Modern opportunities to the diagnosis and treatment of recurrent respiratory papillomatosis with tracheal, bronchial and lung involvement

Recurrent respiratory papillomatosis (RRP) is a rare disease caused by the human papilloma virus (HPV) and characterized by recurrent growth of benign papillomas in the upper and lower respiratory tract. The aim of the study was to increase the effectiveness of RRP treatment using the wide spectrum of diagnostic and therapeutic bronchological methods. 29 patients aged from 18 to 72 years old with RRP were included. In three patients - the juvenile form of RRP was diagnosed, in the remaining- the adult. Flexible bronchoscopy with biopsy and histological examination with microscopic staining and immunohistochemistry (Ki67, p53, p63) were done. Polymerase chain reaction revealed 6, 11, 16, 18 types of HPV. Tracheal RRP was diagnosed in 19 patients, bronchial - in 5, larynx, trachea and lung parenchyma were involved in 5 patients. 10 patients underwent LASER photo-destruction of papillomas, 7 had electrosurgical destruction in combination with LASER or argon plasma coagulation, 4 patients had argon plasma coagulation, and 7 patients received photodynamic therapy. Human papilloma virus was established in all patients by polymerase chain reaction. The most often, 6 and 11 types were identified, but in cases of cancer transformation -16 and 18 types. As a result of this treatment 58.6% of patients achieved full reduction of papillomas, 27.5% - partial reduction. In 4 patients, the transformation of RRP into cancer was diagnosed. The use of PDT as recurrence prevention treatment cont...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Respiratory infections Source Type: research