Abstract：
Sinonasal inverted papillomas (IP) can undergo transformation into IP-squamous cell carcinomas (IP-SCC). More aggressive treatment plan should be established when IP-SCC is suspected. Nevertheless, inaccuracy of the preoperative punch biopsy results to detect IP-SCC from IP raises the need for an additional strategy. The present study aimed to investigate significant clinicoradiological remarks associated with IP-SCC than IP.
Postoperative surgical specimens obtained from patients with confirmed IP or IP-SCC at a single tertiary medical center from 1997 to 2018 were retrospectively evaluated. Patients\' demographic and clinical characteristics, preoperative in-office punch biopsy results, and preoperative computed tomography (CT) or magnetic resonance images were reviewed. Univariate and multivariate analyses were performed to assess the odds ratio (OR) associated with IP-SCC. The area under the curve (AUC) in the receiver Operating Characteristic (ROC) curve was calculated in the prediction model to discriminate IP-SCC from IP.
The study included 44 IP-SCC and 301 patients with IP. The diagnostic sensitivity of in-office punch biopsy to detect IP-SCC was 70.7%. Multivariate analysis showed that factors significantly associated with IP-SCC included tobacco smoking >10PY (adjusted-OR [aOR]: 4.1), epistaxis (aOR: 3.4), facial pain (aOR: 4.2), bony destruction (aOR: 37.6), bony remodeling (aOR: 36.3), and invasion of adjacent structures (aOR: 31.6) (all p < 0.05). Combining all significantly related clinicoradiological features, the ability to discriminate IP-SCC from IP reached an AUC of 0.974.
IP patients with a history of tobacco smoking, facial pain, epistaxis, and bony destruction, remodeling, or invasion of an adjacent structure on preoperative images may be at higher risk for IP-SCC.
3 Laryngoscope, 133:2502-2510, 2023.
Postoperative surgical specimens obtained from patients with confirmed IP or IP-SCC at a single tertiary medical center from 1997 to 2018 were retrospectively evaluated. Patients\' demographic and clinical characteristics, preoperative in-office punch biopsy results, and preoperative computed tomography (CT) or magnetic resonance images were reviewed. Univariate and multivariate analyses were performed to assess the odds ratio (OR) associated with IP-SCC. The area under the curve (AUC) in the receiver Operating Characteristic (ROC) curve was calculated in the prediction model to discriminate IP-SCC from IP.
The study included 44 IP-SCC and 301 patients with IP. The diagnostic sensitivity of in-office punch biopsy to detect IP-SCC was 70.7%. Multivariate analysis showed that factors significantly associated with IP-SCC included tobacco smoking >10PY (adjusted-OR [aOR]: 4.1), epistaxis (aOR: 3.4), facial pain (aOR: 4.2), bony destruction (aOR: 37.6), bony remodeling (aOR: 36.3), and invasion of adjacent structures (aOR: 31.6) (all p < 0.05). Combining all significantly related clinicoradiological features, the ability to discriminate IP-SCC from IP reached an AUC of 0.974.
IP patients with a history of tobacco smoking, facial pain, epistaxis, and bony destruction, remodeling, or invasion of an adjacent structure on preoperative images may be at higher risk for IP-SCC.
3 Laryngoscope, 133:2502-2510, 2023.
摘要：
背景：鼻窦内翻性乳头状瘤（IP）可以转化为IP鳞状细胞癌（IP-SCC）。当怀疑IP-SCC时，应建立更积极的治疗计划。然而，从IP检测IP-SCC的术前穿刺活检结果的不准确性增加了对额外策略的需求.本研究旨在调查与IP-SCC相关的重要临床放射学评论。
方法：回顾性评估从1997年至2018年在一家三级医疗中心确诊的IP或IP-SCC患者的术后手术标本。患者的人口统计学和临床特征，术前办公室穿孔活检结果，和术前计算机断层扫描（CT）或磁共振图像进行审查。进行单变量和多变量分析以评估与IP-SCC相关的比值比(OR)。在预测模型中计算接受者操作特征(ROC)曲线中的曲线下面积(AUC)以区分IP-SCC与IP。
结果：该研究包括44例IP-SCC和301例IP患者。办公室穿刺活检对IP-SCC的诊断敏感性为70.7%。多因素分析显示,与IP-SCC显著相关的因素包括吸烟>10PY(校正OR[aOR]:4.1),鼻出血（AOR：3.4），面部疼痛（OR：4.2），骨破坏（AOR：37.6），骨重塑（AOR：36.3），和邻近结构的侵袭（aOR：31.6）（所有p<0.05）。结合所有显著相关的临床放射学特征，区分IP-SCC和IP的AUC达到0.974.
结论：有吸烟史的IP患者，面部疼痛,鼻出血,和骨质破坏，重塑，或术前图像上相邻结构的侵犯可能有较高的IP-SCC风险.
方法：3喉镜，2023年。
方法：回顾性评估从1997年至2018年在一家三级医疗中心确诊的IP或IP-SCC患者的术后手术标本。患者的人口统计学和临床特征，术前办公室穿孔活检结果，和术前计算机断层扫描（CT）或磁共振图像进行审查。进行单变量和多变量分析以评估与IP-SCC相关的比值比(OR)。在预测模型中计算接受者操作特征(ROC)曲线中的曲线下面积(AUC)以区分IP-SCC与IP。
结果：该研究包括44例IP-SCC和301例IP患者。办公室穿刺活检对IP-SCC的诊断敏感性为70.7%。多因素分析显示,与IP-SCC显著相关的因素包括吸烟>10PY(校正OR[aOR]:4.1),鼻出血（AOR：3.4），面部疼痛（OR：4.2），骨破坏（AOR：37.6），骨重塑（AOR：36.3），和邻近结构的侵袭（aOR：31.6）（所有p<0.05）。结合所有显著相关的临床放射学特征，区分IP-SCC和IP的AUC达到0.974.
结论：有吸烟史的IP患者，面部疼痛,鼻出血,和骨质破坏，重塑，或术前图像上相邻结构的侵犯可能有较高的IP-SCC风险.
方法：3喉镜，2023年。
