Laryngeal papillomatosis: molecular, ultrastructural and clinical evaluation

Our study was designed to correlate the prevalence of human papilloma viruses [HPV] types 6 and 11 in laryngeal papillomatosis specimens using PCR to the clinical and pathological characteristics of these patients as a trial to evaluate the usefulness of HPV typing in identifying which patients are at a higher risk for more frequently recurring aggressive disease or future malignant. This study was conducted on 36 adult patients who were identified clinically and histopathologically as laryngeal papilloma. An index of the number of procedures [laryngoscopy and carbon dioxide laser ablation] needed per year for each patient was calculated to assess the frequency of recurrence and disease aggressiveness. They were subjected to the detection of HPV6 and 11 DNA by PCR and electon microscopic examination of biopsies that were taken from laryngeal papillomas and non diseased sites as controls. We found that all papillomas [100%] were positive for HPV, among them the positive rate of either HPV6 or HPV11 was 25% [9/36] and 41.7% [15/36] respectively, the positive rate of mixed types of HPV6 + 11 was 33.3% [12/36]. Percentage of Patients needed >3 Pr/y were significantly increased [p>0.05 and 0.01] in cases with mixed infection of both HPV6+11 in comparison to those infected with HPV11 orHPV6 respectively and in HPV 11 infected cases in comparison to those infected with HPV 6 [p<0.05]. Percentage of cases revealed dysplastic features [cellular atypia, invasion, keratinization and necrosis] were significantly increased [p<0.05 and 0.01] in mixed infection of both HPV6+11 in comparison to those infected with HPV11 or HPV6 respectively and in HPV11 infected cases in comparison to those infected with HPV6 [p<0.05]. Correlation study revealed direct correlation between percentage of patients needed >3 Pr/y and the appearance of dysplastic features. Our findings suggest that viral typing is one marker that may be useful to identify patients at a higher risk for aggressive disease and, possibly, to malignant potential but more studies with a larger number of cases are needed to assess their agnostic and prognostic value

Expression of human papilloma virus DNA in middle ear cholesteatoma

Basic research in chronic otitis media with cholesteatoma is very important as it may clarify the pathophysiology of the disease and explain the wide variation in clinical course. In the present study aggressive type cholesteatoma has histopathological findings characteristic of human papilloma virus induced-lesions [i.e. obvious koilocytosis] in 33.3% specimens. Moreover 50% of the aggressive cholesteatoma were stained positive for human papilloma virus [HPV] polymerase chain reaction [PCR]. Statistical correlations were established between hyper-proliferation [as revealed by MIB 1 high score] of the cholesteatoma and severe bone erosion [pave the way to major cholesteatoma complications] and also between hyperproliferation and middle ear inflammation [associated with more surgical difficulties and possible higher risk of recurrences]. These findings indicate a possible relationship between HPV with more aggressive cholesteatoma. It may arouse the cleavage, proliferation of cholesteatomatous epithelium and may also play a certain role in the recurrence of the disease following well performed surgical excision

effects of coblation technology on the soft palate of rabbits. An experimental study

This study was designed to evaluate the volumetric reduction and the histologic changes of the soft palate after coblation [cold ablation] technology in experimental animals. Sixty male rabbits were included in the study divided into 3 groups: group [A], group [B] and group [C]. Each group included 10 control and 10 study animals. Exposure of the soft palate to coblation was done in study animals of the 3 groups submucosaly at 3 sites, one at midportion and 2 at lateral sides of the soft palate for one minute duration in each site. The control animals of the 3 groups were left without any interference. The animals of group A. B and C were studied 1 month, 2 months and 3 months respectively. The soft palate of each rabbit was dissected and volume was calculated. Specimens of soft palate of both control and study animals were examined by electron microscopic study. Died animals were excluded from this study. The comparison of the mean volume of soft palate in the study groups showed gradual increased reduction with time as it was more after 3 months [group C] than 2 months [group B] and 1 month [group A]. This result was confirmed by electron microscopic study as there was an increase in the amount of collagen fibers in the subepithelial layer gradually in study groups which was mild, moderate and marked in group A. B and C respectively. Cytoplasmic vacuoles were detected more in the epithelial layer of study group [A] than group [B] this means degenerative changes which is reversible as it was decreased by time and disappeared in group [C]. There is no effect on the mucosal glands of the epithelium or underlying muscles. The only histological difference between study and control groups was the increased amount of collagen fibers in the subepithelial layer. Coblation technology could be considered an effective technology for the reduction of the size of soft palate. It is safe, not painful and not invasive as it maintain the normal histology of the soft palate

NM23-H1 gene protein as a prognostic factor in laryngeal carcinoma

Certain genes may be involved in suppressing metastatic or aggressive tumour behaviour, the non metastatic gene [NM 23H1] is one gene that has been showen to posses metastatic suppressing activity. The expression of NM 23 H1 gene protein was investigated in 60 patients with laryngeal lesions. The patients were divided into 2 groups:-Group [1] 40 cases with laryngeal squamous cell carcinoma [21 cases of them with lymph nodes] and Group [2] 20 cases with laryngeal polyps as control group. The immunoreactivity of NM 23 H1 gene protein was assessed according to both pattern and intensity of immunostaining and the correlation of this immunoreactivity with clinicopathological parameters including grade of differentiation, incidence of Lymph node metastasis and the disease recurrence and/or distant metastasis. The immunoreactivity in the metastatic lymph nodes was investigated and ed with their primary tumours, Results of the study showed that most tumours and polyps expressed NM 23 H1 gene but high expression found in [55%] of laryngeal tumours [22 cases], while [45%] of cases [18 cases] showed reduced expression. Ten metastatic lymph nodes showed reduced expression and 1 with high expression from 11 cases of primary laryngeal tumours that had reduced expression, while 5 metastatic lymph nodes showed reduced expression and 5 showed high expression from 10 cases of primary laryngeal tumours that had high expression of NM 23 H1 gene product. Gene expression is inversely correlates with grade of differentiation. Primary tumours with high expression showed less distant metastasis whilst those with low expression reveald more aggressive behavior. From these data we concluded that the NM23 H1 gene may play a role in distant metastasis and/or disease recurrence and so could be used as a prognostic factor for metastatic in laryngeal carcinoma