挥作用。然而，尚不清楚它们是否直接导致这些乳头状瘤的恶性转化。我们开展这项研究以阐明任何此类关联。对20例RRP患者最新清创组织的p16表达、VEGF评估（组织表达和血清水平）以及组织HPV DNA浓度进行了检测。然后将最终组织病理学结果与这些病理因素以及疾病持续时间、症状发作年龄、疾病范围等临床因素进行关联分析。60%的患者可见鳞状乳头状瘤，25%可见发育异常，15%可见鳞状细胞癌（SCC）。仅1例SCC患者p16免疫染色呈阳性（≥70%的肿瘤细胞染色）。在任何组织学组中，p16表达、组织VEGF表达、血清VEGF水平和组织HPV DNA之间均无统计学显著差异。SCC患者的平均发病年龄显著更高（p = 0.03）。发育异常患者气管支气管受累的比例显著更高（p = 0.022）。我们得出结论，在RRP中没有单一病理因素是恶性肿瘤发生的唯一原因，而气管支气管受累和发病年龄等临床因素可能有助于发育异常或癌的发生。
