Prof. Kassem Mohamed Kassem :: Publications:

Objectives: The present study aimed to estimation of L -issue extract ep¬idermal growth factor receptor (EGFR) and serum squamous cell carcino¬ma antigen (SCCA) levels in patients with inverted papilloma (1P) in varied pathological states as a trial to determine their role in pathogenesis and/ or their applicability for dfferentiation between these different pathologi¬cal changes. Patients 8t Methods: The study included 6 cases with primarily diag¬nosed IP, 4 cases with recurrent IP and 3 cases had IP with SCC and 10 healthy volunteers to give blood samples as control group. All patients un¬derwent full history taking, general and local examination and CT imag¬ing was conducted. All cases underwent endoscopical excision and fresh¬ly excised Ii3 tissues were divided into two parts; the first for histopathoiogical examination and the second was immediately frozen on dry ice and stored in liquid nitrogen at -70°C until processed for estima¬tion of 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 moin pre¬senting symptom followed by epistaxis and headache. Patients with re¬current IP gave history of previous endoscopic removal since a mean du¬ration or 6.2f2.2 months and one iwtient had recurrent IP twice. HistopathUogicai examination documented the diagraosis oJ benign IP in 10 cases and SCC changes in 3 IP. Mean EGFR levels estimated in tissue ; extract of IP with SCC was significantly higher compared to benign IP _. with stgnificantiy higher levels in recurrent IP co,npared to primary IP Preoperative serum SCCA Levels were significantly higher in patients lu IP with SCC compared to Levels in controls and patients with benign and in sera of patients had recurrent IP compared to controls and p tients had primary IP. Postoperative serum SCCA levels were signiftcant lower compared to preoperative levels in all patients groups and in p tients with benign IP nearly returned to control levels, while in patien with cancerous changes postoperative serum SCCA levels were still s4 n ficantiy higher compared to control levels and non-significantly highe compared to levels estimated in patients with benign IP. Conclusion: EGFR tissue expression level could be used for different ation between benign and malignant IP even in early phases of dysplasi and serum SCCA could be used as a marker for complete operative exc sion of IP irrespective of its pathological diagnosis.