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Objective <p>Sinonasal inverted papillomas (IPs) and nasal polyps (NPs) represent distinct benign lesions with different biological behaviors. P-glycoprotein (P-gp), a multidrug resistance transporter, has been implicated in inflammatory and neoplastic processes, but its expression in IPs has not been previously investigated. This study aimed to evaluate and compare the immunohistochemical expression of P-gp in IPs and NPs.</p> Methods <p>In this retrospective cohort study, 89 patients who underwent primary functional endoscopic sinus surgery between 2018 and 2022 were included: 56 with IP and 33 with NP. None of the patients had prior sinonasal surgery. Representative tissue samples were histopathologically examined, and P-gp expression was assessed by quantitative fluorescent immunohistochemistry. Expression was categorized as negative (0), weak (1), moderate (2), or strong (≥3). Statistical comparisons between groups were performed using t-test and chi-square analysis.</p> Results <p>The mean age was significantly higher in the IP group compared to the NP group (49.0 ± 16.2 vs. 40.6 ± 14.1 years; p = 0.012). Sex distribution did not differ significantly between groups (p = 1.000). P-gp expression showed distinct patterns: in the NP group, 3.0% were negative, 60.6% weak, and 36.4% moderate; in the IP group, 12.5% were negative, 35.7% weak, and 51.8% moderate. Strong expression was not observed in either group. A statistically significant difference in the distribution of expression categories was found between the groups (χ² = 6.01, p = 0.049), with moderate expression being more frequent in IPs.</p> Conclusion <p>This study demonstrates, for the first time, P-gp expression in sinonasal inverted papillomas. While mean expression levels did not differ significantly, moderate P-gp expression was significantly more prevalent in IPs compared to NPs. These findings suggest that P-gp may contribute to the distinct inflammatory and proliferative profile of IPs and could represent a potential therapeutic target in sinonasal tumors.</p>

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P-glycoprotein expression in sinonasal inverted papillomas and polyps: Marker or bystander?

  • 期刊论文

  • 发表日期：

    2026年5月5日

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  • Esma Altan,
  • Zülküf Küçüktağ,
  • Sehbal Arslankoz,
  • Efe Yetişgin,
  • Emel Çadallı Tatar

摘要

Objective

Sinonasal inverted papillomas (IPs) and nasal polyps (NPs) represent distinct benign lesions with different biological behaviors. P-glycoprotein (P-gp), a multidrug resistance transporter, has been implicated in inflammatory and neoplastic processes, but its expression in IPs has not been previously investigated. This study aimed to evaluate and compare the immunohistochemical expression of P-gp in IPs and NPs.

Methods

In this retrospective cohort study, 89 patients who underwent primary functional endoscopic sinus surgery between 2018 and 2022 were included: 56 with IP and 33 with NP. None of the patients had prior sinonasal surgery. Representative tissue samples were histopathologically examined, and P-gp expression was assessed by quantitative fluorescent immunohistochemistry. Expression was categorized as negative (0), weak (1), moderate (2), or strong (≥3). Statistical comparisons between groups were performed using t-test and chi-square analysis.

Results

The mean age was significantly higher in the IP group compared to the NP group (49.0 ± 16.2 vs. 40.6 ± 14.1 years; p = 0.012). Sex distribution did not differ significantly between groups (p = 1.000). P-gp expression showed distinct patterns: in the NP group, 3.0% were negative, 60.6% weak, and 36.4% moderate; in the IP group, 12.5% were negative, 35.7% weak, and 51.8% moderate. Strong expression was not observed in either group. A statistically significant difference in the distribution of expression categories was found between the groups (χ² = 6.01, p = 0.049), with moderate expression being more frequent in IPs.

Conclusion

This study demonstrates, for the first time, P-gp expression in sinonasal inverted papillomas. While mean expression levels did not differ significantly, moderate P-gp expression was significantly more prevalent in IPs compared to NPs. These findings suggest that P-gp may contribute to the distinct inflammatory and proliferative profile of IPs and could represent a potential therapeutic target in sinonasal tumors.