Objective:Sinonasal inverted papilloma (IP) is a benign and uncommon tumor of the nasal cavity and paranasal sinuses with a tendency for recurrence and even malignant transformation.Though the morphology and clinical ...Objective:Sinonasal inverted papilloma (IP) is a benign and uncommon tumor of the nasal cavity and paranasal sinuses with a tendency for recurrence and even malignant transformation.Though the morphology and clinical behavior of this lesion has been well described,its etiology remains controversial.Methods:Computerized searches were performed in PubMed,Scopus,and Google scholar through May 2015.In this review,etiologic factors including human papilloma virus (HPV),Epstein-Barr virus (EBV),cell cycle related proteins and angiogenic factors,occupational and environmental exposures,and chronic inflammation,will be discussed.Results:Many studies indicate that HPV has been detected in a significant percentage of IP,while EBV has not been shown to be significantly associated.Certain cell cycle regulatory factors and angiogenic proteins contribute to the dysregulation of proliferation and apoptosis,and facilitate migration and tumor invasion.Occupational exposures,such as welding and organic solvents,have been implicated,and smoking seems more critical to recurrence and dysplasia rather than initial IP occurrence.Chronic inflammation may also have a causative relationship with inverted papilloma,but the mechanism is unclear.Conclusions:Though etiology of sinonasal IP remains controversial,the studies reviewed here indicate a role for viral infection,cell cycle and angiogenic factors,environmental and occupational exposure,and chronic inflammation.Further study on etiologic factors is necessary for clinical guidance and therapeutic targets.展开更多
Background Fascin, an actin binding protein, usually expressed at a low level in normal epithelium, but is significantly increased in transformed epithelial cells and several common carcinomas. In this study, we exami...Background Fascin, an actin binding protein, usually expressed at a low level in normal epithelium, but is significantly increased in transformed epithelial cells and several common carcinomas. In this study, we examined the expression of fascin by immunohistochemistry in sinonasal epithelium with chronic inflammation （control group）, exophytic papilloma （EP）, inverted papilloma （IP） with dysplasia and cancerated IP （including caminoma in situ and invasive squamous cell carcinoma, SCC）, and furthermore investigated the relationship between fascin expression and formation of malignant IP. Methods Fascin expression was immunohistochemically detected using monoclonal antibody against fascin in 86 paraffin embedded tissues, including 10 cases of sinonasal mucosa with chronic inflammation, 10 of EP, 45 of IP with dysplasia （45 cases were divided into three groups： IP with mild dysplasia, IP with moderate dysplasia, and IP with severe dysplasia, 15 cases each）, and 21 of cancerated IP. Results The level of fascin expression was significantly higher in the neoplastic tissue than that in control group. Fascin expression increased gradually with the progression from sinonasal epithelium with chronic inflammation, IP with mild dysplasia, IP with moderate dysplasia, IP with severe dysplasia, to cancerated IP, and significant difference of fascin expression was observed between any two groups of the five. Conclusion Precancerous lesions of IP exhibit elevated levels of fascin that may be associated with carcinogenesis of IP. Fascin may play a role in the formation of IP and EP.展开更多
Background： Sinonasal inverted papilloma （IP） is a rare benign tumor of the nasal cavities and paranasal sinuses. It is destructive or bone-rcmodeling, tends to recur alter surgical resection, and has a significant...Background： Sinonasal inverted papilloma （IP） is a rare benign tumor of the nasal cavities and paranasal sinuses. It is destructive or bone-rcmodeling, tends to recur alter surgical resection, and has a significant malignant potential. The present study aimed to pertbnn a retrospective analysis of patients with squamous cell carcinoma （SCC） arising from IP, including characteristics, survival outcome, and predictors of associated malignancy. Methods： The medical records of 213 patients diagnosed with IP from January 1970 to January 2014 were retrospectively reviewed. Eighty-seven patients were diagnosed with SCC/IP; their clinical characteristics, treatments, and survival outcomes were analyzed. Results： Of the 87 patients with SCC/IP, the 5- and 10-year overall survival outcomes were 39.6% and 31.8%, respectively. Twenty-nine of these patients received surgery and 58 received combined surgery and radiation. Of the patients with stages III-IV, the 5-year survival rate was 30.7% for those treated with surgery only and 39.9% for those given the combination treatment （P = 0.849）. Factors associated with significantly poor prognosis were advanced-stage, metachronous tumors, or with cranial base and orbit invasion. Age, synchronous or metachronous tumors, and pathological stage were independent risk factors for mortality, shown by multivariate analysis. Conclusion： Patients with SCC/IP had low overall survival outcomes. Advanced age, stage, and metachronous tumors are the main factors affecting prognosis. Treatment planning should consider high-risk factors to improve survival outcome.展开更多
文摘Objective:Sinonasal inverted papilloma (IP) is a benign and uncommon tumor of the nasal cavity and paranasal sinuses with a tendency for recurrence and even malignant transformation.Though the morphology and clinical behavior of this lesion has been well described,its etiology remains controversial.Methods:Computerized searches were performed in PubMed,Scopus,and Google scholar through May 2015.In this review,etiologic factors including human papilloma virus (HPV),Epstein-Barr virus (EBV),cell cycle related proteins and angiogenic factors,occupational and environmental exposures,and chronic inflammation,will be discussed.Results:Many studies indicate that HPV has been detected in a significant percentage of IP,while EBV has not been shown to be significantly associated.Certain cell cycle regulatory factors and angiogenic proteins contribute to the dysregulation of proliferation and apoptosis,and facilitate migration and tumor invasion.Occupational exposures,such as welding and organic solvents,have been implicated,and smoking seems more critical to recurrence and dysplasia rather than initial IP occurrence.Chronic inflammation may also have a causative relationship with inverted papilloma,but the mechanism is unclear.Conclusions:Though etiology of sinonasal IP remains controversial,the studies reviewed here indicate a role for viral infection,cell cycle and angiogenic factors,environmental and occupational exposure,and chronic inflammation.Further study on etiologic factors is necessary for clinical guidance and therapeutic targets.
文摘Background Fascin, an actin binding protein, usually expressed at a low level in normal epithelium, but is significantly increased in transformed epithelial cells and several common carcinomas. In this study, we examined the expression of fascin by immunohistochemistry in sinonasal epithelium with chronic inflammation （control group）, exophytic papilloma （EP）, inverted papilloma （IP） with dysplasia and cancerated IP （including caminoma in situ and invasive squamous cell carcinoma, SCC）, and furthermore investigated the relationship between fascin expression and formation of malignant IP. Methods Fascin expression was immunohistochemically detected using monoclonal antibody against fascin in 86 paraffin embedded tissues, including 10 cases of sinonasal mucosa with chronic inflammation, 10 of EP, 45 of IP with dysplasia （45 cases were divided into three groups： IP with mild dysplasia, IP with moderate dysplasia, and IP with severe dysplasia, 15 cases each）, and 21 of cancerated IP. Results The level of fascin expression was significantly higher in the neoplastic tissue than that in control group. Fascin expression increased gradually with the progression from sinonasal epithelium with chronic inflammation, IP with mild dysplasia, IP with moderate dysplasia, IP with severe dysplasia, to cancerated IP, and significant difference of fascin expression was observed between any two groups of the five. Conclusion Precancerous lesions of IP exhibit elevated levels of fascin that may be associated with carcinogenesis of IP. Fascin may play a role in the formation of IP and EP.
文摘Background： Sinonasal inverted papilloma （IP） is a rare benign tumor of the nasal cavities and paranasal sinuses. It is destructive or bone-rcmodeling, tends to recur alter surgical resection, and has a significant malignant potential. The present study aimed to pertbnn a retrospective analysis of patients with squamous cell carcinoma （SCC） arising from IP, including characteristics, survival outcome, and predictors of associated malignancy. Methods： The medical records of 213 patients diagnosed with IP from January 1970 to January 2014 were retrospectively reviewed. Eighty-seven patients were diagnosed with SCC/IP; their clinical characteristics, treatments, and survival outcomes were analyzed. Results： Of the 87 patients with SCC/IP, the 5- and 10-year overall survival outcomes were 39.6% and 31.8%, respectively. Twenty-nine of these patients received surgery and 58 received combined surgery and radiation. Of the patients with stages III-IV, the 5-year survival rate was 30.7% for those treated with surgery only and 39.9% for those given the combination treatment （P = 0.849）. Factors associated with significantly poor prognosis were advanced-stage, metachronous tumors, or with cranial base and orbit invasion. Age, synchronous or metachronous tumors, and pathological stage were independent risk factors for mortality, shown by multivariate analysis. Conclusion： Patients with SCC/IP had low overall survival outcomes. Advanced age, stage, and metachronous tumors are the main factors affecting prognosis. Treatment planning should consider high-risk factors to improve survival outcome.
