Human papillomavirus type, proliferative activity, and p53: potential markers of aggressive papillomatosis.
BACKGROUND
The predictive value of nuclear proliferation antigen (Ki-67), tumor suppressor gene product p53, and human papillomavirus type has not been evaluated for outcome of laryngeal papilloma.


OBJECTIVE
This study was designed to determine whether immunohistochemical analysis of Ki-67 and p53 and human papillomavirus typing by polymerase chain reaction are able to identify patients with a more aggressive course of laryngeal papillomatosis.


METHODS
Immunohistochemistry and polymerase chain reaction were performed on archival, paraffin-embedded, laryngeal papillomatosis biopsy specimens at the time of diagnosis, at an intermediate time during treatment, and at the last procedure available. Staining indexes for Ki-67 and p53 were determined, and human papillomavirus type was analyzed for all biopsies.


METHODS
Twelve patients with recurrent laryngeal papillomatosis for at least 5 years were selected from patients treated at our institution during the last 20 years.


METHODS
Separate analyses were conducted comparing average Ki-67 and p53 indexes against disease outcome, viral type, or average number of procedures per year. Associations were analyzed between virus type, average number of procedures per year, outcome, and histology.


RESULTS
No statistically significant associations were noted in Ki-67 or p53 indexes and outcome. Weak associations were noted for p53 indexes and procedures per year and virus type. Weak associations also were noted between virus type and development of neoplasia.


CONCLUSIONS
Our observations suggest that human papillomavirus typing may be helpful in identifying patients with aggressive recurrent laryngeal papillomatosis. The weak association between p53 indexes and procedures per year and virus type may have some predictive value in identifying aggressive lesions.
Rabah
R
R
Department of Pathology, Children's Hospital of Michigan, Detroit, MI 48201, USA.
Sakr
W
W
Thomas
R
R
Lancaster
W D
WD
Gregoire
L
L
D014408:Biomarkers, Tumor / Q000378:metabolism*; D001706:Biopsy; D002455:Cell Division; D002648:Child; D002675:Child, Preschool; D018450:Disease Progression; D005838:Genotype; D006801:Humans; D007150:Immunohistochemistry; D007223:Infant; D019394:Ki-67 Antigen / Q000378:metabolism*; D007822:Laryngeal Neoplasms / Q000378:metabolism* / Q000473:pathology / Q000821:virology; D009361:Neoplasm Invasiveness; D010212:Papilloma / Q000378:metabolism* / Q000473:pathology / Q000821:virology; D027383:Papillomaviridae / Q000235:genetics / Q000302:isolation & purification*; D011237:Predictive Value of Tests; D012075:Remission, Spontaneous; D018570:Risk Assessment; D016159:Tumor Suppressor Protein p53 / Q000378:metabolism*
D014408:Biomarkers, Tumor; D019394:Ki-67 Antigen; D016159:Tumor Suppressor Protein p53