Histopathological features of juvenile‐onset laryngeal papillomatosis related to severity

Achkar, Vivian Narana Ribeiro El; Duarte, Andressa; Carlos, Román; León, Jorge Esquiche; Ribeiro‐Silva, Alfredo; Pignatari, Shirley Shizue Nagata; Kaminagakura, Estela

doi:10.1002/hed.25602

Cited by 11 publications

(19 citation statements)

References 27 publications

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“…Furthermore, similar to others studies, HPV 11 was significantly associated with a higher severity of the disease in both groups . In fact, the severity of the disease was shown to be strongly associated with age, mainly in affected children under 5 years old . Our study showed the association between higher Derkay scores and HPV 11 infection in juvenile patients, especially when the vocal cords and subglottis sites were affected.…”

Section: Discussionsupporting

confidence: 91%

“…ARRP affects mainly male patients in a 4:1 ratio and has a peak incidence in the 4th decade of life. 2,22 The epidemiological findings of the present study were similar to those described previously for both JRRP and ARRP.…”

Section: Association Between Clinical Pathological Features Of Rrp Insupporting

confidence: 91%

“…[27][28][29] In fact, the severity of the disease was shown to be strongly associated with age, mainly in affected children under 5 years old. 22 Our study showed the association between higher Derkay scores and HPV 11 infection in juvenile patients, especially when the vocal cords and subglottis sites were affected. The distribution of RRP follows a predictable pattern.…”

Section: Association Between Clinical Pathological Features Of Rrp Inmentioning

confidence: 49%

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Role of epstein‐barr virus in the severity of recurrent respiratory papillomatosis

et al. 2019

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The objective was to investigate the prevalence of the Epstein-Barr virus (EBV) and its association with human papilloma virus (HPV) detection, clinicopathological features, and the severity of recurrent respiratory papillomatosis (RRP). Methods: Cases of juvenile recurrent respiratory papillomatosis (JRRP) (n = 36) and adult recurrent respiratory papillomatosis (ARRP) (n = 44) were collected retrospectively and subdivided into low-and high-risk severity groups based on the Derkay score. We performed HPV detection and genotyping using a reverse hybridization protocol and investigated the presence of EBV by polymerase chain reaction (PCR) and in situ hybridization. CD21 levels were accessed by immunohistochemistry. Results: All samples were HPV-positive, including 49 cases of HPV 6, 26 cases of HPV 11, four cases of HPV 6 and 11 coinfections, and one case of HPV 16. EBV-DNA was detected in nine samples by PCR, although none of the cases were positive by means of in situ hybridization. CD21 immunoexpression was not statistically associated with any of the variables analyzed. HPV 6 detection was significantly higher in ARRP cases (P = 0.03), whereas HPV 11 was more prevalent in JRRP cases (P = 0.02) and was even more prevalent in JRRP cases of greater severity (Derkay laryngoscopic scale ≥20) (P = 0.04). Conclusion: The presence of EBV does not seem to play an important role in the progression/severity of RRP.

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Section: Discussionsupporting

confidence: 91%

Section: Association Between Clinical Pathological Features Of Rrp Insupporting

confidence: 91%

Section: Association Between Clinical Pathological Features Of Rrp Inmentioning

confidence: 49%

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Role of epstein‐barr virus in the severity of recurrent respiratory papillomatosis

et al. 2019

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“…68 On histology, while the degree of dysplasia has not been found to be associated with more severe disease, the presence of atypical mitoses and mitoses above the basal cell layer of the epithelium have been found to be associated with more severe disease. 69 A maternal history of condyloma acuminata may be associated with aggressive RRP. 7,21,35 Management There is no cure and treatment consists of repeated microlaryngoscopic procedures to remove the papillomas until the patient goes into remission.…”

Section: Disease Coursementioning

confidence: 99%

<p>Juvenile-Onset Recurrent Respiratory Papillomatosis Diagnosis and Management – A Developing Country Review</p>

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2020

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Recurrent respiratory papillomatosis (RRP) is a condition caused by human papillomavirus (HPV), usually HPV types 6 and 11, which is characterized by recurrent papillomas of the respiratory tract, mainly the larynx. Patients usually present between the ages of 2 and 6 years. The initial presenting symptom is progressive dysphonia, followed by stridor and respiratory distress. Treatment consists of repeated microlaryngoscopic procedures to remove the papillomas as there is no cure. The poor availability and accessibility of appropriate healthcare services in developing countries are barriers to the early diagnosis and appropriate management of patients with juvenile-onset recurrent respiratory papillomatosis (JoRRP), requiring many patients to have a tracheostomy. The introduction of prophylactic vaccines that include HPV6 and HPV11 is necessary in order to reduce the incidence of JoRRP.

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“…Although many studies have focused on clinical severity risk factors, the only one identified to date is the early age of onset of the disease (34,35). To our knowledge only one article investigated in JoRRP histological criteria related to disease severity (such as the presence of mitosis above the basal cell layer) but without significant results (36). Several studies have looked for histological criteria with the help of immunohistochemistry.…”

Section: Introductionmentioning

confidence: 99%

Histological Severity Risk Factors Identification in Juvenile-Onset Recurrent Respiratory Papillomatosis: How Immunohistochemistry and AI Algorithms Can Help?

Lépine

Klein²,

Voron

et al. 2021

Front. Oncol.

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Juvenile-onset recurrent respiratory papillomatosis (JoRRP) is a condition characterized by the repeated growth of benign exophytic papilloma in the respiratory tract. The course of the disease remains unpredictable: some children experience minor symptoms, while others require multiple interventions due to florid growth. Our study aimed to identify histologic severity risk factors in patients with JoRRP. Forty-eight children from two French pediatric centers were included retrospectively. Criteria for a severe disease were: annual rate of surgical endoscopy ≥ 5, spread to the lung, carcinomatous transformation or death. We conducted a multi-stage study with image analysis. First, with Hematoxylin and eosin (HE) digital slides of papilloma, we searched for morphological patterns associated with a severe JoRRP using a deep-learning algorithm. Then, immunohistochemistry with antibody against p53 and p63 was performed on sections of FFPE samples of laryngeal papilloma obtained between 2008 and 2018. Immunostainings were quantified according to the staining intensity through two automated workflows: one using machine learning, the other using deep learning. Twenty-four patients had severe disease. For the HE analysis, no significative results were obtained with cross-validation. For immunostaining with anti-p63 antibody, we found similar results between the two image analysis methods. Using machine learning, we found 23.98% of stained nuclei for medium intensity for mild JoRRP vs. 36.1% for severe JoRRP (p = 0.041); and for medium and strong intensity together, 24.14% for mild JoRRP vs. 36.9% for severe JoRRP (p = 0.048). Using deep learning, we found 58.32% for mild JoRRP vs. 67.45% for severe JoRRP (p = 0.045) for medium and strong intensity together. Regarding p53, we did not find any significant difference in the number of nuclei stained between the two groups of patients. In conclusion, we highlighted that immunochemistry with the anti-p63 antibody is a potential biomarker to predict the severity of the JoRRP.

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Histopathological features of juvenile‐onset laryngeal papillomatosis related to severity

Cited by 11 publications

References 27 publications

Role of epstein‐barr virus in the severity of recurrent respiratory papillomatosis

Role of epstein‐barr virus in the severity of recurrent respiratory papillomatosis

<p>Juvenile-Onset Recurrent Respiratory Papillomatosis Diagnosis and Management – A Developing Country Review</p>

Histological Severity Risk Factors Identification in Juvenile-Onset Recurrent Respiratory Papillomatosis: How Immunohistochemistry and AI Algorithms Can Help?

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