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Human Papillomavirus and Factors Associated with Recurrence in Sinonasal Inverted Papillomas from Poland and Spain

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Abstract

Sinonasal inverted papilloma (SNIP) is a benign but locally aggressive tumor that has a tendency for recurrence and malignant transformation. The role of human papillomavirus (HPV) in SNIP is controversial. To determine the HPV-DNA prevalence and type distribution in SNIP in two different geographic areas and assess the association between SNIP recurrence and HPV infection, as well as additional potential etiologic factors. Two retrospective cohorts of SNIP patients from Poland and Spain were evaluated. Demographic, tobacco/alcohol use, clinical, and follow-up data were collected. All samples were subject to histopathologic evaluation, DNA quality control, and HPV-DNA detection by PCR. HPV-DNA positive samples and a random sample of HPV-DNA negative cases were further subject to p16INK4a analysis. Proportional-hazards models were used to evaluate the risk of recurrence by selected variables. Seventy-nine SNIP patients (46 from Spain diagnosed between 1995 and 2014, and 33 from Poland diagnosed between 2012 and 2017) were included in the study. HPV-DNA was detected in four patients (5.1%), two from each region, and all four were positive for the HPV11 subtype. Seventeen patients (21.5%) experienced recurrence, with a median time to recurrence of 14 months. No association was identified between lesional HPV-DNA positivity, toxic habits, Krouse stage, or malignant transformation and a higher risk of recurrence. The low prevalence of HPV-DNA in SNIPs suggests that HPV is not a main etiology for development of these lesions. With a lack of association between the evaluated factors and recurrence, further research with larger number of patients and additional biomarkers is warranted to further understand predisposing risk factors.

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Funding

We thank CERCA Program/Generalitat de Catalunya for institutional support. This study has been funded by the Instituto de Salud Carlos III (ie, the Spanish government), the European Regional Development Fund—A Way to Build Europe, through the projects CIBERESP CB06/02/0073 and CIBERONC, CB16/12/0040, from the Agència de Gestió d’Ajuts Universitaris i de Recerca (2017SGR1085) and from the Department of Health of the Generalitat de Catalunya (PERIS-2016-2020, SLT002/16/00404) (personal grants to MM and JFG, respectively).

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Correspondence to M. Fulla.

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Conflict of interest

Cancer Epidemiology Research Program (LA MM JF BQ OC MP) has received sponsorship for grants from Merck and co, Roche, Reig-jofre, IDT, Hologic, GlaxoSmithKline and Seegene. The rest of authors have declared no conflicts of interest.

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The original version of this article was revised: The original version of this article unfortunately contained a mistake. Three values in Table 1 were incorrect. In “months of recurrence”, range row, the intervals should be in numbers. They should read as 3-83 instead of Mar-83, 9-83 instead of Sep-83 and 3-36 instead of Mar-36. The corrected Table 1 is given below. The original article has been corrected.

M. Mena and X. Gonzalez are co-senior authors.

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Fulla, M., Szafarowski, T., Frias-Gomez, J. et al. Human Papillomavirus and Factors Associated with Recurrence in Sinonasal Inverted Papillomas from Poland and Spain. Head and Neck Pathol (2020). https://doi.org/10.1007/s12105-019-01125-y

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Keywords

  • Inverted papilloma
  • Schneiderian papilloma
  • Sinonasal papilloma
  • Human papillomavirus
  • HPV