Correlation Between HPV,P53 And Malignant Transformation Of Laryngeal Papilloma In Adults

Objective: In this study,by comparing the changes of HPV and p53 genes at different stages in the process of adult laryngeal papilloma non-malignant transformation and laryngeal papilloma malignant transformationinto laryngeal squamous cell carcinoma,to analysis if there any correlationbetween HPV、p53and malignant transformation of laryngeal papilloma inadults.It is provide relevant information for the early diagnosis,prevention and follow-up of laryngeal papilloma in aduls.Methods: Collected the patients were pathologically diagnosed as laryngealpapilloma and the malignant transformation,from laryngeal papilloma to laryngeal squamous cell carcinoma after surgery,whom from the Department of Otolaryngology head and Neck Surgery,the First Affiliated Hospital of Guangxi Medical University,from May 2012 to April 2020.There isno preoperative radiotherapy or chemotherapy was performed before the surgery.Among them,malignant transformation of laryngeal papilloma into laryngeal squamous cell carcinoma(malignant transformation group): 17 cases,including7 cases with regional malignant transformation at the first diagnosis.A total of 34 wax blocks with regional malignant transformation were selected.Postoperative pathology of laryngeal papilloma showed no atypical hyperplasia and canceration(non-malignant change group): recurrence rate was more than 2 times,cases: 17 cases,a total of 34 wax blocks.HPV and P53 were detected by in situ hybridization and immunohistochemistry.Result: 1.Expression of HPV6/11: In the non-malignant group,the positive rate was 55.88%(19/34);in the malignant group,the positive rate was 0%(0/34);the expression of HPV6/11 in the non-malignant group and the malignant group was statistically significant by chi-square test(p=0.000 < 0.05);the positive rate of HPV6/11 infection was higher in the non-malignant group than in the malignant group.2.HPV16/18 expression: No HPV16/18 expression was found in either the non-malignant transformation group or the malignant transformation group.3.Expression of p53: In the non-malignant change group,the positive rate was 0%(0/34),and in the malignant group,the positive rate was 44.12%(15/34).The expression of p53 in the non-malignant change group and the mali-gnant change group was statistically significant by chi-square test(p=0.008 < 0.05),and the positive rate of p53 infection was higher in the malignant change group than in the non-malignant change group.Conclusion: 1.HPV6/11 mainly causes benign lesions of adult laryngeal papilloma,and HPV16/18 is correlated with malignant lesions of adult laryngeal papilloma.2.The overexpress of p53 is correlated with malignant transformation of adult laryngeal papilloma.3.p53 as a tumor suppressor gene,its expression and correlation of adult laryngeal papilloma progression,and to a certain extent,can prompt adult laryngeal papilloma malignant transformation,clinically,in case of adult laryngeal papilloma in the histopathologic diagnosis of p53 expression,should pay attention to possible malignant transformation,multipoint and multilevel biopsy,in order to avoid missed diagnosis.4.Adult laryngeal papilloma can occur partial regional canceration.In view of this pathological feature,regular examination should be performed for adult laryngeal papilloma patients,and multiple biopsies should be performed at multiple sites to prevent cancer and missed diagnosis.5.The clinical signs of malignant transformation of adult laryngeal papilloma are of great significance to the early clinical diagnosis and follow-up of malignant transformation of adult laryngeal papilloma to some extent.