The Clinical Analysis Of Surgical Treatment For Sinonasal Inverted Papilloma And Investigation Of The Expression And Clinical Significance Of P53 And P73

PartⅠThe choice and effect of surgical treatment for sinonasal inverted papillomaObjective:Inverted papilloma is a kind of benign sinonasal tumor which constitutes 0.5%to 4%of all nasal tumors,It has a marked tendency to recur after surgical treatmeat.The tumour is associated with recurrence and malignancy and during growth it can destroy surrounding tissue.Surgical excision is regarded as the treatment of choice for it.Traditional surgery such as the lateral rhinotomy has served as the standard for surgical management for NSIPs,however,this approach has some questions which have more impaired,more hemorrhagic and more length of hospital stay.Endoscopic surgery or associated with open approaches has been accepted by more and more scholar.The objective of this study was to compare the endoscopic with tradition and associated with open approaches for surgical management of NSIPs.Operative parameters included the operated time(OT),estimated blood loss(EBL),length of hospital stay(HS) were also compared.Methods:Retrospective data analysis was performed on 124 patients with hitopathologically confirmed NSIPs.Parameters for comparison included surgery approach,preoperative symptoms,OT,EBh,HS,and recurrence rate. Results:1.There was significant difference between the group of endoscopic surgery combined with external approach and the group of traditional procedure(P＜0.05).In KrouseⅠandⅡcases,the recurrence was lower in the group endoscopic surgery than that of group of traditional procedure(P＜0.05).In KrouseⅢcases,the recurrence is lower in the group of endoscopic surgery combined with external approach than that of other two groups(P＜0.05),but there was no difference between endoscopic surgery and traditional procedure.2.OT was similar to the three groups,EBL and HS were statistically shorter in the group of endoscopic group than those of other two groups (P＜0.05).3.The recurrence rate of preoperative or intraoperative diagnosis was lower than the postoperative,although there were no significant differences(P=0.266).Conclusions:The endoscopic surgery is the preferred method which it has less bleeding and shorter hospitalization time and reduce the financial burden of patients.The endoscopic surgery is a safe, economical and effective method for the NSIPs cases in KrouseⅠandⅡ, For the KrouseⅢor/andⅣcases in recurrence or extensive disease, endoscopic surgery combined with external approach is a better choice which should be studied in clinical practice.PartⅡInvestigation of the expression and clinical significance of p53 and p73 in sinonasal inverted papillomaObjective:NSIPs is a benign tumor with aggressive evolution,bone destruction,recurrence,and malignant transformation.As a classic anti-oncogene,the role of p53 has been widely confirmed on the tumorigenesis and growth.However,p73,a member of the p53 family,the biological action and the expression of which on the recurrence and development of NSIPs were rarely reported.The objective of this study is to investigate the biological significance in its canceration potential and the synergistic action between them by detecting the expression of p53 and p73.Furthermore,the investigation will reveal the clinical characteristics of NSIPs.Methods:Thirty-four specimens with NSIPs and twelve with squamous cell carcinoma(SCC) were selected in the experiment.All the specimens were sorted into three groups,which were NSIPs,canceration NSIPs,and squamous cell carcinoma.The expressions of p53 and p73 were analyzed according to the quantitative immunohistochemical analysis.Results:Significant increasing expressions of p53 were observed in NSIPs,canceration NSIPs,and SCC(p＜0.05).The expression of p53 had a positive relationship with it of p73 in this experiment(rs=0.963,p =0.000).Conclusion:In our experiment the expressions of p53 and p73 may play an important role in the malignancy of NSIPs.The expression of p53 in NSIPs had a positive relationship with it of p73,but the cooperation mechanisms of them was not clear,which worth our further study.