gms | German Medical Science

Aims: To evaluate selected markers in terms of their possible relation to the development of recurrence in microsurgically resected sinonasal inverted papilloma (SIP) in order to advance our understanding of the mechanisms pathogenetically involved, and to identify novel biomarkers for individual risk assessment in SIP.

Methods: Retrospective computerized database analysis and thorough review of medical charts was performed in order to identify all patients with newly diagnosed SIP who underwent microinvasive endonasal surgery at the HELIOS Klinikum Bad Saarow (the former HUMAINE Klinikum Bad Saarow) and at the Klinikum Hoyerswerda gGmbH (Germany) between 1985 and 2005, yielding a total of 73 patients with newly diagnosed SIP. Amongst these, 22 patients (30.1%) developed recurrence during follow-up which were also microsurgically resected. Therefore, archival paraffin-wax-embedded tissues comprising a total of 95 SIP were immunostained for a panel of selected antigens (Ki67/CK5/CK14/E-cadherin/CD56) functionally involved in cellular adhesion structures or (indirectly) in proliferative activity.1-3 Adjacent non-papillomatous sinonasal mucosa was available in all cases and served as normal controls.

Results: Increased proliferative activity (Ki67) and loss of basal cell keratin 14 (CK14) expression were found to be related to the development of recurrence in microsurgically resected SIP.

Conclusion: Our findings might advance our understanding of the pathogenesis behind the development of recurrence in microsurgically resected SIP by focusing on so far neglected alterations of cell-matrix connections at the epithelial-stromal interface in SIP, and might hint at CK14 as to represent a possible novel biomarker for individual risk assessment in microsurgically resected SIP. This notion remains to be confirmed by larger advanced prospective clinical studies.