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<p>Inverted sinonasal papilloma (ISP) is a benign epithelial neoplasm with potential for malignant transformation into squamous cell carcinoma (ISP-SCC). While high-risk HPV infection has been studied as a possible driver, other factors, including occupational exposures, may play a role. Thirty-two cases (<i>n</i> = 32) of ISP and ISP SCC were retrospectively analysed. These cases had been diagnosed between 2010 and 2022. We assessed their occupational history through the Italian Sino-Nasal Cancer Registry questionnaire and performed p16/p53 immunohistochemistry, HPV DNA and RNA testing. Overall, 41% of ISP and 40% of ISP-SCC cases reported exposure to IARC Group 1–2&#xa0;A carcinogens, and 69% had a history of smoking. Transcriptionally active HPV was detected in only one case (3.1%). Conventional bivariate analyses did not reveal significant associations between occupational exposure and malignant transformation. However, hierarchical cluster analysis identified three distinct phenotypes. Cluster 1 included predominantly male smokers with high cumulative occupational and non-occupational exposure, with ISP-SCC in 17%. Cluster 2, characterized by the highest occupational exposure and lowest smoking prevalence, consisted exclusively of ISP-SCC cases (100%), suggesting occupational carcinogens as a possible independent driver. Cluster 3 had minimal exposure, inflammatory features, and no malignant transformation. These findings highlight the potential of multidimensional analytical approaches to identify high-risk subgroups and inform targeted preventive and surveillance strategies in exposed populations.</p>

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Occupational exposure and risk clusters in malignant transformation of inverted sinonasal papilloma

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年12月21日

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  • Giulia Querzoli,
  • Angela Camagni,
  • Anna Caterina Leucci,
  • Massimiliano Marzadori,
  • Liliana Gabrielli,
  • Simona Venturoli,
  • Paolo Farneti,
  • Alessandra Borriello,
  • Andrea Ambrosini-Spaltro,
  • Paolo Galli,
  • Luca Amorosa,
  • Elisa D’Angelo,
  • Elisa Donini,
  • Alicia Tosoni,
  • Luisa Raffi,
  • Ernesto Pasquini,
  • Maria Pia Foschini

摘要

Inverted sinonasal papilloma (ISP) is a benign epithelial neoplasm with potential for malignant transformation into squamous cell carcinoma (ISP-SCC). While high-risk HPV infection has been studied as a possible driver, other factors, including occupational exposures, may play a role. Thirty-two cases (n = 32) of ISP and ISP SCC were retrospectively analysed. These cases had been diagnosed between 2010 and 2022. We assessed their occupational history through the Italian Sino-Nasal Cancer Registry questionnaire and performed p16/p53 immunohistochemistry, HPV DNA and RNA testing. Overall, 41% of ISP and 40% of ISP-SCC cases reported exposure to IARC Group 1–2 A carcinogens, and 69% had a history of smoking. Transcriptionally active HPV was detected in only one case (3.1%). Conventional bivariate analyses did not reveal significant associations between occupational exposure and malignant transformation. However, hierarchical cluster analysis identified three distinct phenotypes. Cluster 1 included predominantly male smokers with high cumulative occupational and non-occupational exposure, with ISP-SCC in 17%. Cluster 2, characterized by the highest occupational exposure and lowest smoking prevalence, consisted exclusively of ISP-SCC cases (100%), suggesting occupational carcinogens as a possible independent driver. Cluster 3 had minimal exposure, inflammatory features, and no malignant transformation. These findings highlight the potential of multidimensional analytical approaches to identify high-risk subgroups and inform targeted preventive and surveillance strategies in exposed populations.