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. 2025 Feb 6;10(1):e70075.
doi: 10.1002/lio2.70075. eCollection 2025 Feb.

Development of a Clinical Prediction Model to Predict Malignant Transformation of Sinonasal Inverted Papilloma Based on Hematological Indices and Clinical Features

Kai Sun  1 , Ce Wu  1 , Zengxiao Zhang  1 , Jiahong Chen  2 , Xudong Yan  1 , Shunke Li  1 , Lin Wang  1 , Longgang Yu  1 , Yan Jiang  1
Affiliations

Development of a Clinical Prediction Model to Predict Malignant Transformation of Sinonasal Inverted Papilloma Based on Hematological Indices and Clinical Features

Kai Sun et al. Laryngoscope Investig Otolaryngol. .

Abstract

Objective: Sinonasal inverted papilloma (SNIP) has a risk of malignant transformation into SNIP with squamous cell carcinoma (SNIP-SCC). Early detection of SNIP-SCC is crucial for patient outcomes. This study aimed to evaluate the utility of tumor-related hematological indices in the early diagnosis of SNIP-SCC and to develop a nomogram incorporating imaging and clinical features.

Methods: This study included 159 patients with SNIP with (n = 34) or without (n = 125) SCC. Univariate and multivariate logistic regression analyses were employed to identify independent risk factors and develop nomogram. The diagnostic model was evaluated using receiver operating characteristics (ROC), standard, clinical decision, and clinical impact curves.

Results: Elevated serum cytokeratin fragment antigen 21-1 (CYFRA 21-1), the loss of convoluted cerebriform pattern, bone destruction, headache/facial pain, and epistaxis/blood-tinged mucus were identified as independent risk factors for SNIP-SCC. The optimal cut-off value for serum CYFRA 21-1 was 3.51 ng/mL, with the nomogram area under the ROC curve of 0.966 based on the above indicators.

Conclusion: The findings suggest that CYFRA 21-1 is a promising diagnostic marker for SNIP-SCC. The nomogram incorporating serum CYFRA 21-1, imaging features, and clinical factors demonstrates strong clinical utility and can be a reference tool for clinical decision-making.

Keywords: cytokeratin fragment antigen 21‐1; malignant transformation; nomogram; sinonasal inverted papilloma.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
Nomogram for predicting the malignant transformation into sinonasal inverted papilloma with squamous cell carcinoma. CCP, Convoluted Cerebriform Patterning; CYFRA 21‐1, cytokeratin fragment antigen 21‐1.
FIGURE 2
FIGURE 2
(A) The receiver operating characteristic curve for predicting the malignant transformation into sinonasal inverted papilloma with squamous cell carcinoma. (B) Calibration curve for predicting the malignant transformation into sinonasal inverted papilloma with squamous cell carcinoma. (C) Decision curve for predicting the malignant transformation into sinonasal inverted papilloma with squamous cell carcinoma. (D) Clinical impact curve for predicting the malignant transformation into sinonasal inverted papilloma with squamous cell carcinoma. AUC, area under the curve.
See this image and copyright information in PMC

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