title: Laryngeal papillomatosis associated dysplasia in the adult population: an update on prevalence and HPV subtyping.
abstract: OBJECTIVE
  The objectives were to determine the prevalence of laryngeal dysplasia and associated human papilloma virus (HPV) subtypes in adult patients, 18 years or older, suffering from laryngeal papillomatosis at a tertiary care institution.
  
  
  METHODS
  Retrospective cohort study.
  
  
  METHODS
  Patients with biopsy proven laryngeal papillomatosis were identified via chart review. All available pathology specimens were reviewed by a dedicated head and neck pathologist to confirm/refute the diagnosis of laryngeal dysplasia, and grade the level of dysplasia. Interrater agreement was compared using cross-tabulation methods. Specimens identified to be positive for dysplasia underwent further testing via in situ hybridization for low-risk (6/11) or high-risk (16/18) HPV subtypes.
  
  
  RESULTS
  Of the 85 subjects identified to have laryngeal papillomatosis, 24(28%) demonstrated laryngeal dysplasia. There was good interrater agreement on the presence of dysplasia; however, there was only fair agreement on the grade of dysplasia. Of the pathology specimens tested for HPV subtype, the majority of patients (62%) were positive for HPV 6/11, including all high-grade dysplasia patients. Three (12%) dysplasia specimens were negative for both high- and low-risk HPV subtypes.
  
  
  CONCLUSIONS
  We found a 28% prevalence of dysplasia in our patient population with the majority of patients positive for low-risk HPV subtypes indicating that high-risk HPV subtypes do not predispose laryngeal papilloma patients to dysplasia.
authors.forename: Taryn
authors.initials: T
authors.lastname: Davids
authors.forename: Susan
authors.initials: S
authors.lastname: Muller
authors.forename: Justin C
authors.initials: JC
authors.lastname: Wise
authors.forename: Michael M
authors.initials: MM
authors.lastname: Johns
authors.forename: Adam
authors.initials: A
authors.lastname: Klein
mesh_terms: D000293:Adolescent; D000328:Adult; D000369:Aged, 80 and over; D005260:Female; D061809:Human Papillomavirus DNA Tests; D052140:Human papillomavirus 11 / Q000302:isolation & purification; D052162:Human papillomavirus 16 / Q000302:isolation & purification; D052161:Human papillomavirus 18 / Q000302:isolation & purification; D052163:Human papillomavirus 6 / Q000302:isolation & purification; D006801:Humans; D017403:In Situ Hybridization; D007822:Laryngeal Neoplasms / Q000473:pathology* / Q000821:virology*; D007830:Larynx / Q000473:pathology* / Q000821:virology*; D008297:Male; D008875:Middle Aged; D010212:Papilloma / Q000473:pathology* / Q000821:virology*; D027383:Papillomaviridae / Q000145:classification / Q000302:isolation & purification*; D015995:Prevalence; D012189:Retrospective Studies