| Objective: Vocal cord polyp (VCP), as a kind of chronic laryngitis, is mainly caused by inflammatory edema in the membranous true vocal folds, the liquid is accumulated in the proper layer. Different people have different opinions to the etiology of vocal cord polyps in the past years, of which one of the most remarkable ideas is that mechanical friction damages the vocal cord, but the vasodilatation, interstitial edema, and inflammatory cell infiltration are not common. To have a better understanding of etiology of the disease, it is very important to diagnose and treat the patient earlier. Ten years ago, the scientists found out the virus grain inside the epithelial nucleus of VCP. As their further understanding of HPV (Human Papilloma Virus), they found its pathogenicity is more powerful than other types of virus in larynx. The expression of the virogene is controlled by transcription factor of the host cell and the virus. The host falls sick when transformable protein expressed exceedingly. HPV is a small, DNA-containing, nonenvelopedicosahedral (20-side) capsid virus with a double-stranded circular DNA near 8000 base pairs (bp) long. At present, more than 90 types of HPV have been identified. The gene is divided into three-function areas: early period region (E), late period region (L) and long control region (LCR). The inhomogeneous areas distinguish the different virus types accordingly, which causes people to consider that HPV is thought to be the pathogen to VCP.Methods: One hundred fifty nine biopsy specimens received from a surgical therapy and diagnosed by pathology enrolled in the study from Dec. 1992 to Dec. 2000 were selected from the pathologic department of the Second Hospital of Tianjin Medicine University, All samples were first visit cases including 88 males and 71 females; smoker: 78 cases, nonsmoker: 81 cases; age range from 16 to 70 years old, average age: 45.43 + 10.76 years old, the duration of disease from 1 month to 4 years, average 11.53 + 17.83 months, unilateral: 156 cases, bilateral: 3 cases.To observe the slices' morphological features under the optical microscope and to go subsequent evaluation by immuno-histochemistry staining the 159 original histopathologicslices, through formalin treatment, paraffin embedment and haematoxylin-eosin (HE) staining.Results: In our studies, the vasodilatation, interstitial edema, and inflammatory cell infiltration in VCP are not common , and 77 (48.43%) cases of koilocytosis in VCP are found including 39 males and 38 females, it is proved that there are no significant relationship between koilocytosis or HPV positive and keratinization, poor keratinization, proliferation, atypical proliferation, keratinization with proliferation of epithelia by statistic [ x 2 ( p>0.05)]. but there is relationship between koilocytosis and HPV positive (p < 0.005) .We think that the HPV infect the epithelial cell of vocal cord and subsequently lead to a replication, assembling in the nuclei, interfering in normal metabolism, and finally resulting in koilocytosis. It is probably because HPV infects the cell and cause the cell to proliferate excessively and age quickly, there is a hole around the nuclei, thus a so-called koilocytoid cell appears. The koilocytoid cell of VCP is similar to that of condyloma, but there is a certain difference in size, and in appearance. The common ground is that koilocytoid cell is located in the surface layer as a cluster or scatteration, cellularboundary is not clear, karyopycnosis is like falcate or tuberiform and different in size, there is a hole around the nuclear; the difference is koilocytoid cell has no obvious enlargement, nor a little kytoplasm around nuclei as radicalized silk attached to the karyolemma. In view of the differentiation, this kind of cell is regard as koilocytoid cell type I . 92 cases of original histopathologic slices chosen randomly are undergone evaluation by immuno-histochemistry staining. There are 49 cases of tan stained in nuclei, in 5 of them koilocytoid cell... |
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