title: Significance of DNA ploidy and cell proliferation in juvenile respiratory papillomatosis.
abstract: The clinical course of recurrent respiratory papillomatosis (RRP) in children is variable and unpredictable. At present there is no way to identify patients at risk for aggressive disease. The objective of this study was to evaluate whether DNA ploidy and cell proliferation analyses can predict the clinical course in children with RRP. Two different methods of estimating proliferation activity were compared. Nonembedded papilloma biopsy specimens from 18 pediatric patients were analyzed by flow cytometry providing DNA content with cell cycle analysis. The expression of the proliferative marker Ki-67 in papilloma tissue was quantified by immunohistochemistry. The patients were prospectively observed for 12 to 18 months. DNA content analysis and Ki-67 expression were compared to clinical information regarding number of disease sites, distal tracheobronchial spread, number of recurrences, need for tracheostomy, and disease remission. High S-phase fraction, proliferative index, and Ki-67 expression correlated with an aggressive clinical course. DNA ploidy analysis and immunodetection of proliferative markers may assist in predicting prognosis in children with RRP.
authors.affiliation: Department of Pediatric Otolaryngology and Maxillofacial Surgery, Children's Hospital Medical Center, University of Cincinnati College of Medicine, Ohio 45229, USA.
authors.forename: Y
authors.initials: Y
authors.lastname: Stern
authors.forename: P E
authors.initials: PE
authors.lastname: Hurtubise
authors.forename: R T
authors.initials: RT
authors.lastname: Cotton
mesh_terms: D000293:Adolescent; D002455:Cell Division / Q000235:genetics*; D002648:Child; D002675:Child, Preschool; D004273:DNA, Neoplasm / Q000235:genetics*; D005260:Female; D015972:Gene Expression Regulation, Neoplastic / Q000502:physiology; D006801:Humans; D007223:Infant; D019394:Ki-67 Antigen / Q000235:genetics; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000235:genetics* / Q000473:pathology; D010212:Papilloma / Q000235:genetics* / Q000473:pathology; D011003:Ploidies; D011379:Prognosis; D012137:Respiratory System / Q000473:pathology; D012142:Respiratory Tract Neoplasms / Q000235:genetics* / Q000473:pathology
chemical_list: D004273:DNA, Neoplasm; D019394:Ki-67 Antigen