HPV infection associated with elevated risk of sinonasal inverted papilloma, finds study

A new study published in the journal of Otolaryngology–Head and Neck Surgery showed an elevated risk of sinonasal inverted papilloma (SNIP) recurrence may be linked to human papillomavirus (HPV) infection.

First identified by Ward in 1854, inverted papillomas are benign, well-differentiated, locally aggressive tumors of the respiratory epithelium. They are distinguished by a high risk of recurrence and a 5% to 9% correlation with malignancy. Also, 5% to 15% of inverted papilloma lesions have been observed to undergo malignant transformation, with 1.7% to 56% of these lesions going on to produce synchronous carcinomas.

One kind of benign tumor that develops from the nasal epithelial mucosa or inside the paranasal sinuses is called a sinus inverted papilloma (IP) also known as Schneiderian papilloma, inverted papilloma, and sinonasal, epithelial, or transitional apillomas. These tumors frequently recur and have the potential to be locally devastating. Studies have not been able to consistently show a genuine link between HPV and inverted papilloma, despite the fact that its involvement in cervical cancer is widely documented and that inverted papilloma should play a comparable role. Therefore, Fayssal Alqudrah and team conducted this systematic review and meta-analysis to assess this possible link in detail.

To find the study data, the electronic databases Embase, PubMed, and Scopus were extensively searched. The analysis included case-control studies that reported SNIP recurrence data and HPV status determined by in-situ hybridization (ISH) and polymerase chain reaction (PCR). To calculate the 95% CI and pooled odds ratios (ORs), meta-analysis was conducted.

A total of 1116 benign SNIP tumors from 25 investigations were found. There were 849 SNIP that were HPV-, 231 of which were recurrent, and 267 SNIP that were HPV+, 103 of which were recurrent. In HPV+ tumors, the pooled standard OR for recurrence was 2.05 (95% CI: 1.31-3.19).

There was no statistically significant difference in stratification by high-risk and low-risk HPV subtypes. For both low-risk and high-risk HPV+ subtypes, the standard OR for SNIP recurrence was 1.57 and 1.67, respectively. According to recent data, benign sinonasal inverted papilloma tumors are more likely to recur if an HPV infection is present.

The meta-analysis of 1,116 benign SNIP cases revealed a pooled OR of 2.05 for recurrence in tumors that tested positive for HPV. The connection was true throughout the trials, even though there was no discernible difference in the recurrence risk between low-risk and high-risk HPV subtypes. Overall, HPV infections may be associated with an increased risk of SNIP recurrence.

Source:

Alqudrah, F., Kota, S., Morgan, J., Purnell, P. R., & McCormick, J. P. (2024). Human Papilloma Virus Infection and Sinonasal Inverted Papilloma Recurrence: A Meta‐Analysis. In Otolaryngology–Head and Neck Surgery. Wiley. https://doi.org/10.1002/ohn.1108