Relationship between p21 and p53 expression, human papilloma virus infection and malignant transformation in sinonasal-inverted papilloma

Aims: To identify the relationship between p21 and p53 expression, human papilloma virus (HPV) infection and malignant transformation in sinonasal-inverted papilloma. Material and methods: Nasal tissues, exophytic papilloma, inverted papilloma (IP) with dysplasia, IP with carcinoma and invasive squamous cell carcinoma (SCC) were stained with the monoclonal antibodies p21 and p53. In-situ hybridisation for HPV DNA was also carried out for types 6/11, 16/18 and 31/33. Results: Significant increased staining of p21 and p53 was observed in IP with severe dysplasia, IP with carcinoma and invasive carcinoma compared with control nasal mucosa. A significant increase of dysplasia was observed in IP in the HPV 6/11 and 16/18-positive group, compared with the HPV 6/11 and 16/18-negative group. Significant decrease in expression of p21 and p53 was observed in HPV 16/18-positive IP compared with HPV 16/18-negative IP. Conclusions: Our data raise the possibility that testing for p21, p53 and HPV may help to screen out papilloma lesions with a potential for dysplasia or carcinoma.