Characterization of human papillomavirus in airway papillomas by histologic and biochemical analysis

The role of human papillomavirus (HPV) in airway papillomas has been well d efined in recent literature. The chronicity and recurrence of papillomas ha s been postulated to be a result of residual viral genome in tissue treated with standard laser techniques. Thirteen patients with airway papillomas w ere selected for study with polymerase chain reaction (PCR) methods to dete ct viral DNA. Specimens taken prior to laser therapy and specimens taken at laser margins were consistently positive for HPV DNA by PCR. The HPV DNA i s apparently present in tissues after macroscopic disease has been ablated by laser techniques. Histologic analysis of laser biopsies demonstrated fra gments of squamous epithelium with cytologic features of HPV infection. Las er treatment is ineffective in eradicating HPV-infected tissues from airway papillomas, and this finding supports the notion that recurrence is a prod uct of HPV incorporated into tissue not ablated by laser irradiation. Speci fic methods, results, and clinical correlation will be discussed.