The Expression Of Squamous Cell Carcinoma Antigen In Sinonasal Inverted Papillomas And Its Clinical Significance

Background And Objective Sinonasal inverted papilloma (NIP) is a benign proliferative lesion of the squamous epithelium lining the sinonasal tract that occurs in the nasal cavity and paranasal sinuses. The typical histopathological feature is inversion of the multilayer epithelium into the underlying stroma. Clinical problems of NIP include a tendency towards local destruction, recurrence and malignant transformation. Therefore,besides complete surgical resection, the long-term postoperative follow-up of these patients is recommended. Squamous cell carcinoma (SCC) antigen (SCCA), which was first isolated from SCC tissue of the uterine cervix, is a kind of tumor-associated protein. At present, SCCA is widely used as a laboratory marker for cancers of squamous cell origin. Recently, some studies demonstrated that serum levels of SCCA are elevated in patients with NIP, and the comparison of serum SCCA levels before and after surgical resection shows that the post-operation serum SCCA levels decreased significantly. Thus, SCCA may have the potential to serve as a reliable biologic marker for NIP. The purpose of the present research was to study the expression of SCCA in NIPs and to evaluate the usefulness of SCCA as a biologic marker for the clinical use in the management of NIP.Materials And Methods 31 NIP specimens, 15 NP specimens and 8 NSCC specimens were stained with a monoclonal antibody against the SCCA by using an immunoperoxidase method. All specimens are surgically removed specimens that were obtained from patients who were treated at the Department of Otorhinolaryngology of Anhui Provincial Hospital. The specimens had been fixed in 10% neutral formalin solution and embedded in paraffin, 4-μm consecutive sections were cut from them and mounted on glass slides.Results SCCA immunoreactivity was detected in all specimens. When compared with NP and NSCC specimens, NIP specimens are strongly positive for monoclonal anti-SCC antibody and well stained, while NP specimens stained weakly. There is a significant statistical difference of the degree of tissue SCCA staining levels between NIP and NP ,and between NIP and NSCC as well. In most NIP cases, the cells of the basal layer were not stained with the anti-SCC antibody, while in 3 NIP cases, which were detected with malignant transformation during the follow-up, the cells of the basal layer were positively stained. Comparison of racioes of the basal layer positive stain between metachronous carcinoma NIP and non-metachronous carcinoma NIP shows a statistical difference.Conclusion The results of the present study demonstrate that SCCA expresses strongly in NIP specimens, this may indicates that SCCA may play a biologic role in the development of NIP. SCCA has a potential to serve as a reliable biologic marker and a useful tool in the management and prognosis of the NIP.