Ky. Lin et al., COINFECTION OF HPV-11 AND HPV-16 IN A CASE OF LARYNGEAL SQUAMOUS PAPILLOMAS WITH SEVERE DYSPLASIA, The Laryngoscope, 107(7), 1997, pp. 942-947
Human papillomavirus (HPV) types 6 and 11 have been associated with be
nign laryngeal papilloma, while HPV-16 is occasionally associated with
laryngeal carcinoma. In this study, a case of laryngeal squamous papi
llomas with severe dysplasia was evaluated for the presence of HPV inf
ection. The biopsy specimens were taken from a 58-year-old female pati
ent at two different time points 3 months apart, Architecturally, the
tumor showed papillary configuration reminiscent of squamous papilloma
. Cytologically, the lesion showed morphologic features characteristic
of severe squamous epithelial dysplasia. HPV infection was determined
by DNA in situ hybridization using type-specific HPV-DNA probes. HPV-
11 probes demonstrated homogeneous nuclear staining, suggesting produc
tive viral replication. In contrast, HPV-16 probe produced a speckled
pattern, suggesting HPV-16 DNA integration. Normal laryngeal epitheliu
m did not yield specific hybridization. The presence of HPV-11 and HPV
-16 was confirmed by PCR using HPV type-specific primers. Immunocytoch
emical staining was performed to detect Ki-67, a proliferation marker,
and p53. Ki-67 expression was demonstrated throughout the whole thick
ness of epithelium, Staining for p53 was negative. This study suggests
that multiple HPV infections can occur in the same lesion and that HP
V-16 infection and its DNA integration may contribute to the occurrenc
e of severe dysplasia in the lesion described.