A Study On The Histopathology And The Expression Of Cytokeratin Of Different Types Of Sinonasal Papilloma

Objective:To observe the pathology morphology and the expression of CK10,CK13 and CK8/18 of the three types of sinonasal papilloma respectively. To preliminarily explore different origins of different types of sinonasal papilloma.Methods: Thirty-one cases of sinonasal papilloma and 20 cases of rhinopolyp admitted to the First Affiliated Hospital of Fujian Medical University during the period from September 1, 2011 to June 1, 2015 were amassed. HE stain were used to observed different epithelial types of sinonasal papilloma and rhinopolyp. According to the World Health Organization classification(1991), sinonasal papilloma cases were divided into three types: exophytic papilloma(EP) 2 cases; inverted papilloma(IP) 23 cases, columnar cell papilloma(CCP) 2cases, and columnar cells papilloma is also known as oncocytic papilloma(OSP). Immunohistochemical technique(En Vision) was used to detect the expression of CK10, CK13 and CK8/18 in sinonasal papilloma cases and rhinopolyp cases.Results:1. Exophytic(n =4), inverted(n=23) and oncocytic types(n=2) were identified, and two cases had a papilloma with features of both EP and IP. Rhinopolyp is given priority to the pseudostratified ciliated columnar epithelium, squamous metaplasia phenomenon is common. 2. Different epithelium and keratin expression patterns were seen in different types of sinonasal papilloma. EP shows well-differentiated stratified squamous epithelium and positive staining results with antibodies to CK10 and CK13, and the expression of CK10 was more pronounced than CK13 in cornified cells, with a negative staining result with antibodies to CK8/18; IP has three major epithelium :columnar epithelium, squamous epithelium and transitional epithelium, the transitional epithelial predominate which is the transition morphology form between columnar epithelium and squamous epithelium, with positive staining results with antibodies to CK8/18 and CK13. The abundant expression of CK8/18 was found in OSP, with a negative staining result with antibodies to CK10 and CK13. In the rhinopolyp epithelium, positive staining results with antibodies to CK8/18 were observed, and in the transition area of squamous metaplasia, the staining of CK13 became more enhanced, and the expression of CK10 was negative.Conclusions:1. Nasal mucosa epithelial basal cells with multi-directional differentiation potential. 2. The most common type of sinonasal papilloma is IP,and EP comes second, and the least common type is OSP. 3. In the EP epithelium, expressions of CKs typical for squamous differentiation were observed. In the OSP epithelium, the columnar CK group was detected. A co-expression of CKs typical for columnar and squamous differentiation in transitional epithelium in IP must be concluded.The different types of sinonasal papilloma may have different origins.