Phenotypic Characteristics of Sinonasal Polyps and Papillomas, Factors of Recurrence and Progression
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Sinonasal polyps and papillomas represent common pathological lesions of the upper respiratory tract which, despite their predominantly benign nature, are frequently associated with chronic progression, high recurrence rates, and in certain cases, malignant transformation potential. Sinonasal polyps are mainly associated with chronic rhinosinusitis, allergic and immunologic dysregulation, whereas sinonasal papillomas, particularly inverted papillomas, demonstrate locally aggressive behavior and an increased risk of squamous cell carcinoma development.
The aim of this critical review is to evaluate the phenotypic characteristics, histomorphological and molecular features, as well as the factors associated with recurrence and progression of sinonasal polyps and papillomas. The review discusses epidemiology, inflammatory microenvironment, cytokine and immunologic mechanisms, epithelial–mesenchymal transition-related processes, tissue remodeling, and the role of the microbiota. Particular emphasis is placed on the role of human papillomavirus (HPV), especially HPV16, in the pathogenesis and malignant progression of sinonasal papillomas.
This review also summarizes current evidence regarding molecular and immunohistochemical markers such as p16, EGFR, Ki67, VEGF, matrix metalloproteinases, and inflammatory cytokines, which may serve as valuable tools for disease prognostication, recurrence risk assessment, and the development of personalized therapeutic strategies. Analysis of the available literature demonstrates that the pathogenesis of sinonasal polyps and papillomas is multifactorial and heterogeneous, requiring further molecular and clinical investigations.
Comprehensive evaluation of the phenotypic and molecular profiles of sinonasal lesions may improve early diagnosis, facilitate more accurate prediction of recurrence and malignant transformation, and contribute to the development of targeted therapeutic approaches.
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