Clinical characteristics of sinonasal inverted papilloma associated with recurrence and malignant transformation

He, Xindi; Wang, Ying

doi:10.1016/j.anl.2021.04.008

Cited by 8 publications

(13 citation statements)

References 16 publications

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“…The predilection sites of NIP were the ethmoid sinus, maxillary sinus, lateral wall of the nasal cavity, and frontal sinus, but because of the highly invasive nature of the disease, tumor lesions can easily invade other surrounding tissues [ 11 ]. Therefore, there will be a great risk of disease recurrence or even deterioration once the lesion is not completely removed during surgery [ 12 ]. In addition, although NIP is of epithelial origin, some studies have found abnormal bone in the tumor base, which not only elevates the potential threat of NIP but also increases the difficulty of surgical treatment [ 13 ].…”

Section: Discussionmentioning

confidence: 99%

Dynamic Incision under Nasal Endoscope and Low-Temperature Plasma Radiofrequency Ablation for Nasal Inverted Papilloma: An Analysis of Differences in Efficacy and the Destructive Effect on Immune Function

Liu

et al. 2022

Computational and Mathematical Methods in Medicine

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Background and Objective. This study sets out to provide reference for the clinical treatment and provide reference for clinical practice by comparing the therapeutic effects of dynamical-system surgery under nasal endoscope and low-temperature plasma radiofrequency ablation (LTPRA).Methods. NIP patients ( n = 106 ) admitted between January 2020 and March 2021 were selected and grouped as follows according to the random number table method: a dissection group treated with dynamical-system surgery under nasal endoscope and an ablation group treated with LTPRA. The clinical curative effects of the two procedures were compared, and the related indexes (operation time (OT), intraoperative blood loss (IBL), and length of stay (LOS)) and postoperative adverse reactions (ARs) were counted. In addition, fasting venous blood samples were collected before treatment (T0), as well as 3 (T1) and 7 days after treatment (T2) to detect inflammatory factors (IFs; C-reactive protein (CRP), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α)) and T lymphocyte subsets (CD3+, CD4+, and CD8+). Finally, all patients received a one-year follow-up to compare the differences in prognostic survival rate and disease recurrence rate between groups. Results. The ablation group has a similar LOS to the dissection group ( P > 0.05 ), but lower OT and IBL. No marked difference was observed between groups in terms of the total effective rate ( P > 0.05 ), but the adverse reaction rate was higher in the dissection group compared with the ablation group ( P < 0.05 ). Compared with T0, elevated CRP, IL-6, TNF-α, and CD3+ were observed in both cohorts at T1, with lower levels in the ablation group as compared to the dissection group, while CD4+ and CD8+ decreased in both cohorts and were higher in the ablation group ( P < 0.05 ). Meanwhile, the levels of CRP, IL-6, TNF-α, and CD3+ in both groups were lower at T2 compared to T1, whereas those of CD4+ and CD8+ in both groups were higher at T2 compared to T1 ( P < 0.05 ). As indicated by the statistics on prognostic follow-up, the two cohorts of patients showed no evident difference in the 1-year survival rate and disease recurrence rate ( P > 0.05 ). Conclusions. Both dynamical-system surgery under nasal endoscope and LTPRA have good therapeutic effects on NIP, but the latter is safer and can effectively reduce the postoperative inflammatory reaction of patients and maintain the stability of immune function, which has higher clinical application value.

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Section: Discussionmentioning

confidence: 99%

Dynamic Incision under Nasal Endoscope and Low-Temperature Plasma Radiofrequency Ablation for Nasal Inverted Papilloma: An Analysis of Differences in Efficacy and the Destructive Effect on Immune Function

Liu

et al. 2022

Computational and Mathematical Methods in Medicine

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“…Accurate diagnosis of sinonasal papillomas is critical as they have a significant risk of recurrence 1,3 and IPs transform into invasive carcinoma in ~5% of patients. 1,2,8,9 In contrast to the other entities we examined, IPs require complete surgical excision, either through endoscopic surgery or more radical, open procedures.…”

Section: Discussionmentioning

confidence: 99%

“…Sinonasal papillomas are a diverse group of benign epithelial neoplasms of the sinonasal tract, with inverted papilloma (IP) being the most common and most important. Between 5% and 10% of IPs develop carcinoma, usually squamous cell carcinoma 1. The distinction between IP and non-neoplastic or other benign lesions with no malignant potential is critical, but can be difficult, particularly on small biopsies.…”

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confidence: 99%

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CD163 Immunohistochemical “Circle Sign” Staining Pattern Differentiates Sinonasal Papillomas From Morphologically Similar Non-neoplastic Lesions

Sterling

Mehrad

Ely

et al. 2022

American Journal of Surgical Pathology

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Sinonasal papillomas are a diverse group of benign epithelial neoplasms of the sinonasal tract. Inverted papilloma, in particular, must be distinguished from other lesions with no malignant potential. The aim of this study was to distinguish sinonasal papillomas from morphologically similar lesions using CD163 immunostaining. Cases from a 19-year period were identified. These included 49 inverted, 10 exophytic, and 12 oncocytic papillomas, 21 chronic sinusitides with squamous metaplasia, 27 inflammatory polyps, 5 verrucae vulgares, 5 respiratory epithelial adenomatoid hamartomas, and 6 DEK:: AFF2 carcinomas of the sinonasal tract. A subset of biopsy cases (8 inverted papillomas, 5 inflammatory polyps) was separately analyzed. CD163 immunohistochemistry (IHC) was performed. A unique "circle" staining pattern was identified in the surface epithelium. After locating a hotspot, circles were quantified in 10 consecutive high-power fields. Circles were present in 66/71 (93%) cases of sinonasal papilloma, with a mean of 35 circles/ 10 HPF (range: 0 to 160/10 HPF) and a median of 19 circles/ 10 HPF. Circles were present in 20/58 (34%) non-neoplastic cases, with a mean of 2 circles/10 HPF (range: 0 to 27/10 HPF) and a median of 0. Considering all resection and biopsy cases, performance for distinguishing papillomas from non-neoplastic lesions was best at a cutoff of 10 circles/10 HPF (2-tailed P < 0.0001) with sensitivity, specificity, positive predictive value, and negative predictive value of 66.2%, 93.1%, 92.1%, and 69.2%, respectively. The results were similar in the biopsy subset. One other neoplastic entity, the DEK::AFF2 carcinomas, also showed prominent CD163 circle staining. In summary, si-nonasal papillomas demonstrate extensive CD163 "circle" staining in the epithelium compared with the nonneoplastic lesions studied. As such, the "circle sign" on CD163 IHC may be helpful in distinguishing between diagnoses, particularly on small biopsies or equivocal specimens.

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“…Habitualmente en estos casos es necesario realizar una osteoplastia frontal además de un abordaje endoscópico mediante Draf III [2,[13][14][15][16][17]. Si la patología se extiende de forma extrasinusal o presenta malignización carcinomatosa, puede estar indicado un abordaje externo más agresivo [2,7,11,[18][19][20].…”

Section: Discussionunclassified

Eficacia del tratamiento quirúrgico del papiloma invertido nasosinusal

Martínez-Ruiz-Coello

Bosco

Amarillo-Espitia

et al. 2022

ORL

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Introducción y objetivo: El papiloma invertido nasosinusal tiene un comportamiento localmente agresivo con riesgo de recidiva, por lo que requiere un tratamiento quirúrgico adecuado y un seguimiento prolongado en consulta. Nuestro objetivo es determinar la eficacia del tratamiento quirúrgico de los papilomas invertidos mediante cirugía endoscópica nasosinusal (CENS), evaluando la incidencia de recurrencia y la persistencia de enfermedad tras la cirugía. Método: Se realiza un estudio retrospectivo de 39 pacientes tratados de papiloma invertido entre 2006 y 2020 en un hospital universitario, registrando datos demográficos y características tumorales. Se analiza la persistencia (antes de 6 meses) o recidiva (después de 6 meses) tras tratamiento quirúrgico. Resultados: El 82% (32/39) de los casos fueron varones y la edad media fue de 54 años. La localización más frecuente fue la pared lateral nasal (38,5%). El 89,7% (35/39) de los casos fue tratado quirúrgicamente mediante CENS, obteniendo un porcentaje de persistencia y recidiva del 2,6%. Un 7,7% (3/39), al ser lesiones del vestíbulo nasal, se resecaron de forma simple. En un caso concreto (2,6%), se necesitó realizar osteoplastia frontal por extensión del papiloma. No se encontró atipia ni malignización en ninguno de los casos. Discusión y conclusiones: El tratamiento quirúrgico de elección del papiloma invertido es la CENS, considerando realizar maxilectomía medial en todos los casos. El tratamiento quirúrgico del PI mediante esta técnica presenta una baja tasa de persistencia y de recurrencia. PALABRAS CLAVE: Papiloma invertido, senos paranasales, cirugía, recidiva, persistencia, malignización, maxilectomía medial.

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Clinical characteristics of sinonasal inverted papilloma associated with recurrence and malignant transformation

Cited by 8 publications

References 16 publications

Dynamic Incision under Nasal Endoscope and Low-Temperature Plasma Radiofrequency Ablation for Nasal Inverted Papilloma: An Analysis of Differences in Efficacy and the Destructive Effect on Immune Function

Dynamic Incision under Nasal Endoscope and Low-Temperature Plasma Radiofrequency Ablation for Nasal Inverted Papilloma: An Analysis of Differences in Efficacy and the Destructive Effect on Immune Function

CD163 Immunohistochemical “Circle Sign” Staining Pattern Differentiates Sinonasal Papillomas From Morphologically Similar Non-neoplastic Lesions

Eficacia del tratamiento quirúrgico del papiloma invertido nasosinusal

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