The Relationship Between Clinical Course And Human Papillomavirus Infection In Papillomas Of Patients With Paediatric-

The purpose of the article was to evaluate human papilloma virus (HPV) infection in paediatric-onset recurrent laryngeal papillomatosis(PORLP),and determine the prognostic role of the HPV types for clinical courses.Materials and Methods: 31 patients with PORJLP and 40 with adult-onset recurrent laryngeal papillomatosis (AORLP) were retrospectively analyzed for clinical behavior. Polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP) was used to detect the presence of HP V6b, IK 13, 16, 18, 25, 31, 31b, 32, 33, 34, 35> 39, 40, 42, 44, 45, 51, 52, 53, 54, 55, 56DNA in 21 fresh specimens of PORLP,10 of nondiseased sites (NDS) in PORLP and 10 of vocal noduli.The relationship between HPV infection and clinical courses was also evaluated.Results: (1) Of 31 cases in PORLP, 13 were classified into aggressive group (AG) and 18 nonagressive group (NAG), The difference of remission rate of AG(0,0/13) and NAG (83.3%,15/18) was statistically significant ( P <0.05). (2) The positive rate of HPV in PORLP was 100% (21/21), among then HPV6 and HPV11 were 42.9% (9/21) and 57.1% (12/21); and in NDS 50%(5/10), among them HPV6 and HPV 11 were 20% (1/5) and 80% (4/5) respectively. All types were HPV6 or HPV11. the positive rate of HPV 16, 18, 31, 33, 35, 51was negative, the positive rate of HPV in vocal noduli was also negative. (3) PCR-RFLP technigue had merit of sensitivity,specificity and rapidity in identifying HPV types, specially for a small tissue sample and large-scale epidemiological study.lt was ableto type HPV and ascertain the results of PCR at the same time. (4) The difference of positive rates of HPV 11 in AG (76.9%, 10/13) and NAG (25%,2/8) was statistically significant ( P <0.05), and that of HPV6 in AG (23.1%,3/13) and NAG(75%,6/8) was also significant ( P <0.05). (5) In NDS, the difference of positive rates of HPV in AG (83.3%,5/6) and NAG (0,0/4) was statistically significant (P O.05) .Also.HPV type was identical in NDS and papillomas in the same patient.According to the above observations, following problems had been discussed with reference to literatures: (1) HPV infection in PORLP. (2) The role of PCR-RFLP analysis in detecting HPV. (3) The relationship between HPV latent infection in NDS and recurrence of PORLP. (4) Prognostic role of HPV type for clinical courses of PORLP.