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Lucidi D, Cantaffa C, Miglio M, Spina F, Alicandri Ciufelli M, Marchioni A, Marchioni D. Tumors of the Nose and Paranasal Sinuses: Promoting Factors and Molecular Mechanisms-A Systematic Review. Int J Mol Sci 2023; 24:ijms24032670. [PMID: 36768990 PMCID: PMC9916834 DOI: 10.3390/ijms24032670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 01/22/2023] [Accepted: 01/29/2023] [Indexed: 02/01/2023] Open
Abstract
Sinonasal neoplasms are uncommon diseases, characterized by heterogeneous biological behavior, which frequently results in challenges in differential diagnosis and treatment choice. The aim of this review was to examine the pathogenesis and molecular mechanisms underlying the regulation of tumor initiation and growth, in order to better define diagnostic and therapeutic strategies as well as the prognostic impact of these rare neoplasms. A systematic review according to Preferred Reporting Items for Systematic Review and Meta-Analysis criteria was conducted between September and November 2022. The authors considered the three main histological patterns of sinonasal tumors, namely Squamous Cell Carcinoma, Intestinal-Type Adenocarcinoma, and Olfactory Neuroblastoma. In total, 246 articles were eventually included in the analysis. The genetic and epigenetic changes underlying the oncogenic process were discussed, through a qualitative synthesis of the included studies. The identification of a comprehensive model of carcinogenesis for each sinonasal cancer subtype is needed, in order to pave the way toward tailored treatment approaches and improve survival for this rare and challenging group of cancers.
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Affiliation(s)
- Daniela Lucidi
- Department of Otolaryngology, Head and Neck Surgery, University Hospital of Modena, 41124 Modena, Italy
| | - Carla Cantaffa
- Department of Otolaryngology, Head and Neck Surgery, University Hospital of Modena, 41124 Modena, Italy
- Correspondence: ; Tel.: +39-3385313850; Fax: +39-0594222402
| | - Matteo Miglio
- Department of Otolaryngology, Head and Neck Surgery, University Hospital of Modena, 41124 Modena, Italy
| | - Federica Spina
- Department of Otolaryngology, Head and Neck Surgery, University Hospital of Modena, 41124 Modena, Italy
| | - Matteo Alicandri Ciufelli
- Department of Otolaryngology, Head and Neck Surgery, University Hospital of Modena, 41124 Modena, Italy
| | - Alessandro Marchioni
- Respiratory Diseases Unit, Department of Medical and Surgical Sciences, University Hospital of Modena, 41124 Modena, Italy
| | - Daniele Marchioni
- Department of Otolaryngology, Head and Neck Surgery, University Hospital of Modena, 41124 Modena, Italy
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Human Papillomavirus in Sinonasal Squamous Cell Carcinoma: A Systematic Review and Meta-Analysis. Cancers (Basel) 2020; 13:cancers13010045. [PMID: 33561073 PMCID: PMC7796014 DOI: 10.3390/cancers13010045] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Revised: 12/19/2020] [Accepted: 12/21/2020] [Indexed: 12/18/2022] Open
Abstract
Simple Summary The causative role of human papillomavirus (HPV) in sinonasal squamous cell carcinoma (SNSCC) remains unclear and is hindered by small studies using variable HPV detection techniques. This meta-analysis aims to provide an updated overview of HPV prevalence in SNSCC stratified by detection method, anatomic subsite, and geographic region. From 60 eligible studies, an overall HPV prevalence was estimated at 26%. When stratified by detection method, HPV prevalence was lower when using multiple substrate testing compared to single substrate testing. Anatomic subsite HPV prevalence was higher in subsites with high exposure to secretion flow compared to low exposure subsites. HPV prevalence in SNSCC followed the global distribution of HPV+ oropharyngeal squamous cell carcinoma. Taken together, this meta-analysis further supports a role for HPV in a subset of SNSCCs. Abstract Human papillomavirus (HPV) drives tumorigenesis in a subset of oropharyngeal squamous cell carcinomas (OPSCC) and is increasing in prevalence across the world. Mounting evidence suggests HPV is also involved in a subset of sinonasal squamous cell carcinomas (SNSCC), yet small sample sizes and variability of HPV detection techniques in existing literature hinder definitive conclusions. A systematic review was performed by searching literature through March 29th 2020 using PubMed, Embase, and Web of Science Core Collection databases. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed by two authors independently. A meta-analysis was performed using the random-effects model. Sixty studies (n = 1449) were eligible for statistical analysis estimating an overall HPV prevalence of 25.5% (95% CI 20.7–31.0). When stratified by HPV detection method, prevalence with multiple substrate testing (20.5%, 95% CI 14.5–28.2) was lower than with single substrate testing (31.7%, 95% CI 23.6–41.1), highest in high-exposure anatomic subsites (nasal cavity and ethmoids) (37.6%, 95% CI 26.5–50.2) vs. low-exposure (15.1%, 95% CI 7.3–28.6) and highest in high HPV+ OPSCC prevalence geographic regions (North America) (30.9%, 95% CI 21.9–41.5) vs. low (Africa) (13.1, 95% CI 6.5–24.5)). While small sample sizes and variability in data cloud firm conclusions, here, we provide a new reference point prevalence for HPV in SNSCC along with orthogonal data supporting a causative role for virally driven tumorigenesis, including that HPV is more commonly found in sinonasal subsites with increased exposure to refluxed oropharyngeal secretions and in geographic regions where HPV+ OPSCC is more prevalent.
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Long C, Jabarin B, Harvey A, Ham J, Javer A, Janjua A, Thamboo A. Clinical evidence based review and systematic scientific review in the identification of malignant transformation of inverted papilloma. J Otolaryngol Head Neck Surg 2020; 49:25. [PMID: 32354352 PMCID: PMC7193386 DOI: 10.1186/s40463-020-00420-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Accepted: 04/22/2020] [Indexed: 12/11/2022] Open
Abstract
Background Inverted papilloma (IP) is an unusual type of benign tumor that has high recurrence rates and the potential to transform into squamous cell carcinomas (SCC). The mechanism of the transformation process from IP to IP-SCC is uncertain and there is no consensus regarding the best practice for IP-SCC detection. The goal of this study is to identify the best clinical methods to detect for IP-SCC. Methods An evidence-based review was performed using Medline and Ovid to obtain all articles up to October 10th, 2019 pertaining to identification of IP malignant transformation. All manuscripts discussing clinical methods or biomarkers were included. Results Based on clinical research studies, convoluted cerebriform pattern and apparent diffusion coefficient values on Magnetic Resonance Imaging (MRI) can help differentiate benign IP from SCC and increased SUVmax on PET/CT is associated with higher probability of malignancy although not as specific. No consensus about the best biomarker for IP-SCC has been reached among researchers and continues to be exploratory. Conclusion Endoscopy with biopsy is the gold standard practice to identify IP-SCC; however, MRI is the preferred imaging modality to recognize malignant transformation in cases where biopsy is difficult. Multiple biomarkers have shown positive results, but no single indicator with clinical significance for monitoring malignant transformation process has been found.
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Affiliation(s)
- Cai Long
- Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Basel Jabarin
- St Paul's Sinus Centre, University of British Columbia, Vancouver, BC, Canada
| | - Alexandra Harvey
- Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Jennifer Ham
- Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Amin Javer
- St Paul's Sinus Centre, University of British Columbia, Vancouver, BC, Canada
| | - Arif Janjua
- St Paul's Sinus Centre, University of British Columbia, Vancouver, BC, Canada
| | - Andrew Thamboo
- St Paul's Sinus Centre, University of British Columbia, Vancouver, BC, Canada.
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Elliot A, Näsman A, Westman M, Marklund L, Stjärne P, Hammarstedt-Nordenvall L. Human papillomavirus and infiltration of CD8- and Foxp3-positive immune cells in sinonasal inverted papillomas. Acta Otolaryngol 2019; 139:1019-1023. [PMID: 31486701 DOI: 10.1080/00016489.2019.1654616] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Background: Sinonasal inverted papilloma (IP) is a benign tumor with a high risk of local recurrence and a potential to malignify and Human papillomavirus (HPV) has been suggested an etiological factor. p16INK4a (p16) overexpression is considered a surrogate marker for HPV, but whether p16 and HPV correlate to IP is uncertain. Besides, a prognostic role of tumor infiltrating lymphocytes (TILs) are observed in many tumors, however their role in IP is sparsely studied. Aims/objectives: We hence analyzed IPs for the presence and the prognostic role of HPV and p16 overexpression together with CD8+ and FoxP3+ TILs in a population-based study. Material and methods: 98 IP patients diagnosed 2001-2010 were identified from the Swedish Cancer Registry and analyzed for HPV by PCR and p16, CD8 and FoxP3 was by immunohistochemistry. Results: In total, 12.2% of the IPs were HPV-positive (nine HPV-11, two HPV-6 and one HPV-45). Patients with HPV-positive lesions were younger (p = .003) and tended to present with more dysplasia. No correlation was observed between TILs and prognosis. Conclusions and significance: Our data suggests that patients with HPV-positive IPs present with different clinical characteristics, suggesting possibly different disease entities. Moreover, recurrences may occur >5 years, which should be considered in the follow-up.
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Affiliation(s)
- Alexandra Elliot
- Department of Oto-Rhino-Laryngology, Karolinska Institute, Stockholm, Sweden
- Department of Clinical Science, Intervention and Technology, Karolinska Institute, Stockholm, Sweden
| | - Anders Näsman
- Department of Oncology-Pathology, Department of Clinical Pathology, Cancer Center Karolinska, Karolinska Institute, Stockholm, Sweden
| | - Marit Westman
- Department of Oto-Rhino-Laryngology, Karolinska Institute, Stockholm, Sweden
- Department of Medicine Solna, Immunology and Allergy Unit, Karolinska Institute, Stockholm
| | - Linda Marklund
- Department of Oto-Rhino-Laryngology, Karolinska Institute, Stockholm, Sweden
- Department of Clinical Science, Intervention and Technology, Karolinska Institute, Stockholm, Sweden
| | - Pär Stjärne
- Department of Oto-Rhino-Laryngology, Karolinska Institute, Stockholm, Sweden
- Department of Clinical Science, Intervention and Technology, Karolinska Institute, Stockholm, Sweden
| | - Lalle Hammarstedt-Nordenvall
- Department of Oto-Rhino-Laryngology, Karolinska Institute, Stockholm, Sweden
- Department of Clinical Science, Intervention and Technology, Karolinska Institute, Stockholm, Sweden
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Sbrana MF, Borges RFR, Pinna FDR, Neto DB, Voegels RL. Sinonasal inverted papilloma: rate of recurrence and malignant transformation in 44 operated patients. Braz J Otorhinolaryngol 2019; 87:80-84. [PMID: 31455578 PMCID: PMC9422717 DOI: 10.1016/j.bjorl.2019.07.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 07/02/2019] [Accepted: 07/03/2019] [Indexed: 11/25/2022] Open
Abstract
Introduction Although sinonasal inverted papillomas are benign lesions, they are locally aggressive and have a potential malignant transformation ranging from 5% to 15%, with a high recurrence rate. Objective The aim of this article is to describe the rate of recurrence and malignant transformation in patients with a diagnosis of inverted papilloma who underwent surgery in a tertiary hospital in São Paulo. Methods We performed a retrospective analysis of patients diagnosed with sinonasal papilloma who had undergone surgery in a tertiary hospital in São Paulo, between August 1998 and August 2017. A patient chart review was conducted to assess data of patients’ demographics, tumors characteristics, follow-up appointments, recurrence and malignancy. Inverted papillomas were analyzed and classified under the Krouse staging system. Results A total of 69 surgeries were performed in patients with diagnosis of sinonasal papilloma. Inverted papilloma was the most prevalent subtype (49 cases ‒ 80.33%), followed by exophytic papilloma (6 cases ‒ 9.84%) and by oncocytic papilloma (6 cases – 9.84%). The recurrence rate was 34.09% for inverted papilloma (15/44) and the mean time of recurrence was 24.6 months. Malignant transformation occurred in 6 patients (13.64%). Three of these patients presented carcinoma in the first surgery and three patients developed carcinoma during the follow-up. Conclusion The high recurrence rate and malignancy potential allow us to consider inverted papillomas as aggressive tumors. In a tertiary hospital in São Paulo the recurrence rate the mean time to recurrence is 24.6 months. The recurrence after 10 years implies was 34.09% and the need for long-term follow up. It is possible that the high recurrence rate and the high malignant transformation rate we found are due to the large number of tumors discovered at an advanced stage (most of them staged T3 and T4), secondary to poor access to health system, in developing countries.
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Affiliation(s)
- Mariana Ferreira Sbrana
- Universidade de São Paulo (USP), Departamento de Otorrinolaringologia, São Paulo, SP, Brazil.
| | | | - Fábio de Rezende Pinna
- Universidade de São Paulo (USP), Departamento de Otorrinolaringologia, São Paulo, SP, Brazil
| | - Deusdedit Brandão Neto
- Universidade de São Paulo (USP), Departamento de Otorrinolaringologia, São Paulo, SP, Brazil
| | - Richard Louis Voegels
- Universidade de São Paulo (USP), Departamento de Otorrinolaringologia, São Paulo, SP, Brazil
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Wang H, Li H, Hu L, Wang J, Liu Q, Wang D, Sun X. Overexpression of FoxM1 in Sinonasal Inverted Papilloma and Associated Squamous Cell Carcinoma. Am J Rhinol Allergy 2019; 33:706-715. [PMID: 31333047 DOI: 10.1177/1945892419863193] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Background Sinonasal inverted papilloma (IP) is a rare tumor of nasal cavity and paranasal sinuses. Its etiology and factors associated with tumor progression remains unclear. Forkhead Box M1 (FoxM1) has also been suggested to serve as an oncogene due to its pivotal roles in cell proliferation and cell cycle regulation. The aim of this study was to characterize the expression pattern of FoxM1 in IP and IP with associated squamous cell carcinoma (IPwSCC). Methods The study included 8 subjects with IPwSCC, 17 subjects with sinonasal IP, and 8 normal uncinate tissue (UT) mucosa. Real-time polymerase chain reaction (PCR) and immunohistochemistry were used to assess the expression and distribution of FoxM1, polo-like kinase 1 (PLK1), cyclin B1, and cyclin D1 in IP tissues and normal control. The expression of FoxM1, PLK1, cyclin B1, and cyclin D1 in IPwSCC was evaluated using immunohistochemistry. Results The messenger RNA (mRNA) expression of FoxM1, PLK1, cyclin B1, and cyclin D1 was significantly upregulated in IP tissues versus normal UT by real-time PCR (all P values < .05). Using immunohistochemistry, the expression of FoxM1 was observed in the tumor cells of sinonasal IP and IPwSCC, but scarce positive cells in normal UT mucosa. The percentage of positive FoxM1-staining cells was statistically higher in IPwSCC than IP and normal UT mucosa (both P < .05). Both mRNA and protein expression of FoxM1 in IP with or without associated squamous cell carcinoma was correlated with tumor histological grades (both P < .05). Conclusion FoxM1, a proliferation specific transcription factor, was overexpressed in sinonasal IP and IPwSCC. FoxM1 might be a key molecule associated with growth of IP and malignant transformation of IP into IPwSCC.
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Affiliation(s)
- Huan Wang
- Department of Otolaryngology, Eye, Ear, Nose and Throat Hospital, Fudan University, Shanghai, China
| | - Han Li
- Department of Otolaryngology, Eye, Ear, Nose and Throat Hospital, Fudan University, Shanghai, China
| | - Li Hu
- Department of Otolaryngology, Eye, Ear, Nose and Throat Hospital, Fudan University, Shanghai, China.,Department of Experimental Center, Eye, Ear, Nose and Throat Hospital, Fudan University, Shanghai, China
| | - Jingjing Wang
- Department of Otolaryngology, Eye, Ear, Nose and Throat Hospital, Fudan University, Shanghai, China
| | - Quan Liu
- Department of Otolaryngology, Eye, Ear, Nose and Throat Hospital, Fudan University, Shanghai, China
| | - Dehui Wang
- Department of Otolaryngology, Eye, Ear, Nose and Throat Hospital, Fudan University, Shanghai, China
| | - Xicai Sun
- Department of Otolaryngology, Eye, Ear, Nose and Throat Hospital, Fudan University, Shanghai, China
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7
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Lobo BC, D'Anza B, Farlow JL, Tang D, Woodard TD, Ting JY, Sindwani R. Outcomes of sinonasal squamous cell carcinoma with and without association of inverted papilloma: A multi-institutional analysis. Am J Rhinol Allergy 2018; 31:305-309. [PMID: 28859706 DOI: 10.2500/ajra.2017.31.4470] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Sinonasal squamous cell carcinoma (SCC) accounts for <1% of all malignancies but represents 70% of sinonasal cancer. Up to 10% of SCCs are associated with inverted papilloma (IPSCC). Studies that compare patients, treatment, and outcomes of SCC and IPSCC are absent in the literature. METHODS A retrospective review of patients with SCC and those with IPSCC at Cleveland Clinic and Indiana University from 1995 to 2015. The records were analyzed for demographics, tumor characteristics, treatment, and outcomes. RESULTS The study comprised 117 patients with SCC, of whom, 29 had IPSCC. The mean age at diagnosis was similar: 63 and 64 years for patients with SCC and patients with IPSCC, respectively; with female patients representing 36% and 34%, respectively (p > 0.99).Smokers represented 64% of the patients with SCC and 55% of patients with IPSCC (p = 0.3); excessive alcohol intake was noted in 16% of the patients with SCC and 21% of the patients with IPSCC (p = 0.56).The maxillary sinus was most commonly involved, followed by the nasal cavity (51% versus 35% SCC, 45% versus 38% IPSCC). Frontal ethmoid and sphenoid sinuses contained primary tumors only in patients with SCC. Upfront treatment was surgery in 84% of patients with SCC and 97% of patients with IPSCC (p = 0.18); 68 and 55% received radiation, respectively, and 25 and 21% received chemotherapy, respectively.Overall survival averaged 5.5 and 3.4 years for patients with SCC and patients with IPSCC, respectively (p = 0.12); disease-free survival was 4.8 and 2.9 years, respectively (p = 0.18). Nodal metastasis was more likely in patients with SCC (18 versus 0%; p = 0.02). When divided into high- and low-stage disease: more common nodal metastases were demonstrated in high-stage SCC than in low-stage disease (p = 0.03). Overall survival was decreased between high- and low-grade disease but not when subdivided between SCC and IPSCC. CONCLUSION Although SCC with and without IP association are considered different diseases, their demographics and outcomes seem similar. Nodal metastasis was noted to be higher in the SCC cohort, which may indicate different tumor biology. Further study is warranted.
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Affiliation(s)
- Brian C Lobo
- Cleveland Clinic Foundation, Cleveland, Ohio, USA
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Kılıç S, Kılıç SS, Kim ES, Baredes S, Mahmoud O, Gray ST, Eloy JA. Significance of human papillomavirus positivity in sinonasal squamous cell carcinoma. Int Forum Allergy Rhinol 2017; 7:980-989. [PMID: 28859244 DOI: 10.1002/alr.21996] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Revised: 06/29/2017] [Accepted: 07/07/2017] [Indexed: 12/16/2022]
Abstract
BACKGROUND The role of human papillomavirus (HPV) in sinonasal squamous cell carcinoma (SNSCC) is not well understood. METHODS The National Cancer Database was queried for cases of SNSCC with known HPV status. Demographics, socioeconomic variables, TNM stage, histology, grade, treatment modalities, and overall survival (OS) through 5 years were compared between HPV-positive and HPV-negative tumors. Cox proportional hazard regression analyses were performed. RESULTS Seven hundred seventy (770) cases were identified; 526 were HPV-negative (68.3%) and 244 (31.7%) were HPV-positive. Patients with HPV-positive tumors were younger (58.0 vs 63.7 years, p < 0.0001). Nasal cavity (49.4%) tumors were more likely to be HPV-positive (p < 0.05) than maxillary (18.8%), ethmoid (18.8%), and frontal (18.2%) sinus tumors. Large cell nonkeratinizing (42.4%), papillary (42.1%), and basaloid (56.5%) tumors were more likely than keratinizing (25.2%) tumors to be HPV-positive (p < 0.05). Well-differentiated (grade I) tumors (9.0%) were less likely than higher grade tumors to be HPV-positive (p < 0.05). Gender, race, facility type, insurance type, median income, education level, Charlson-Deyo comorbidity score, overall stage, T stage, N stage, M stage, tumor size, treatment modality, surgical approach, and surgical margins did not vary by HPV status (p ≥ 0.05). HPV-positive tumors had higher OS than HPV-negative tumors (p < 0.0001). At 5 years, OS was 68.1% and 51.5% for HPV-positive and HPV-negative tumors, respectively. On multivariate analyses, HPV positivity remained a favorable prognostic factor (hazard ratio, 0.49; 95% confidence interval, 0.34-0.70). CONCLUSION HPV positivity is more common in nasal cavity SCC and nonkeratinizing SNSCC. It is also a favorable prognostic factor in SNSCC. Future studies on SNSCC should take HPV positivity into consideration.
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Affiliation(s)
- Suat Kılıç
- Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, NJ
| | - Sarah S Kılıç
- Department of Radiation Oncology, Rutgers New Jersey Medical School, Newark, NJ
| | - Emilie S Kim
- Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, NJ
| | - Soly Baredes
- Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, NJ.,Center for Skull Base and Pituitary Surgery, Neurological Institute of New Jersey, Rutgers New Jersey Medical School, Newark, NJ
| | - Omar Mahmoud
- Department of Radiation Oncology, Rutgers New Jersey Medical School, Newark, NJ
| | - Stacey T Gray
- Department of Otolaryngology, Harvard Medical School, Boston, MA.,Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, MA
| | - Jean Anderson Eloy
- Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, NJ.,Center for Skull Base and Pituitary Surgery, Neurological Institute of New Jersey, Rutgers New Jersey Medical School, Newark, NJ.,Department of Neurological Surgery, Rutgers New Jersey Medical School, Newark, NJ.,Department of Ophthalmology and Visual Science, Rutgers New Jersey Medical School, Newark, NJ
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Kakizaki T, Hatakeyama H, Nakamaru Y, Takagi D, Mizumachi T, Sakashita T, Kano S, Homma A, Fukuda S. Role of microRNA-296-3p in the malignant transformation of sinonasal inverted papilloma. Oncol Lett 2017; 14:987-992. [PMID: 28693263 DOI: 10.3892/ol.2017.6193] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2016] [Accepted: 03/03/2017] [Indexed: 12/24/2022] Open
Abstract
Inverted papilloma (IP) is a benign tumor occurring in the nasal cavity and paranasal sinuses. It is reported that 5-15% of IPs undergo malignant transformation into squamous cell carcinoma (SCC), and the role of microRNAs (miRNA/miR) in this process remains to be elucidated. In the present study, whole miRNA profiles using samples of IP and SCC were investigated, in order to detect the function of miRNA in the carcinogenesis of IP. Samples from IPs (n=5) and SCC lesions (n=5), which arose from IPs, were used for miRNA analysis. A total of 200 miRNAs exhibited a >2-fold differential expression between IP and SCC. miR-296-3p was markedly upregulated in SCC with a 23-fold difference. Computational analysis indicated that miR-296-3p targeted PTEN, which regulates the phosphoinositide 3-kinase (PI3K)/protein kinase B (Akt) signaling pathway and PTEN is involved in the carcinogenesis of SCC. miR-296-3p directly regulated PTEN expression in head and neck cancer cells, with PTEN protein levels decreased in 4/19 the SCCs (21.0%), as compared with those in the IPs (76.4%). Positive p21 staining was observed in 64.7% of IPs; this was a significantly increased rate compared with that for SCCs (26.3%, P=0.0086). The results of the present study indicated that there were marked changes in the miRNA expression signature during the malignant transition. miR-296-3p may serve an important role in the malignant transformation of IPs via the regulation of PTEN, combined with the subsequent inhibition of the PI3K/Akt signaling pathway, and may be a novel agent for cancer prevention.
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Affiliation(s)
- Tomohiko Kakizaki
- Department of Otolaryngology-Head and Neck Surgery, Hokkaido University Graduate School of Medicine, Sapporo 060-8638, Japan
| | - Hiromitsu Hatakeyama
- Department of Otolaryngology-Head and Neck Surgery, Hokkaido University Graduate School of Medicine, Sapporo 060-8638, Japan
| | - Yuji Nakamaru
- Department of Otolaryngology-Head and Neck Surgery, Hokkaido University Graduate School of Medicine, Sapporo 060-8638, Japan
| | - Dai Takagi
- Department of Otolaryngology-Head and Neck Surgery, Hokkaido University Graduate School of Medicine, Sapporo 060-8638, Japan
| | - Takatsugu Mizumachi
- Department of Otolaryngology-Head and Neck Surgery, Hokkaido University Graduate School of Medicine, Sapporo 060-8638, Japan
| | - Tomohiro Sakashita
- Department of Otolaryngology-Head and Neck Surgery, Hokkaido University Graduate School of Medicine, Sapporo 060-8638, Japan
| | - Satoshi Kano
- Department of Otolaryngology-Head and Neck Surgery, Hokkaido University Graduate School of Medicine, Sapporo 060-8638, Japan
| | - Akihiro Homma
- Department of Otolaryngology-Head and Neck Surgery, Hokkaido University Graduate School of Medicine, Sapporo 060-8638, Japan
| | - Satoshi Fukuda
- Department of Otolaryngology-Head and Neck Surgery, Hokkaido University Graduate School of Medicine, Sapporo 060-8638, Japan
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10
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Sun Q, An L, Zheng J, Zhu D. Advances in recurrence and malignant transformation of sinonasal inverted papillomas. Oncol Lett 2017; 13:4585-4592. [PMID: 28599459 DOI: 10.3892/ol.2017.6089] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2016] [Accepted: 01/26/2017] [Indexed: 01/06/2023] Open
Abstract
Sinonasal inverted papilloma (SIP) is a benign tumor of the nasal cavity and sinus. SIP is characterized by aggressive malignant transformation and a high rate of recurrence. Inadequate removal of the tumor during surgery is one of the most significant contributors to SIP recurrence. A growing body of evidence suggests that molecular alteration in SIP, including human papilloma virus infections, single nucleotide polymorphisms of key genes, deregulation of signaling pathways and immunological changes, may lead to SIP occurrence and malignant transformation. However, the extent to which these molecular mechanisms contribute to SIP pathology and transformation remains unclear due to limited research. Further studies are warranted to elucidate the primary dependent factors that contribute to SIP etiology. The present article reviewed risk factors of progression and recurrence of SIP, including outdoor and industrial occupational exposure, smoking, septal deviation, SIP location, recurrent cases, stage of SIP-associated squamous cell carcinoma and choice of surgical method.
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Affiliation(s)
- Qingjia Sun
- Department of Otorhinolaryngology Head and Neck Surgery, The China-Japan Union Hospital of Jilin University, Changchun, Jilin 130033, P.R. China
| | - Lifeng An
- Department of Otorhinolaryngology Head and Neck Surgery, The China-Japan Union Hospital of Jilin University, Changchun, Jilin 130033, P.R. China
| | - Jun Zheng
- Department of Otorhinolaryngology Head and Neck Surgery, The China-Japan Union Hospital of Jilin University, Changchun, Jilin 130033, P.R. China
| | - Dongdong Zhu
- Department of Otorhinolaryngology Head and Neck Surgery, The China-Japan Union Hospital of Jilin University, Changchun, Jilin 130033, P.R. China
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11
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Wang X, Lv W, Qi F, Gao Z, Yang H, Wang W, Gao Y. Clinical effects of p53 overexpression in squamous cell carcinoma of the sinonasal tract: A systematic meta-analysis with PRISMA guidelines. Medicine (Baltimore) 2017; 96:e6424. [PMID: 28328848 PMCID: PMC5371485 DOI: 10.1097/md.0000000000006424] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND The level of p53 protein expression in sinonasal squamous cell carcinoma (SNSCC) has been estimated, but the results remain inconsistent and the point of consensus has not been reached. This study was first determined to evaluate the clinical effects of p53 expression in SCC of the sinonasal tract. METHODS According to the preferred reporting items for systematic reviews and meta-analyses (PRISMA) statement criteria, the potential literature was searched from diverse databases. The pooled odds ratios (ORs) with corresponding 95% confidence intervals (CIs) were calculated to assess the strength of association between p53 expression and SNSCC. RESULTS Final 17 eligible studies were included in a total of 258 cases and 748 controls. The result of p53 expression was shown to be notably higher in SNSCC than in benign sinonasal papillomas and normal sinonasal mucosa (OR = 26.93, P < 0.001; OR = 39.79, P < 0.001; respectively). Subgroup analyses of ethnicity revealed that p53 expression had significant association with SNSCC in Asian and Caucasian populations in cancer versus benign sinonasal papillomas or normal sinonasal mucosa. The expression of p53 was notably higher in moderately or poorly differentiated SNSCC than in well-differentiated SNSCC (OR = 3.51, P = 0.021), while p53 expression was not associated with histological type. CONCLUSION The results suggested that p53 overexpression may be correlated with the carcinogenesis and progression of SNSCC. The p53 gene may become a novel drug target of SNSCC. Additional studies on the correlation of p53 expression with clinicopathological features are needed.
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Yan CH, Newman JG, Kennedy DW, Palmer JN, Adappa ND. Clinical outcomes of sinonasal squamous cell carcinomas based on tumor etiology. Int Forum Allergy Rhinol 2017; 7:508-513. [DOI: 10.1002/alr.21899] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Revised: 11/11/2016] [Accepted: 11/21/2016] [Indexed: 11/10/2022]
Affiliation(s)
- Carol H. Yan
- Department of Otorhinolaryngology-Head and Neck Surgery; University of Pennsylvania; Perelman School of Medicine Philadelphia PA
| | - Jason G. Newman
- Department of Otorhinolaryngology-Head and Neck Surgery; University of Pennsylvania; Perelman School of Medicine Philadelphia PA
| | - David W. Kennedy
- Department of Otorhinolaryngology-Head and Neck Surgery; University of Pennsylvania; Perelman School of Medicine Philadelphia PA
| | - James N. Palmer
- Department of Otorhinolaryngology-Head and Neck Surgery; University of Pennsylvania; Perelman School of Medicine Philadelphia PA
| | - Nithin D. Adappa
- Department of Otorhinolaryngology-Head and Neck Surgery; University of Pennsylvania; Perelman School of Medicine Philadelphia PA
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Pajor AM, Danilewicz M, Stasikowska-Kanicka O, Józefowicz-Korczyńska M. The immunoexpression of CD34, Bcl-2, and Ki-67 antigens in sinonasal inverted papillomas. Am J Rhinol Allergy 2015; 28:e31-4. [PMID: 24717877 DOI: 10.2500/ajra.2014.28.3980] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Numerous molecular markers of sinonasal inverted papillomas (IP) were investigated in the past; however, significance of angiogenesis and inhibition of apoptosis were not well documented. This study was designed to determine expression of angiogenic marker CD34 antigen, antiapoptotic marker Bcl-2 oncoprotein, and proliferative marker Ki-67 antigen in the group of patients with IP. We matched up these findings to the group of patients with sinonasal carcinoma (SNC) and used chronic rhinosinusitis (CRS) patients as control group. In addition, we compared expression of the markers among IP patients who displayed distinctly different patterns of clinical behavior. METHODS Tissue samples were obtained from 46 surgically treated patients; 18 of them had a diagnosis of IP, 9 had documented SNC, and the remaining 19 patients had CRS. All specimens were stained using immunohistochemistry techniques for CD34 (mean vessel density [MVD]), Bcl-2, and Ki-67 antigens. Morphometry was evaluated by computer image analysis system. RESULTS We noted statistically significant differences in expression of CD34 antigen, Bcl-2 protein, and Ki-67 antigen (for all groups, ANOVA p < 0.001) among the investigated groups. The mean value of CD34 antigen was significantly higher in the IP group than in the CRS group, but it was below the levels of the SNC group. Compared with the cases not complicated by recurrence, the patients with recurrent IP exhibited higher MVD levels, while levels of bcl-2 and Ki67 protein expression did not differ in a significant way between recurrent and nonrecurrent cases. The significant positive correlations were observed between Bcl-2 protein and Ki-67 antigen in IP and SNC groups and between Bcl-2 protein and CD34 antigen in the CRS group. CONCLUSION Our findings underscore importance of angiogenesis in the development and prognosis of IP and support further investigation of this aspect of IP tumor growth.
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Affiliation(s)
- Anna M Pajor
- Department of Otolaryngology, Medical University of Lodz, Barlicki University Hospital, Lodz, Poland
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Pagella F, Pusateri A, Giourgos G, Tinelli C, Matti E. Evolution in the treatment of sinonasal inverted papilloma: pedicle-oriented endoscopic surgery. Am J Rhinol Allergy 2015; 28:75-81. [PMID: 24717892 DOI: 10.2500/ajra.2014.28.3985] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND In the literature, the global endoscopic sinus surgery (ESS) success in the treatment of sinonasal inverted papilloma (IP) is 95%. This study was designed to describe a conservative endoscopic approach, based on research of the tumor's pedicle and treatment concentrated on its site of attachment, and to compare the results of this technique with the outcome of standard endoscopic treatment. METHODS Retrospective analysis of the patients treated in our institution for paranasal inverted papilloma (IP), between 2002 and 2011 with a minimum of 18 months follow-up was performed. Group A received a standard ESS including whole sinus demucosization (maxillary, ethmoid, frontal, or sphenoid sinus) and bony wall drilling. Group B patients instead underwent pedicle-oriented endoscopic surgery (POES); in this group, bony demucosization and drilling were selectively conducted around the site of pedicle attachment of the tumor. RESULTS The cohort included 73 patients (median age, 60.5 years; median follow-up, 58 months). Group A/group B consisted of 37/36 patients. IP persistence-recurrence for group A/group B was 0/1 cases. Oncological success for global endoscopic/group A/group B was 98.6% (72/73)/100% (37/37)/97.2% (35/36). We noticed a significant difference in surgical operative time and postoperative complication rate among the groups, in favor of POES technique. CONCLUSION Our data confirm the efficacy of the endonasal endoscopic treatment for sinonasal IP. Moreover, the even more conservative endoscopic treatment proposed (POES) seems to offer good control of the disease, shorter operating times, avoidance of unnecessary surgery with respect to uninvolved structures, and permits a follow-up aimed at the site of the pedicle attachment.
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Affiliation(s)
- Fabio Pagella
- Department of Otorhinolaryngology, Fondazione I.R.C.C.S. Policlinico San Matteo, University of Pavia, Pavia, Italy
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15
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Vorasubin N, Vira D, Suh JD, Bhuta S, Wang MB. Schneiderian papillomas: comparative review of exophytic, oncocytic, and inverted types. Am J Rhinol Allergy 2013; 27:287-92. [PMID: 23883810 DOI: 10.2500/ajra.2013.27.3904] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Sinonasal papillomas are benign epithelial neoplasms arising from Schneiderian mucosa. The three subtypes, exophytic, oncocytic, and inverted (inverted papilloma [IP]), should be distinguished from one another histopathologically. This study (1) highlights the histopathological and clinical differences between the Schneiderian papilloma subtypes and (2) identifies clinical features that potentially predict papilloma subtypes. METHODS A retrospective review was performed of patients with Schneiderian papillomas over an 11-year period. RESULTS Seventy patients with sinonasal papillomas who underwent sinus surgery were identified. There were 50 (71%) male and 20 (29%) female subjects diagnosed at an average age of 53 years (range, 13-80 years). Exophytic (n = 25), oncocytic (n = 9), and IP (n = 37) were identified. IP was associated with transformation into squamous cell carcinoma in three (8%) cases and dysplasia in three (8%) cases. Neither oncocytic nor exophytic subtypes were associated with dysplasia or malignancy. On multivariate analysis of potential predictors of papilloma subtype, history of chronic rhinosinusitis (CRS) and location of papilloma were significantly associated with papilloma subtype. Using classification and regression tree model, papilloma subtypes can be predicted based on presence or absence of CRS and papilloma location with nominal 82.4% accuracy. CONCLUSION The inverted and exophytic type are the most common sinonasal papillomas, with the inverted type having an 8% rate of malignant transformation in this study. In contrast, the oncocytic type was not associated with dysplasia or malignancy in our series despite reports in the literature indicating malignant potential. History of CRS and papilloma location can provide clues to the histological subtype, which is important for surgical planning and patient counseling.
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Affiliation(s)
- Nopawan Vorasubin
- Head and Neck Surgery, University of California-Los Angeles, 10833 Le Conte Avenue, Los Angeles, CA 90095-1624, USA.
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Lewis JS, Westra WH, Thompson LDR, Barnes L, Cardesa A, Hunt JL, Williams MD, Slootweg PJ, Triantafyllou A, Woolgar JA, Devaney KO, Rinaldo A, Ferlito A. The sinonasal tract: another potential "hot spot" for carcinomas with transcriptionally-active human papillomavirus. Head Neck Pathol 2013; 8:241-9. [PMID: 24338611 PMCID: PMC4126925 DOI: 10.1007/s12105-013-0514-4] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2013] [Accepted: 12/03/2013] [Indexed: 11/30/2022]
Abstract
While high risk human papillomavirus (HPV) is well established as causative and clinically important for squamous cell carcinoma (SCC) of the oropharynx, its role in non-oropharyngeal head and neck SCC is much less clearly elucidated. In the sinonasal region, in particular, although it is a relatively uncommon site for SCC, as many as 20 % of SCC harbor transcriptionally-active high risk HPV. These tumors almost always have a nonkeratinizing morphology and may have a better prognosis. In addition, specific variants of SCC as well as other rare carcinoma types, when arising in the sinonasal tract, can harbor transcriptionally-active HPV. This article reviews the current literature on HPV in sinonasal carcinomas, attempts to more clearly demonstrate what tumors have it and how this relates to possible precursor lesions like inverted papilloma, and discusses the possible clinical ramifications of the presence of the virus.
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Affiliation(s)
- James S Lewis
- Departments of Pathology and Immunology and Otolaryngology Head and Neck Surgery, Division of Anatomic and Molecular Pathology, Washington University School of Medicine, St. Louis, MO, USA,
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Suzuki M, Deng Z, Hasegawa M, Uehara T, Kiyuna A, Maeda H. Squamous cell carcinoma antigen production in nasal inverted papilloma. Am J Rhinol Allergy 2013; 26:365-70. [PMID: 23168150 DOI: 10.2500/ajra.2012.26.3797] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND The clinical importance of serum squamous cell carcinoma antigen (SCCA) and SCCA subclasses has not been established for treating inverted papilloma (IP). The aim of this study was to clarify the clinical importance of serum SCCA and its subclasses in IP, compared with maxillary squamous cell carcinoma and inflammatory disease. METHODS Serum SCCA was measured in 22 patients with IP (IP group), 11 with maxillary squamous cell carcinoma (carcinoma group), and 22 with inflammatory disease (inflammatory group). mRNA expression of SCCA subclasses was examined using quantitative real-time polymerase chain reaction. RESULTS In the IP group, 81.8% showed elevated serum SCCA, and 90.3% with recurrent IP showed elevated SCCA. The preoperative SCCA value (mean ± SD, 3.99 ± 4.39) in the IP group was significantly higher than in the carcinoma (1.28 ± 0.88; p = 0.012) and inflammatory (0.60 ± 0.31; p < 0.001) groups. mRNA expression of SCCA1 and SCCA2 in the IP group was higher than in the carcinoma and inflammatory groups. The SCCA2/SCCA1 ratio of mRNA expression (0.11 ± 0.06) in the IP group was similar to that (0.11 ± 0.09) in the inflammatory group, although the ratio (0.20 ± 0.12) in the carcinoma group was significantly higher than in the IP and inflammatory groups. The receiver operating characteristic curve analysis for the SCCA2/SCCA1 ratio to detect carcinoma yielded an area under the curve of 0.760 (95% confidence interval, 0.626-0.894). CONCLUSION The serum level of SCCA is effective for detecting IP, including recurrent IP. In contrast, the SCCA2/SCCA1 ratio is useful for detecting squamous cell carcinoma among other sinonasal diseases.
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Affiliation(s)
- Mikio Suzuki
- Department of Otorhinolaryngology, Head and Neck Surgery, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan.
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Inflammation and apoptosis in malignant transformation of sinonasal inverted papilloma: the role of the bridge molecules, cyclooxygenase-2, and nuclear factor κB. Am J Otolaryngol 2013; 34:22-30. [PMID: 22951321 DOI: 10.1016/j.amjoto.2012.07.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2012] [Revised: 07/17/2012] [Accepted: 07/20/2012] [Indexed: 11/23/2022]
Abstract
PURPOSE This study examined the early events in the neoplastic progression of the sinonasal inverted papilloma to squamous cell carcinoma from the viewpoint of chronic inflammation and apoptosis. MATERIALS AND METHODS In total, 118 archival slides stained with hematoxylin and eosin from 45 patients were graded according to histopathology (grades I-IV). Their representative portions were transferred to a tissue microarray, sections of which were stained immunohistochemically for cyclooxygenase-2, p53, bax, bcl-2, and nuclear factor κB. RESULTS Cyclooxygenase-2 expression was positively correlated with histopathologic grade, with higher expression in advanced grades. p53s were detected in all cores from advanced grades (III, IV), but not in early grades (I, II). The expressions of nuclear factor κB, bax, and bcl-2 were not correlated with the grade. CONCLUSIONS A p53 mutation seems be a critical event for the malignant transformation of the sinonasal inverted papilloma. Cyclooxygenase-2-mediated inflammatory signals, activated as a consequence of the p53 mutation, may contribute to promoting the proliferation of the advanced sinonasal inverted papilloma.
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Lee GH, Yoon YH, Kim YM, Yeo MK, Liang ZL, Kim JM, Rha KS. Pattern of expression of cyclooxygenase-2 in malignant transformation of sinonasal inverted papilloma. Am J Otolaryngol 2012; 33:585-9. [PMID: 22534023 DOI: 10.1016/j.amjoto.2012.03.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2012] [Revised: 03/05/2012] [Accepted: 03/11/2012] [Indexed: 10/28/2022]
Abstract
OBJECTIVE Cyclooxygenases (COXs) are enzymes that catalyze the conversion of arachidonic acid to prostaglandins. Many studies have suggested that COX-2, the inducible form of COX, is important in carcinogenesis. However, little is known about the pattern of expression of COX-2 in a multistep process of malignant transformation of sinonasal inverted papilloma (IP). In this study, we investigated COX-2 expression in IPs, IPs with dysplasia, IPs with squamous cell carcinoma (SCC), and primary SCCs of sinonasal tract. STUDY DESIGN A retrospective study was conducted. SETTING The setting was a tertiary care referral center. SUBJECTS AND METHODS The expression of COX-2 was evaluated by immunohistochemistry in 56, 7, 18, and 17 cases of IPs, IPs with dysplasia, IPs with SCC, and primary SCCs, respectively. Furthermore, we investigated the possible correlation between the expression of COX-2 and clinicopathologic variables in patients with IPs with SCC and primary SCC patients. RESULTS Positive immunoreactivity for COX-2 was observed in 3 (5.4%) of 56 IPs, 7 (38.9%) of 18 IPs with SCC, and 7 (41.2%) of 17 primary SCCs, whereas it was not observed in IPs with dysplasia. The percentage of tumors with COX-2-positive immunostaining was significantly higher in IPs with SCC and primary SCCs compared with benign IPs. There was no significant correlation between the expression of COX-2 and clinicopathologic variables, such as tumor stage, histologic differentiation, and the proportion of malignant areas in patients with IPs with SCC. CONCLUSION Cyclooxygenase-2 may play an important role in the process of malignant transformation from IP to SCC.
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Jin J, Lee JW, Rha KS, Kim DW, Kim YM. Expression pattern of IQGAP1 in sinonasal inverted papillomas and squamous cell carcinomas. Laryngoscope 2012; 122:2640-6. [PMID: 22833392 DOI: 10.1002/lary.23541] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/01/2012] [Indexed: 11/09/2022]
Abstract
OBJECTIVES/HYPOTHESIS The scaffold protein IQGAP1 is a ubiquitously expressed 190 kDa protein that participates in protein-protein interactions, integrating diverse signaling pathways. In this study, we examined the expression of IQGAP1 in sinonasal inverted papillomas (IP) and sinonasal squamous cell carcinomas (SCC), which include IP with SCC (IPcSCC) and SCC alone. We also tried to elucidate whether the amount of IQGAP1 expression is related with any clinicopathologic features of sinonasal SCCs. STUDY DESIGN This was a retrospective study. METHODS The expression of IQGAP1 was analyzed by means of immunohistochemistry. The degrees of IQGAP1 expression and subcellular localization (rim formation) were analyzed with respect to the following clinicopathologic variables: age, gender, T stage, histologic differentiation, local recurrence, and distant metastasis. RESULTS The expression of IQGAP1 was significantly higher in patients with IPcSCC (3.62 ± 0.14), and SCC (2.93 ± 0.34) compared with IP (1.43 ± 0.26). The rim formation scale was significantly higher in IPcSCC (2.39 ± 0.24) compared with IP (1.68 ± 0.15). Distant metastasis in patients with SCC significantly correlated with an increased IQGAP1 rim formation (p = 0.011). Histologic differentiation was also significantly correlated with a positive staining scale for IQGAP1 in IPcSCCs (p = 0.038). CONCLUSION These results indicated that IQGAP1 expression is associated with both the histologic differentiation of IPcSCCs and is present in SCC cases where distant metastasis has occurred.
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Affiliation(s)
- Jun Jin
- Department of Otorhinolarynbgology-Head and Neck Surgery, Chungnam National University School of Medicine, Daejeon, Korea
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Sinonasal tumors: a clinicopathologic update of selected tumors. Eur Arch Otorhinolaryngol 2012; 270:5-20. [PMID: 22610012 DOI: 10.1007/s00405-012-2025-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2012] [Accepted: 04/17/2012] [Indexed: 12/11/2022]
Abstract
The sinonasal cavities show a wide variety of neoplasms of epithelial, mesenchymal, neural/neuroectodermal or hematopoietic origin. The differential diagnosis for these tumors may be difficult due to overlapping morphologies, variable patterns in ancillary studies, and potentially confusing terminology. In this report, an updated review of the spectrum of neoplasia is provided, using the World Health Organization 2005 classification as a guide. Classic tumors that are generally limited to the sinonasal tract are described and new information regarding molecular pathogenesis is reviewed. Also new entities that have the sinonasal tract as a site of predilection, such as sinonasal renal cell-like adenocarcinoma and NUT midline carcinoma are highlighted.
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Strojan P, Ferlito A, Lund VJ, Kennedy DW, Silver CE, Rinaldo A, Barnes L. Sinonasal inverted papilloma associated with malignancy: the role of human papillomavirus infection and its implications for radiotherapy. Oral Oncol 2011; 48:216-8. [PMID: 22098797 DOI: 10.1016/j.oraloncology.2011.10.009] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2011] [Revised: 10/11/2011] [Accepted: 10/17/2011] [Indexed: 11/26/2022]
Abstract
Sinonasal inverted papilloma (IP) is a benign but destructive tumor originating from the ciliated respiratory mucosa of the sinonasal tract. It can be associated with malignancy (squamous cell histology, in particular) and human papillomavirus infection has been investigated as a potential etiological factor linked to malignant alterations of IP. Surgery is the treatment of choice for IP, however, radiotherapy as an adjunct to surgery is indicated for IP with associated malignancy.
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Affiliation(s)
- Primož Strojan
- Department of Radiation Oncology, Institute of Oncology, Ljubljana, Slovenia
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Sinonasal inverted papilloma associated with squamous cell carcinoma. Radiol Oncol 2011; 45:267-72. [PMID: 22933964 PMCID: PMC3423751 DOI: 10.2478/v10019-011-0033-4] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2011] [Accepted: 09/01/2011] [Indexed: 11/20/2022] Open
Abstract
Background The aims of the study were to review single-institution experiences with sinonasal inverted papilloma associated with squamous cell carcinoma (IP/SCC), to analyze the presence of human papillomavirus (HPV) and to evaluate the role of radiotherapy. Patients and methods Five patients with IP/SCC were identified in the prospective institutional databases (1995–2005) and HPV status was determined in all five tumors. Results Four out of five patients had T3-4 tumors; no nodal involvement was seen in any of them. Four patients had curative surgery, supplemented in three of them with radiotherapy. Debulking surgery was performed in the patient with a non-resectable tumor followed by radical radiotherapy. Tumor was controlled locally in three patients at 8, 46 and 58 months post-surgery. Local failure occurred in two patients: after endoscopic resection of a T1 tumor (the recurrent tumor was successfully salvaged with additional surgery) and in a patient with an inoperable tumor. No regional or distant metastases occurred. HPV status was determined in all five tumors and three of them were found positive for HPV type 11. Conclusions In operable sinonasal IP/SCC, upfront surgery and postoperative radiotherapy to the tumor bed with dose levels comparable to those used for invasive SCC are recommended. For non-resectable disease, radical radiotherapy to a dose of 66–70 Gy could be of benefit.
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