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. 2022 Oct-Dec;26(4):501-508.
doi: 10.4103/jomfp.jomfp_120_21. Epub 2022 Dec 22.

Sinonasal mass lesions: A clinicopathological study with p63 and p16 immunohistochemical expressions

Ankita P Mandal  1 , Rama Saha  1 , Chhanda Das  1 , Arunabha Sengupta  2
Affiliations

Sinonasal mass lesions: A clinicopathological study with p63 and p16 immunohistochemical expressions

Ankita P Mandal et al. J Oral Maxillofac Pathol. 2022 Oct-Dec.

Abstract

Introduction: The worldwide annual incidence of carcinomas of the sinonasal tract is 0.5 to 1.0 patients per 100,000 per year. P63 plays a role in epithelial development and is used as a marker for basal and myoepithelial cells. Expression of p16 occurs as a result of functional inactivation of the retinoblastoma protein (pRb) by the human papilloma virus (HPV) E7 protein.

Aims: This study aims to study the histological spectrum of benign and malignant sinonasal mass lesions and to study the immunohistochemical expression of p63 in different type of sinonasal mass lesions. It also aims to ascertain the incidence of high-risk HPV in primary sinonasal mass lesions with p16 immunohistochemistry and delineate the histological spectrum of HPV-related sinonasal lesions.

Materials and methods: This cross-sectional study was conducted on 80 cases from June 2018 to June 2020 at a tertiary care hospital. Clinical history including demographic parameters were collected in the study proforma. The gross findings of the specimens noted and histopathological examination by H&E staining done. Immunohistochemistry staining for p63 and p16 expression was performed on all cases.

Results: Most common age group affected was 41-60 years with male:female ratio of 1.67:1. Nonneoplastic lesions (38.7%) comprised majority of the cases followed by benign neoplastic lesions (31.3%) and malignant neoplastic lesions (30%). Among the malignant neoplastic lesions, p63 showed positive expression in 75% (p = 0.005) and p16 showed positive expression in 41.7% (p = 0.023). Among benign and nonneoplastic lesions, p63 showed positivity in 21.4% (p = 0.000) and p16 showed positivity in 44.6% (p = 0.040).

Conclusion: We analyzed p63 and p16 expression in varied lineages like carcinomas, papillomas, and neuroectodermal differentiation arising from the sinonasal tract and also in relation to other clinicopathological parameters. This study revealed p63 expression was associated more with the squamous cell carcinomas and nasopharyngeal carcinomas. Sinonasal tract malignancies are also associated with HPV infections that are identifiable by p16 immunostaining and, thus, could provide new prospects in identifying any definite biological and clinical characteristics associated with HPV as well as advancement in the targeted therapies for this patient population.

Keywords: Immunohistochemistry; neoplastic lesion; sinonasal tract.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Sinonasal papilloma, inverted type (a) Section shows multiple inversions of surface epithelium into the underlying stroma with an intact basement membrane (×100, H&E) Keratinizing squamous cell carcinoma (b) Section shows squamous epithelium with abundant keratinization (×100, H&E); non-keratinizing squamous cell carcinoma (c) Section shows solid sheets composed of malignant cells with no keratinization (×400, H&E); Nasopharyngeal carcinoma, undifferentiated type (d) Section shows large tumours cells with a syncytial appearance, round to oval vesicular nuclei and large central nucleoli and scanty eosinophilic cytoplasm (×400, H&E)
Figure 2
Figure 2
Keratinizing squamous cell carcinoma (a) IHC staining for p63 showing positivity (×400); non-keratinizing squamous cell carcinoma (b) IHC staining for p63 showing positivity (×400)
Figure 3
Figure 3
Keratinizing squamous cell carcinoma (a) IHC staining for p16 showing positivity (×100; b) IHC staining for p16 showing positivity (×400); Sinonasal undifferentiated carcinoma (c) IHC staining for p16 showing positivity (×100); Sinonasal papilloma, inverted type (d) IHC staining for p16 showing positivity (×100)
See this image and copyright information in PMC

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