The Prevalence of Human Papillomavirus Infection in Benign Sinonasal Lesions: A Single-Center Retrospective Analysis

Abstract

It is suggested that just like cigarette smoking and occupational exposure, HPV plays a significant role in the etiology of benign sinonasal lesions. It is evident through literature review that low-risk HPV types 6 and 11 are usually confined to benign lesions, whereas the reverse is true for the oncogenic HPV types 16 and 18. Our aim was to seek the prevalence and the types of HPV coinfection in a benign head and neck surgical specimen. Benign specimens from head and neck sites with available HPV wide spectrum testing and immunohistochemistry for HPV and p16 were retrospectively reviewed (January 2011 to October 2015). Thirty-seven sinonasal surgical specimens were identified, requiring direct examination and enough changes warranting a biopsy. On histology, these revealed focal viral cytopathic changes, inverted papillomas, squamous hyperplasia, squamous papilloma, and verrucous hyperplasia type of morphology. The results for HPV wide spectrum, HPV 6, 11, 16, 18, 33, 35, and 45, were collected. Thirteen of 37 benign lesions showed positive results for HPV wide spectrum. Two of 13 came out to be positive for HPV 16 with positive p16 staining on immunohistochemistry. The remaining (11/13) cases were positive by HPV wide spectrum for HPV 6 and HPV 11 (n = 7 with HPV 6, n = 4 with HPV 11) showing focal p16 staining. Twenty-one of 37 showed focal p16 staining, which was interpreted as negative. Current studies link HPV to at least a proportion of benign sinonasal papillomas. HPV 6 and HPV 11 seem to be present in a large number (30%) of these benign lesions in our cohort. This corresponds with the available literature (30%-35%). Although two of our cases did show infection with HPV 16, there was no dysplasia identified in the lesion.