Detection of Human Papillomavirus(HPV) in Sinonasal Inverted Papillomas Using Polymerase Chain Reaction(PCR)

Hwang, Chan Seung; Hong, Min Ki; Kim, Hoon; Kim, Chun Gil; Lee, Young Jin; Park, Seol Hee; Yeom, Bum Woo

Abstract

The human papillomavirus(HPV) is a subfamily of the Papovaviridae family as a double stranded DNA virus, and HPV is the etiological agent of squamous cell papillomas in different anatomic regions including the skin and the mucous membranes of oral cavity, esophagus, respiratory and anogenital tracts. Inverted papilloma of the nasal cavity and paranasal sinuses is uncommon benign lesion, in which there is a inversion of the neoplastic epithelium into the underlying stroma. The local aggressiveness, high rate of recurrence, associated malignancy, and tendency of multicentricity have led to the advocation of radical removal of the tumor. The cause of sinonasal inverted papilloma remains unknown. However, the involved etiologic factors are thought to be smoking, allergy, environmental factors, HPV, and chronic infections. The purpose of this study was to detect HPV in sinonasal inverted papilloma, to examine the relationship between cellular dysplasia and recurrence of inverted papilloma, to examine the relationship between HPV and recurrence of inverted papilloma in forty two sinonasal inverted papillomas(inverted papilloma without dysplasia 30 cases, inverted papilloma with dysplasia 6 cases, inverted papilloma associated squamous cell carcinoma 5 cases, inverted papilloma transformed squamous cell carcinoma 1 case). For these purposes, paraffin-embedded tissues were subjected to polymerase chain reaction using type-specific primers pairs. Following results were obtained: 1) The HPV was detected in 5(12%) out of 42 cases of inverted papilloma, one contained human papillomvirus 6, two contained human papillomavirus 11, and two contained human papillomavirus 16. 2) The recurrence of inverted papilloma occurred in 1(16%) out of 6 cases exhibited dysplasia, in 3(10%) out of 30 cases not exhibited dysplasia. 3) The recurrence of inverted papilloma occurred in 2(66%) out of 3 cases positive for HPV, in 2(6%) out of 33 cases negative for HPV. In conclusion HPV was thought to be the etiological factor of sinonasal inverted papilloma. Also there was a relationship between HPV and recurrence of inverted papilloma. Further work is in progress to determine the possible mechanisms by which HPV induces oncogenesis in inverted papilloma.