鼻内翻性乳头状瘤局部炎症浸润特征分析
|
摘要
【目的】探讨鼻内翻性乳头状瘤局部炎症细胞浸润程度与分布特征。【方法】收集2016年6月至2018年6月在中山大学附属第一医院耳鼻咽喉科住院的50例鼻内翻性乳头状瘤患者肿瘤组织,与20例接受单纯鼻中隔偏曲矫正手术患者的鼻腔鼻窦粘膜,通过免疫组织化学与流式细胞术分析组织内局部炎症细胞浸润程度,并与临床病理特征关联性分析。【结果】鼻内翻性乳头状瘤相对于正常对照组,嗜酸性粒细胞、嗜中性粒细胞、巨噬细胞明显高表达,P <0.001;CD4~+T淋巴细胞也呈现明显高表达,P=0.005;CD8~+T淋巴细胞未见明显差异,P=0.990。流式细胞术分析肿瘤组织内淋巴细胞表达比例及胞内因子IFN-γ表达特征,鼻内翻性乳头状瘤组内淋巴细胞主要类型为CD4~+T淋巴细胞,正常对照组内淋巴细胞主要类型为CD8~+T淋巴细胞;且相对于正常对照组,TH1(CD4~+IFN-γ~+T),呈现明显高表达,P=0.005;TC1(CD8~+IFN-γ~+T),未见明显高表达,P=0.538。Luminex分析组织局部IFN-γ蛋白表达水平,肿瘤组相对于正常对照组呈现明显高表达,P <0.001;NIP组内非复发组相对于复发组呈现明显高表达,P <0.001。其他临床病理特征与鼻内翻性乳头状瘤局部炎症细胞浸润程度无明显相关性。【结论】组织局部炎症细胞浸润程度可能是鼻内翻性乳头状瘤发生发展过程中的重要影响因素。
【Objective】To investigate the histopathological patterns and local inflammatory infiltration characteristics in patients with nasal inverted papilloma.【Methods】Tissues of 50 patients with nasal inverted papilloma and 20 controls which all underwent surgery in the Department of Otolaryngology,the First Affiliated Hospital of Sun Yat-sen University between June,2016 and June,2018. The histological patterns and inflammatory cell infiltration were evaluated and analyzed for association with clinical characteristics by immunohistochemistry and flow cytometry.【Results】Eosinophils,neutrophils,macrophages were significantly elevated in nasal inverted papilloma compared with control samples(P < 0.001).CD4~+T cells(P = 0.005),TH1 cells(CD4~+IFN-γ~+T cells,P = 0.005)were also elevated in inverted papilloma,except CD8~+T cells(P = 0.990)and TC1 cells(CD8~+IFN-γ~+T cells,P = 0.538)compared with controls. Flow cytometry shows the predominating T lymphocytes in nasal inverted papilloma were CD4~+T cells,but they were CD8~+T cells in the controlsamples. IFN-γ protein level was significantly increased in papilloma tissues compared with control samples analyzed by Luminex,P < 0.001. IFN-γ protein level was also significantly increased in non-recurrence compared with recurrence analyzed by Luminex,P < 0.001. The remaining clinical pathological features were not significantly corre-lated with the degree of local inflammatory cells infiltration in NIP.【Conclusion】Inflammation may have potential roles in nasal inverted papilloma.
【Objective】To investigate the histopathological patterns and local inflammatory infiltration characteristics in patients with nasal inverted papilloma.【Methods】Tissues of 50 patients with nasal inverted papilloma and 20 controls which all underwent surgery in the Department of Otolaryngology,the First Affiliated Hospital of Sun Yat-sen University between June,2016 and June,2018. The histological patterns and inflammatory cell infiltration were evaluated and analyzed for association with clinical characteristics by immunohistochemistry and flow cytometry.【Results】Eosinophils,neutrophils,macrophages were significantly elevated in nasal inverted papilloma compared with control samples(P < 0.001).CD4~+T cells(P = 0.005),TH1 cells(CD4~+IFN-γ~+T cells,P = 0.005)were also elevated in inverted papilloma,except CD8~+T cells(P = 0.990)and TC1 cells(CD8~+IFN-γ~+T cells,P = 0.538)compared with controls. Flow cytometry shows the predominating T lymphocytes in nasal inverted papilloma were CD4~+T cells,but they were CD8~+T cells in the controlsamples. IFN-γ protein level was significantly increased in papilloma tissues compared with control samples analyzed by Luminex,P < 0.001. IFN-γ protein level was also significantly increased in non-recurrence compared with recurrence analyzed by Luminex,P < 0.001. The remaining clinical pathological features were not significantly corre-lated with the degree of local inflammatory cells infiltration in NIP.【Conclusion】Inflammation may have potential roles in nasal inverted papilloma.
引文
[1]Von BC,Bradley PJ.Risks of malignancy in inverted papilloma of the nose and paranasal sinuses[J].Curr Opin Otolaryngol Head Neck Surg,2007,15(2):95-98.
[2]Krouse JH.Evolution in the management of inverted papilloma[J].Otolaryngol Head Neck Surg,2009,140(3):336-337.
[3]Busquets JM,Hwang PH.Endoscopic resection of sinonasal inverted papilloma:A meta-analysis[J].Otolaryngol Head Neck Surg,2006,134(3):476-482.
[4]Udager AM,Mchugh JB,Goudsmit CM,et al.Human papillomavirus(HPV)and somatic EGFR mutations are essential,mutually exclusive oncogenic mechanisms for inverted sinonasal papillomas and associated sinonasal squamous cell carcinomas[J].Ann Oncol,2018,29(2):466-471.
[5]Zhao L,Li CW,Jin P,et al.Histopathological features of sinonasal inverted papillomas in chinese patients[J].Laryngoscope,2016,126(4):E141-E147.
[6]张罗,韩德民,张盛忠,等.鼻腔鼻窦内翻性乳头状瘤[J].中国耳鼻咽喉头颈外科,2008,15(10):599-604.Zhang L,Han DM,Zhang SZ,et al.Nasal inverted papilloma[J].Chin Otolaryngol Head Neck Surg,2008,15(10):599-604.
[7]Nygren A,Kiss K,Von BC,et al.Rate of recurrence and malignant transformation in 88 cases with inverted papilloma between 1998-2008.[J].Acta laryngol,2016,136(3):333.
[8]Wang MJ,Noel JE.Etiology of sinonasal inverted papilloma:A narrative review[J].World J Otorhinolaryngol Head Neck Surg,2017,3(1):54-58.
[9]Orlandi RR,Rubin A,Terrell JE,et al.Sinus inflammation associated with contralateral inverted papilloma[J].Am J Rhinol,2002,16(2):91-95.
[10]Suh JD,Ramakrishnan VR,Thompson CF,et al.Inverted papilloma of the sphenoid sinus:Risk factors for disease recurrence[J].Laryngoscope,2015,125(3):544-548.
[11]房高丽,王成硕,张罗.鼻腔鼻窦内翻性乳头状瘤起源部位的影像学研究进展[J].临床耳鼻咽喉头颈外科杂志,2014(23):1902-1906.Fang GL,Wang CS,Zhang L.Prediction of the original location of sinonasal inverted papilloma by preoperative imaging[J].J Clin Otorhinolaryngol Head Neck Surg(China),2014(23):1902-1906.
[12]Yoon JH,Kim CH,Choi EC.Treatment outcomes of primary and recurrent inverted papilloma:an analysis of 96 cases[J].J Laryngol Otol,2002,116(9):699-702.
[13]Roh HJ,Procop GW,Batra PS,et al.Inflammation and the pathogenesis of inverted papilloma[J].Am J Rhinol,2004,18(2):65-74
[14]Liang N,Huang Z,Liu H,et al.Bone involvement:Histopathological evidence for endoscopic management of sinonasal inverted papilloma[J].Laryngoscope,2017,127(12):2703.
[15]Zhu J,Yamane H,Paul WE.Differentiation of effector CD4 T cell populations[J].Ann Rev Immunol,2010,28(1):445-489
[16]Mittrücker HW,Visekruna A,Huber M.Heterogeneity in the differentiation and function of CD8+Tcells[J].Arch Immunol Ther Exp,2014,62(6):449.
[17]Tomazic PV,Hubmann F,Stammberger H.The problem of high recurrence rate in endoscopic revision surgery for inverted papilloma[J].Laryngorhinootologie,2015,94(7):447-450.
[18]杨智云,苏振忠,李健.鼻内翻性乳头状瘤的CT诊断及鉴别诊断[J].新医学,2004,35(10):612-613.Yang ZY,Su ZZ,Li J.CT diagnosis and differental diagnosis of nasal inverted papilloma[J].New Med,2004,35(10):612-613.
[2]Krouse JH.Evolution in the management of inverted papilloma[J].Otolaryngol Head Neck Surg,2009,140(3):336-337.
[3]Busquets JM,Hwang PH.Endoscopic resection of sinonasal inverted papilloma:A meta-analysis[J].Otolaryngol Head Neck Surg,2006,134(3):476-482.
[4]Udager AM,Mchugh JB,Goudsmit CM,et al.Human papillomavirus(HPV)and somatic EGFR mutations are essential,mutually exclusive oncogenic mechanisms for inverted sinonasal papillomas and associated sinonasal squamous cell carcinomas[J].Ann Oncol,2018,29(2):466-471.
[5]Zhao L,Li CW,Jin P,et al.Histopathological features of sinonasal inverted papillomas in chinese patients[J].Laryngoscope,2016,126(4):E141-E147.
[6]张罗,韩德民,张盛忠,等.鼻腔鼻窦内翻性乳头状瘤[J].中国耳鼻咽喉头颈外科,2008,15(10):599-604.Zhang L,Han DM,Zhang SZ,et al.Nasal inverted papilloma[J].Chin Otolaryngol Head Neck Surg,2008,15(10):599-604.
[7]Nygren A,Kiss K,Von BC,et al.Rate of recurrence and malignant transformation in 88 cases with inverted papilloma between 1998-2008.[J].Acta laryngol,2016,136(3):333.
[8]Wang MJ,Noel JE.Etiology of sinonasal inverted papilloma:A narrative review[J].World J Otorhinolaryngol Head Neck Surg,2017,3(1):54-58.
[9]Orlandi RR,Rubin A,Terrell JE,et al.Sinus inflammation associated with contralateral inverted papilloma[J].Am J Rhinol,2002,16(2):91-95.
[10]Suh JD,Ramakrishnan VR,Thompson CF,et al.Inverted papilloma of the sphenoid sinus:Risk factors for disease recurrence[J].Laryngoscope,2015,125(3):544-548.
[11]房高丽,王成硕,张罗.鼻腔鼻窦内翻性乳头状瘤起源部位的影像学研究进展[J].临床耳鼻咽喉头颈外科杂志,2014(23):1902-1906.Fang GL,Wang CS,Zhang L.Prediction of the original location of sinonasal inverted papilloma by preoperative imaging[J].J Clin Otorhinolaryngol Head Neck Surg(China),2014(23):1902-1906.
[12]Yoon JH,Kim CH,Choi EC.Treatment outcomes of primary and recurrent inverted papilloma:an analysis of 96 cases[J].J Laryngol Otol,2002,116(9):699-702.
[13]Roh HJ,Procop GW,Batra PS,et al.Inflammation and the pathogenesis of inverted papilloma[J].Am J Rhinol,2004,18(2):65-74
[14]Liang N,Huang Z,Liu H,et al.Bone involvement:Histopathological evidence for endoscopic management of sinonasal inverted papilloma[J].Laryngoscope,2017,127(12):2703.
[15]Zhu J,Yamane H,Paul WE.Differentiation of effector CD4 T cell populations[J].Ann Rev Immunol,2010,28(1):445-489
[16]Mittrücker HW,Visekruna A,Huber M.Heterogeneity in the differentiation and function of CD8+Tcells[J].Arch Immunol Ther Exp,2014,62(6):449.
[17]Tomazic PV,Hubmann F,Stammberger H.The problem of high recurrence rate in endoscopic revision surgery for inverted papilloma[J].Laryngorhinootologie,2015,94(7):447-450.
[18]杨智云,苏振忠,李健.鼻内翻性乳头状瘤的CT诊断及鉴别诊断[J].新医学,2004,35(10):612-613.Yang ZY,Su ZZ,Li J.CT diagnosis and differental diagnosis of nasal inverted papilloma[J].New Med,2004,35(10):612-613.
© 2004-2018 中国地质图书馆版权所有 京ICP备05064691号 京公网安备11010802017129号 地址：北京市海淀区学院路29号 邮编：100083 电话：办公室：(+86 10)66554848；文献借阅、咨询服务、科技查新：66554700 |