METHODS: From 1978 to 2020, 186 sinonasal IPs surgeries corresponding to 152 patients were treated in our center. We performed a pathology evaluation of all the recurrent cases reviewing the histological diagnosis, the presence of mixed component other than IP, the koilocytic changes, the p16 over expression and HPV-DNA detection.
RESULTS: Overall recurrence rate was 19 % (35/186). The 35 IP recurrences correspond to 22 patients, 9 of whom presented a single recurrence (single recurrence group) while 13 of them presented more than one recurrence (multi-recurrent group). Immunohistochemical analysis showed a higher percentage of p16 overexpression (54 % vs 33 % p = 0.415) and HPV-DNA presence (23 % vs 0 % p = 0.240) in the multi-recurrent group compared with single recurrence group. In addition, the revision showed more IP with exophytic papilloma focus (38 vs 22 % p = 0.648) and a higher proportion of IP with koilocytotic changes (61 % vs 22 % p = 0.099) in the multirecurrent group. There is no significant difference between groups in our results.
CONCLUSIONS: The analysis of our patients may differentiate between two groups with recurrent papillomas. A single recurrence group where the cause of recurrence is probably an anatomical problem related to an incomplete resection, and a second pattern, the multi-recurrence group, where HPV infection may be the main cause of recurrence.
方法:从1978年到2020年,在我们中心治疗了186例对应152例患者的鼻窦IPs手术。我们对所有复发病例进行病理评估,回顾组织学诊断,IP以外的混合成分的存在,肾细胞的变化,p16过表达和HPV-DNA检测。
结果:总复发率为19%(35/186)。35例IP复发对应于22例患者,其中9例出现单次复发(单次复发组),而13例出现一次以上复发(多次复发组)。免疫组织化学分析显示,与单次复发组相比,多复发组中p16过表达(54%vs33%p=0.415)和HPV-DNA存在(23%vs0%p=0.240)的百分比更高。此外,修订显示,在多复发组中,发生外生性乳头状瘤病灶的IP较多(38vs22%p=0.648),发生肾细胞改变的IP比例较高(61%vs22%p=0.099).我们的结果在组间没有显著差异。
结论:对我们患者的分析可以区分两组复发性乳头状瘤。单一复发组,复发的原因可能是与不完全切除有关的解剖学问题,还有第二种模式,多复发组,其中HPV感染可能是复发的主要原因。