Immunohistopathologic Distinctive Features of Primary and Recurrent Nasal Polyps

Immunohistopathologic Distinctive Features of Primary and Recurrent Nasal Polyps

Background: The pathophysiology of recalcitrant form of nasal polyp (NP) can not be explained but it is believed to be multifactorial.

Objective: We aimed to characterize the distinctive immunohistopathologic features of primary and recalcitrant NPs and investigate the importance these features in predicting polyp recurrence.

Materials and Methods: Pathologic sections of 61 patients following primary or revision endoscopic sinus surgery for NP were analyzed. Immunohistochemical staining of primary antibodies; CD4, CD8, TGF-β, NF-kB, TNF-α, and VEGF were performed for all sections and evaluated for presence and staining degree. We also assessed eosinophilic infiltration in all specimens.

Results: The presence of eosinophils was 53.3% for patients with revision surgery and 46.7% for patients with primary surgery. There were significantly differences in presence of eosinophils between two groups (p = 0.048). 31.9% of patients in primary group, 68.1% patients in revision group had high tissue eosnophillia. There were significantly differences in eosinophil counts between primary and revision group (p = 0.45). There were no difference in presence and concentration of other markers between two groups (p<0.05).

Conclusion: Patients with histopathologically eosonophilia may have a tendency for recurrence of the disease. Potentially, patients with high tissue eosonophillia may benefit the most from postoperative corticosteroid therapy to prevent further recurrence.