Epidemiological studies on Juvenile laryngeal papillomatosis in Thailand.

幼年性喉乳头状瘤（JLP）的发生率目前较低。文献报道在过去十年中变得罕见，而其在泰国的呈现仍然很常见。目前的研究集中在泰国JLP的临床流行病学和病毒学方面，重点是该国存在的特定环境因素。临床流行病学方面在泰国耳鼻喉科门诊治疗的259例JLP患者和本研究组成员收集的62例JLP患者可用于临床研究分析。临床发病各不相同，从新生儿到青春期；89%的病例在6岁之前被诊断出来。它们最常见于第一次分娩的婴儿。大多数人口生活在泰国的内陆地区，那里一定程度的贫困和恶劣的卫生条件导致传染病的发病率较高。在这些JLP病例中更频繁地涉及到声门区域，在大多数病例中，当孩子开始说话时，声音嘶哑就开始了，随后是完全失音和呼吸困难。对29份JLP样本进行了分子生物学研究。斑点杂交、southern杂交和PCR检测结果显示，23例为11型HPV， 3例为6型HPV。然而，在这些情况下，16型和18型都无法检测到。这些结果表明，尽管我们在东北亚或西方国家经常发现HPV 6型，但在泰国儿童中发生的JLP最常见的类型是HPV 11型。JLP的临床特征与HPV类型之间的关系尚不清楚。通过对HPV-11的DNA克隆，成功制备了重组HPV-L-2蛋白。结果表明，该重组L-2蛋白对泰国11型JLP患儿血清有明显的应答。该抗L-2抗体在JLP患者及相关病例血清学诊断中的临床应用前景广阔。少

The existence of juvenile laryngel papilloma (JLP) is presently low. Reports in the literatures become rare over the past decade whereas its presentation in Thailand is still very common. The present study concentrates on the clinicoepidemiological and virological aspects of JLP in Thailand with emphasis on specific environmental factor as they exist in this country.1. Clinicoepidimiological aspectsTwo hundred fifty nine patients with JLP who have been treated in the ENT clinics in Thailand and 62 cases who were collected by the members of this research group could be analyzed in the clinical study.The clinical onset varies and is from the newborn to puberty ; 89% of the cases are diagnosed before the age of 6 years. They are most frequently seen in the firstly delivered baby. The majority of the population lives in upcountry areas in Thailand where a certain level of poverty and bad hygienic cicumstances contribute to higher frequency of infectious diseases.The glottic region is frequ … More ently involved in these JLP cases and in the majority of these cases, hoarseness starts already when children begin to speak, followed by complete aphonia and dyspnea.2. Virological studyTwenty nine samples of JLP were studied molecular-biologically. Both dot and southern blot hybridization techniques, and PCR revealed the type 11 of HPV in 23 cases and the type 6 in 3 cases. However, type 16 and type 18 could not be detected in any of these cases. These results indicate that type 11 of HPV is the most frequent type of JLP which occurs in Thai children, although we have found frequently HPV 6 in north east Asia or western countries. A relationship between the clinical features of JLP and the HPV type is not clear.We could made successfully recombinant HPV-L-2 protein by HPV-11 DNA cloning. It is found that this recombinant L-2 protein could be responded markedly to the sera which were collected Thai children with JLP type 11.Using this anti L-2 antibody, clinical application for the serological diagnosis to the JLP patients and the related cases in the field works will be expected. Less