Potential conflict of interest: None provided.
COX-2 overexpression in sinonasal inverted papilloma
Article first published online: 16 SEP 2013
© 2013 ARS-AAOA, LLC
International Forum of Allergy & Rhinology
Volume 3, Issue 12, pages 997–1000, December 2013
How to Cite
How to Cite this Article: COX-2 overexpression in sinonasal inverted papilloma. Int Forum Allergy Rhinol. 2013;3:997–1000., , , .
Presented orally at the Combined Otolaryngology Spring Meeting on April 10, 2013, Orlando, FL.
- Issue published online: 16 DEC 2013
- Article first published online: 16 SEP 2013
- Manuscript Accepted: 25 JUL 2013
- Manuscript Revised: 8 JUL 2013
- Manuscript Received: 28 MAR 2013
- inverted papilloma;
- sinus tumor;
- endoscopic sinus surgery;
Inverted papilloma (IP) is a benign, but locally aggressive neoplasm of the nasal cavity and paranasal sinuses. The mainstay of treatment of IP is surgical resection, but high rates of tumor recurrence have been reported. Cyclo-oxygenase-2 (COX-2) has been found to be overexpressed in many tumors and has been used successfully as a therapeutic target. The goal of this study is to highlight COX-2 expression in IP.
Immunohistochemistry for COX-2 was performed on IP samples obtained during surgical resection between January 2012 and June 2013. The intensity of staining was evaluated by 2 head and neck pathologists blinded to the clinical features and outcomes. A positive stain was defined as having 10% or more of tumor cells exhibiting immunoreactivity.
The study includes 13 tumor samples from 7 females and 6 males. Mean age was 54.5 (range, 18–81) years. Tumor locations included: nasal septum (1), ethmoid (3), sphenoid (4), and maxillary (5) sinuses. No tumors demonstrated malignancy or dysplasia. Five (38%) of the 13 IP samples stained strongly positive for COX-2, and 3 of 13 (23%) stained weakly positive. There were no clinical differences in patients that stained strongly or weakly for COX-2.
COX-2 overexpression was identified in 62% of cases of IP in this study, and strongly positive in 38% of cases. Larger studies are necessary to identify the true incidence of COX-2 expression for this tumor. Pharmaceuticals targeting COX-2 may eventually provide an additional therapeutic option for select cases of recurrent or unresectable IP.