PDF(Pubmed)
Abstract：
Recurrent respiratory papillomatosis (RRP) is a non-malignant disease, characterized by the production of wart-like growths in the respiratory tract, affecting both young people and adults (juvenile-onset recurrent respiratory papillomatosis, JORRP, and adult-onset recurrent respiratory papillomatosis, AORRP, respectively). Infection caused by human papillomavirus (HPV) is known as the main factor involved in RRP development. Complications of RRP may rarely occur, including lung involvement and malignant transformation. The present systematic review aimed to evaluate the prevalence of severe complications, such as lung involvement and lung tumor in JORRP and AORRP patients, and assess the role of HPV genotypes in the progression of disease severity following the guideline for reporting systematic reviews and meta-analysis (PRISMA Statement). A total of 378 studies were found on PubMed and Scopus using the following MESH terms: \"recurrent respiratory papillomatosis and lung tumor\" and \"pulmonary tumor and recurrent respiratory papillomatosis\". Basing on inclusion and exclusion criteria, a total of 11 studies were included in the systematic review. We found a pooled prevalence of 8% (95% CI: 4-14%; I2: 87.5%) for lung involvement in RRP patients. In addition, we found a pooled risk difference of 5% in lung involvement between JORRP and AORRP (95% CI: -7-18%; I2: 85.6%, p-value: 0.41). Among patients with lung involvement, we observed a pooled prevalence of lung tumor of 4% (95% CI:1-7%; I2: 67.1%) and a pooled prevalence mortality for this group of 4% (95% CI:2-6%; I2: 0%). Overall, the positivity rate for HPV-6 and -11 in patients with RRP was 91%. Considering only cases with pulmonary involvement, the pooled prevalence for HPV-11 was 21% (95% CI: 5-45%; I2: 77.2%). Our results evidenced a low/middle risk of pulmonary involvement and lung tumor in JORRP and AORRP patients, with an increased risk for HPV-11-positive patients. Further studies should be performed to improve knowledge and adopt preventive measures to contrast the progression to severe diseases in RRP patients.
摘要：
复发性呼吸道乳头状瘤病（RRP）是一种非恶性疾病，其特点是在呼吸道产生疣样生长，影响年轻人和成年人(青少年发作的复发性呼吸道乳头状瘤病，JORRP,和成人复发性呼吸道乳头状瘤病，AORRP,分别)。人乳头瘤病毒（HPV）引起的感染被认为是参与RRP发展的主要因素。RRP的并发症可能很少发生，包括肺部受累和恶变。本系统综述旨在评估严重并发症的患病率。如JORRP和AORRP患者的肺部受累和肺部肿瘤，并根据系统评价和荟萃分析报告指南(PRISMAStatement)评估HPV基因型在疾病严重程度进展中的作用。在PubMed和Scopus上共发现了378项研究，使用以下MESH术语：“复发性呼吸道乳头状瘤病和肺部肿瘤”和“肺部肿瘤和复发性呼吸道乳头状瘤病”。根据纳入和排除标准，本系统综述共纳入11项研究.我们发现RRP患者肺部受累的合并患病率为8％（95％CI：4-14％；I2：87.5％）。此外,我们发现JORRP和AORRP之间肺部受累的合并风险差异为5％（95％CI：-7-18％；I2：85.6％，p值：0.41）。在肺部受累的患者中，我们观察到肺肿瘤的合并患病率为4%(95%CI:1-7%;I2:67.1%),该组的合并患病率死亡率为4%(95%CI:2-6%;I2:0%).总的来说,RRP患者中HPV-6和-11的阳性率为91%.只考虑肺部受累的病例，HPV-11的合并患病率为21%(95%CI:5~45%;I2:77.2%).我们的结果表明，在JORRP和AORRP患者中，肺部受累和肺部肿瘤的风险较低/中等，HPV-11阳性患者的风险增加。应进行进一步的研究以提高知识水平并采取预防措施，以对比RRP患者向严重疾病的进展。
