Development of a novel prognostic assessment tool for recurrent respiratory papillomatosis

作者：Satoshi Yamada, Taro Ikegami, Takahiro Fukuhara, Yuto Horichi, Hirotaka Shinomiya, Ken-ichi Nibu, Koji Ebisumoto, Hiroaki Iijima, Akihiro Sakai, Kenji Okami, Koichiro Wasano, Yosuke Nakanishi, Tomokazu Yoshizaki, Takuya Nakagawa, Toyoyuki Hanazawa, Jun Okamura, Yushi Ueki, Arata Horii, Norimoto Kise, Mikio Suzuki, Mariko Kasuga, Shu Yokota, Yutaka Takumi, Hajime Ishinaga, Masako Kitano, Ichiro Ota, Takashi Masui, Nobuhiro Yoshimi, Yutaka Sasaki, Yoshihiro Noda, Sho Morita, Goro Takahashi, Kazutaka Takeuchi, Yuki Nakamura, Kotaro Ishida, Kosuke Sugawara, Shigeru Matsuda, Yusei Makoshi, Natsuki Sugiyama, Kotaro Kano, Sosuke Sahara, Junya Kita, K. Morita, Daiki Mochizuki, Hiroshi Nakanishi, Atsushi Imai, Yuki Misawa, Yoshinori Takizawa, Hideya Kawasaki, Kiyoshi Misawa · 发表于：BMC Medicine · 年份：2026 · DOI：10.1186/s12916-026-04832-w · 被引用次数：1 · 研究领域：Cervical Cancer and HPV Research、Women's cancer prevention and management、Head and Neck Cancer Studies

BACKGROUND: Recurrent respiratory papillomatosis (RRP), caused by the human papillomavirus (HPV), is associated with an unpredictable clinical course. Although the Derkay Score is widely used to determine clinical severity, its prognostic value has rarely been evaluated. We developed a pathological severity score, the Hamamatsu Recurrent Respiratory Papillomatosis Pathological (HARRP) Score and combined it with the Derkay Score to develop a novel clinicopathological system-the Derkay-HARRP (D-H) Classification. We aimed to validate its prognostic value. METHODS: We retrospectively analyzed 125 patients who were clinically diagnosed with RRP from 16 Japanese institutions, randomly divided into validation (n = 38) and test (n = 87) cohorts. HPV-typing and immunohistochemistry for HPV-L1, HPV-E4, Ki-67, and p16 were performed. HPV particles were confirmed using the NanoSuit-correlative light and electron microscopy (CLEM) method. Receiver operating characteristic (ROC) curve analysis evaluated marker performance and defined recurrence cut-offs. HARRP and Derkay Scores were further assessed by ROC analysis and Cox proportional hazards models. We stratified patients using the D-H Classification and analyzed disease progression over time. RESULTS: No significant demographic differences were observed between the two cohorts. Positivity of HPV-L1, HPV-E4, and Ki-67 in the upper third of the epithelium was associated with recurrence. NanoSuit-CLEM confirmed HPV particles in HPV-L1-pos...