Brandwein M, Nuovo G, Ramer M, Orlowski W, Miller L
Department of Pathology and Oral Pathology, Mount Sinai School of Medicine, New York 10021, USA.
Mod Pathol. 1996 Mar;9(3):298-303.
Hairy leukoplakia, often seen in patients with acquired immunodeficiency syndrome, is strongly associated with Epstein-Barr virus (EBV) infection and questionably associated with human papillomavirus (HPV) infection. To date, most in situ hybridization (ISH) studies suggest that the EBV is localized only to the superficial squamous layers, favoring the theory of lingual infection by saliva rather than by reactivation of latent lingual infection. We describe 11 formalin-fixed, paraffin-embedded specimens from patients with lingual hairy leukoplakia that we examined for the presence of the EBV, HPV, cytomegalovirus, and human immunodeficiency virus. We used standard DNA ISH for the EBV and cytomegalovirus and polymerase chain reaction ISH for the EBV, HPV, and human immunodeficiency virus. The EBV was present in all 11 specimens according to polymerase chain reaction ISH studies but in only seven specimens according to conventional DNA ISH. Polymerase chain reaction ISH localized the EBV to the basal and parabasal layers in addition to the strong localization in the upper epithelial layers. No evidence for HPV or cytomegalovirus DNA was found. The human immunodeficiency virus was focally localized to rare superficial squamous cells in seven specimens. The presence of EBV DNA in basal and parabasal lingual cells, as well as localization of latency-associated proteins in these layers, suggests that hairy leukoplakia in patients with acquired immunodeficiency syndrome might represent a reactivation of latent lingual infection accompanied by a dramatic increase in viral copy number in the more mature, superficial, squamous cells. The human immunodeficiency virus was also found in seven specimens, but the significance of this new finding is uncertain and requires further study. There is no evidence to suggest that the HPV is involved in the development of hairy leukoplakia.
毛状白斑常见于获得性免疫缺陷综合征患者，与爱泼斯坦-巴尔病毒（EBV）感染密切相关，与人乳头瘤病毒（HPV）感染的相关性尚存在疑问。迄今为止，大多数原位杂交（ISH）研究表明，EBV仅局限于浅表鳞状上皮层，这支持了唾液导致舌部感染而非潜伏性舌部感染再激活的理论。我们描述了11例来自舌部毛状白斑患者的福尔马林固定、石蜡包埋标本，对其进行了EBV、HPV、巨细胞病毒和人类免疫缺陷病毒的检测。我们使用标准DNA ISH检测EBV和巨细胞病毒，使用聚合酶链反应ISH检测EBV、HPV和人类免疫缺陷病毒。根据聚合酶链反应ISH研究，所有11个标本中均存在EBV，但根据传统DNA ISH检测，仅7个标本中存在EBV。聚合酶链反应ISH显示，除了在上皮上层有强烈定位外，EBV还定位于基底和副基底层。未发现HPV或巨细胞病毒DNA的证据。在7个标本中，人类免疫缺陷病毒局灶性定位于罕见的浅表鳞状细胞。基底和副基底舌细胞中存在EBV DNA，以及这些层中潜伏相关蛋白的定位，表明获得性免疫缺陷综合征患者的毛状白斑可能代表潜伏性舌部感染的再激活，同时伴随着更成熟的浅表鳞状细胞中病毒拷贝数的显著增加。在7个标本中也发现了人类免疫缺陷病毒，但这一新发现的意义尚不确定，需要进一步研究。没有证据表明HPV参与了毛状白斑的发生发展。
