Abstract
BackgroundSquamous metaplasia (SM) is an irreversible form of airway epithelial remodeling. Hyperproliferation of basal cells was observed in squamous metaplastic epithelium of chronically inflamed airway. However, the association of such aberrant proliferation of basal cells with SM in the nasal epithelium after radiation damage remains unclear. The aim of this study was to investigate SM and accompanying levels of p63+Krt5+ (basal cell markers) cells in the nasal epithelium of patients with radiation-induced chronic rhinosinusitis (CRSr) and patients with chronic rhinosinusitis without nasal polyps (CRSsNP) compared to healthy controls.MethodsWe assessed the prevalence of SM and the expression of p63+, Krt5+, p63+Krt5+, and Ki67+ cells through immunofluorescence(IF) staining of the inferior turbinate (IT) tissues from patients with CRSr (n = 36), CRSsNP (n = 33) and controls (n = 28).ResultsThe prevalence of SM and the number of p63+Krt5+ cells were both significantly increased in patients with CRSr compared to patients with CRSsNP and controls. The number of Ki67+ cells were both significantly increased in patients with CRSr and CRSsNP compared to controls, but the ratio of Ki67+ cells to p63+Krt5+ cells was significantly lower in patients with CRSr compared to patients with CRSsNP. In patients with CRSr, an increased number of p63+Krt5+ basal cells was observed in SM epithelium compared to non-SM epithelium.ConclusionSM is increased in the nasal epithelium of patients with CRSr, in which aberrant levels of p63+Krt5+ basal cells serves as an important pathologic feature in the squamous metaplastic epithelium.
Highlights
Nasopharyngeal carcinoma (NPC) is one of the most common cancers in the head and neck region, and the incidence of NPC is remarkably high in Southern China at up to 25 per 100,000 [1]
We found an increase of poorly proliferated p63+/Ki67+ basal cells in squamous metaplastic epithelium from patients with nasal polyps (NPs), suggesting that pathologic proliferation of basal cells may play an important role in remodeled epithelium from NPs [16]
Epithelial hyperplasia was present in 21.2% of patients with chronic rhinosinusitis without nasal polyps (CRSsNP) and in 27.8% of patients with radiation-induced chronic rhinosinusitis (CRSr), and goblet cell hyperplasia was found in 9.1% of patients with CRSsNP and in 13.9% of patients with CRSr
Summary
Nasopharyngeal carcinoma (NPC) is one of the most common cancers in the head and neck region, and the incidence of NPC is remarkably high in Southern China at up to 25 per 100,000 [1]. Unlike conventional CRS, the treatment of CRSr remains a challenge on account of the lack of effective method to restore the structure and function of irradiated nasal epithelium. The aim of this study was to investigate SM and accompanying levels of p63+Krt5+ (basal cell markers) cells in the nasal epithelium of patients with radiation-induced chronic rhinosinusitis (CRSr) and patients with chronic rhinosinusitis without nasal polyps (CRSsNP) compared to healthy controls. Results: The prevalence of SM and the number of p63+Krt5+ cells were both significantly increased in patients with CRSr compared to patients with CRSsNP and controls. In patients with CRSr, an increased number of p63+Krt5+ basal cells was observed in SM epithelium compared to non-SM epithelium. Conclusion: SM is increased in the nasal epithelium of patients with CRSr, in which aberrant levels of p63+Krt5+ basal cells serves as an important pathologic feature in the squamous metaplastic epithelium
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