Histopathological parameters of recurrence and malignant transformation in sinonasal inverted papilloma.
CONCLUSIONS
A combination of parameters may be useful in predicting the clinical course of squamous cell carcinoma in inverted papilloma (IP). In particular, the parameters hyperkeratosis, squamous epithelial hyperplasia and high mitotic index were negative prognostic indicators.


OBJECTIVE
To define histopathological parameters which could predict the recurrence and development of squamous cell carcinoma in IP.


METHODS
We analyzed the histopathological characteristics of 39 cases of IP using the following parameters: site of origin of tumor; presence of bone invasion; presence of inflammatory polyp; ratio of endophytic to exophytic lesions; ratio of neoplastic epithelium to stroma; presence of hyperkeratosis; presence of squamous epithelial hyperplasia; mitotic index; number of mucin globules; and number of eosinophils.


RESULTS
Malignancy was related to the presence of bone invasion (p=0.039), the absence of inflammatory polyp (p=0.033), increase in the ratio neoplastic epithelium:stroma (p=0.037), increase in hyperkeratosis (p=0.030), the presence of squamous epithelial hyperplasia (p=0.044), increase in the mitotic index (p=0.029) and a decrease in the number of eosinophils (p=0.037). Multiple recurrences (without malignancy) were related to frontal sinus origin (p=0.042), increase in hyperkeratosis (p=0.041), the presence of squamous epithelial hyperplasia (p=0.044) and increase in the mitotic index (p=0.031). Clinically benign behavior was related to the presence of inflammatory polyp (p=0.010) and the absence of hyperkeratosis (p=0.008).
Katori
Hideaki
H
Department of Otolaryngology, Yokohama City University Medical Center, Yokohama, Japan. hhkatori@yahoo.co.jp
Nozawa
Akinori
A
Tsukuda
Mamoru
M
D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000473:pathology*; D002471:Cell Transformation, Neoplastic / Q000473:pathology*; D004804:Eosinophils; D004848:Epithelium; D005260:Female; D006801:Humans; D006965:Hyperplasia; D008297:Male; D008875:Middle Aged; D008940:Mitotic Index; D009077:Mucins; D009364:Neoplasm Recurrence, Local / Q000473:pathology*; D018308:Papilloma, Inverted / Q000473:pathology*; D010255:Paranasal Sinus Neoplasms / Q000473:pathology*; D012307:Risk Factors
D009077:Mucins