THE APPLICABILITY OF BIOMARKERS FOR DIFFERENTIATION OF INVERTED • PAPILLOMA WITH DIFFERENT PATHOLOGICAL DIAGNOSES
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Objectives: The present study aimed tolestimation of tissue extract epidermal growth factor receptor (EGFR) and serum squamou_s cell carcinoma. antigen (SCCA) levels in patients with inverted papilloma (IP) in varied pathological states as a trial to determine their role in pathogenesis and/ or their applicability for differentiation between these different patho/ogical changes. • Patients & Methods: The study included 6 cases with primarily diagnosed IF. 4 cases with recurrent IF and 3 cases had IF with SCC and 10 healthy volunteers to give blood samples as control group. All patients underwent full history taking. general and local examination and CT irnag- • ing was conducted. All cases underwent endoscopical excision and freshly excised IF tissues were divided into two parts: the first for histopathological examination and the second was immediately frozen on dry ice and stored in liquid nitrogen at -70°C until processed for estimationof tissue extract level of EGFR. Venous blood samples were obtained prior to and after surgical resection for ELISA estimation of serum SCCA. Results: The study included 13 patients: 10 males and 3 females. with mean age of 62.4+6.2 years. Nasal obstruction was the main presenting symptom followed by epistcods arid headache. Patients with recurrent IF gave history of previous endoscopic removal since a mean duration of . 6.24-2.2 months and one patient had recurrent IF twice. Histopathological examination documented the diagnosis of benign IP in 10 cases and SCC changes in 3 IP. Mean EGFR levels estimated in tissue extract of IP with SCC was signOcantly higher compared to benign IF with significantly higher levels in recurrent IF compared to primary IP. 401 Ahmed S. El-Kady, et al... Preoperative serum SCCA levels were significantly higher in patients had IP with SCC compared to levels ik controls arid patients with benign IP and in sera of patients had recurrent IP compared to controls and patients had prirrianj IP. Postoperative serum SCCA levels were significantly lower compared to preoperative levels in all patients' groups and in patients with benign IP nearly- returned to control levels, while in patients with cancerous changes postoperative serum SCCA levels were still signiftcantly higher compared to control levels and non-signiftcarttly higher compared to levels estimated in patients with benign IP. Conclusion: EGFR tissue expression level could be used for differentiation between benign and malignant IP even in early phases of dysplasia and serum SCCA could be used as a marker for complete operative excision of IP irrespective of its pathological diagnosis.