复发性呼吸道乳头状瘤病(RRP)是由人乳头瘤病毒(HPV)感染引起的上消化道良性疾病,影响儿童和年轻人。这篇综述的目的是描述主要的病因,流行病学,临床,诊断,和RRP的治疗方面。大多数儿童感染发生在出生时,在通过受污染的母亲的出生运河期间。在成年人中,HPV是通过性传播的。乳头状瘤通常表现为外生结节,主要在喉部,但偶尔涉及鼻咽,气管支气管树,和肺实质.病情是不可预测的,从自发缓解到侵袭性持续性或复发性疾病。虽然很少发生,RRP具有向鳞状细胞癌恶性转化的潜力。临床上,RRP通常表现为气道受累的非特异性症状,包括慢性咳嗽,声音嘶哑,喘息,语音变化,stridor,和慢性呼吸困难.螺旋计算机断层扫描(CT)对于识别和表征结节性植物性病变引起的局灶性或弥漫性气道狭窄非常准确。肺乳头状瘤病的典型CT模式包括许多不同大小的多小叶结节性病变,经常空化,散布在整个肺部。支气管镜检查是诊断RRP的最可靠方法;它可以直接观察中央气道中的病变并收集活检样本以进行组织病理学诊断。并且对于治疗计划也是有用的。RRP的明确诊断基于组织病理学分析。目前,RRP尚无明确的治愈性治疗;尽管有辅助治疗,手术仍然是治疗的主要手段。
Recurrent respiratory papillomatosis (RRP) is a benign disease of the upper aero-digestive tract caused by human papillomavirus (HPV) infection, which affects children and young adults. The aim of this
review is to describe the main etiological, epidemiological, clinical, diagnostic, and treatment aspects of RRP. Most infections in children occur at birth, during passage through the birth canals of contaminated mothers. In adults, HPV is transmitted sexually. Papillomas usually appear as exophytic nodules, primarily in the larynx, but occasionally involving the nasopharynx, tracheobronchial tree, and pulmonary parenchyma. The disease course is unpredictable, ranging from spontaneous remission to aggressive persistent or recurrent disease. Although it occurs rarely, RRP has the potential for malignant transformation to squamous cell carcinoma. Clinically, RRP usually presents with nonspecific symptoms of airway involvement, including chronic cough, hoarseness, wheezing, voice change, stridor, and chronic dyspnea. Helical computed tomography (CT) is highly accurate for the identification and characterization of focal or diffuse airway narrowing caused by nodular vegetant lesions. The typical CT pattern of lung papillomatosis consists of numerous multilobulated nodular lesions of various sizes, frequently cavitated, scattered throughout the lungs. Bronchoscopy is the most reliable method for the diagnosis of RRP; it enables direct visualization of lesions in the central airways and collection of biopsy samples for histopathological diagnosis, and is also useful for therapeutic planning. The definitive diagnosis of RRP is based on histopathological analysis. Currently, no definitive curative treatment for RRP is available; despite the availability of adjunctive treatments, surgery remains the mainstay of treatment.