摘要【目的】探讨外耳道乳头状瘤(PEAC)的病因机制,分析外耳道乳头状瘤与人乳头状瘤病毒(HPV)感染组织病理学基础。【方法】选取2011年1月至2016年12月本院收集的130例PEAC手术切除标本,采用HE染色和原位杂交技术检测低危型病毒(HPV6/11)DNA感染和高危型病毒(HPV16/18)DNA感染情况。【结果】PEAC伴挖空细胞低危型HPV6/11DNA感染率(79.52%)显著高于PEAC不伴挖空细胞(P<0.05),而PEAC伴挖空细胞HPV16/18 DNA感染率(17.54%)高于PEAC不伴挖空细胞(0),但差异不具有统计学意义(P>0.05);男性在HPV6/11DNA感染率(80.21%)显著高于女性(47.06%)(P<0.05),而男性和女性在HPV16/18 DNA感染率(21.87% vs 14.71%)比较,差异不具有统计学意义(P>0.05);HE染色结果显示,鳞状上皮呈乳头状增生,表皮轻度角化或重度角化,表层有角化不全细胞散在,中心结缔组织有淋巴细胞浸润,表皮浅层或中层细胞可见大量挖空细胞,真皮乳头部毛细血管增生扩张;原位杂交结果显示,HPV6/11阳性呈现细胞核阳性,而HPV16/18阳性主要呈现细胞质阳性。【结论】PEAC的致病机制可能由HPV病毒感染所致。
Abstract:【Objective】To investigate the etiology and pathogenesis of papilloma of external auditory canal (PEAC), and analyze the relationship between the PEAC and human papilloma virus (HPV) infection.【Methods】From January 2011 to December 2016, 130 PEAC surgical specimens were collected from our hospital. The infection of HPV6 / 11 DNA and HPV16/18 DNA infection were detected by HE staining and in situ hybridization.【Results】The low-risk HPV6/11 DNA infection rate of PEAC with koilocyte (79.52%) was significantly higher than that of PEAC without koilocyte (P<0.05), while the HPV16/18 DNA infection rate of PEAC with half koilocyte (17.54%) was higher than that of PEAC without koilocyte, but the difference was not statistically significant (0) (P>0.05). The HPV6/11DNA infection rate in men was significantly higher than that in women (80.21% vs 47.06%), but there was no statistically significant difference between men and women in the HPV16/18 DNA infection rate (21.87% vs 14.71%). HE staining showed that squamous epithelium was papillary hyperplasia, mild or severe hyperkeratosis of epidermis, parakeratosis cells scattered in epithallium, lymphocytes infiltration in central connective tissues, a large number of koilocytes in epidermal superficial or middle-level cells and dermal papilla hyperplasia and dilatation of capillaries. The results of in situ hybridization found that HPV6/11 positive cells showed positive nucleus, while HPV16/18 positive cells showed positive cytoplasm.【Conclusion】The etiology and pathogenesis of PEAC may due to HPV virus infection.
程默羽,汪旭. 外耳道乳头状瘤与HPV感染的病理学及原位杂交研究[J]. 医学临床研究, 2018, 35(4): 696-699.
CHENG Mo-yu, WANG Xu. Pathological and In Situ Hybridization Study of HPV Infection in Papilloma of External Auditory Canal. JOURNAL OF CLINICAL RESEARCH, 2018, 35(4): 696-699.