Laryngeal papillomatosis: molecular, histopathological, and clinical evaluation

Abstract

Molecular, histopathological, and clinical studies were carried out on a series of 79 laryngeal papillomas (LP) from 36 patients in order to investigate the hypothesis that juvenile and adult LP may represent a biological entity causally related to Human papilloma virus (HPV) infection. Using in situ hybridization with biotin-labelled probes and polymerase chain reaction, we detected human papilloma virus (HPV) 6/11 in 28 of 29 juvenile LP, in 26 of 30 adult multiple, and in 17 of 20 adult solitary LP. None of LP was found to harbour HPV types 16, 18, 31, 33, and 51. There were no clear-cut histological differences between juvenile and adult LP, the presence of koilocytosis was equally observed in both, and there was no prevalent type of epithelial hyperplasia in either form, except that all three cases of atypical hyperplasias (precancerous lesions) were found among adult patients. During a 14 year follow-up, no carcinomatous transformation of LP was observed. All juvenile LP in our study had frequent recurrences of the disease, however, numerous surgical procedures were also required in 16 of 27 adult patients. Our study supports Lindeberg's hypothesis of a similar pathogenesis for all forms of LP caused by the HPV types 6/11.

In Inverted Papillomas HPV more likely represents incidental colonization than an etiological factor

“…Technical specificities, such as fixation duration and length of tissue storage, may considerably affect DNA quality [25,27]. However, our previous experience with DNA recovery from 15-year-old paraffin blocks of laryngeal papillomas is an appropriate assurance of adequate methodology [20,46]. In addition, it is also important to ascertain that the histological characteristics of IPs are strictly considered as a specific group of SPs.…”

Detection and identification of human papillomavirus using a PCR-restriction fragment mass polymorphism assay

“…More than 100 forms of HPV have been described and are classified as high-or low-risk types depending on oncogenicity (2). HPV types 16 and 18 cause 70% of all cervical cancers (3), whereas HPV types 6 and 11 give rise to 90% of cases of genital warts and laryngeal papillomas (4,5). To study the natural history of HPV, and to aid in vaccine development and the management of infected patients, the detection and genotyping of HPV DNA are crucial (6).…”

Squamous carcinoma of the larynx and hypopharynx in children: An enigma and a dilemma

“…This, however, may not necessarily be a causal association as there is a strong selection bias with RT being given to children with more aggressive RRP, which may have an inherently higher risk of malignant transformation. Malignant transformation has been reported in none [5], 1.5% [11], and 7% [10] of the patients with RRP. This risk may have been overestimated in these hospital-based or surgical series due to the inherent referral bias of patients with more aggressive disease.…”

“…RRP is very rare in adult SCC, even though the population incidence of 3.6 and 3.9 per million for the juvenile onset RRP (JORRP) and adult onset RRP (AORRP) is similar [3]. Human papilloma virus (HPV) type 6 and 11 infection is almost universally found in both JORRP and AORRP [4,5]. While HPV in JORRP is acquired from mothers with genital HPV during vaginal delivery, AORRP is related to the number of lifetime sexual partners and to oral sex [6,7].…”