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Sinonasal inverting papilloma (SNIP) is a common benign tumour of the sinuses. Difficulty lies in the association with metachronous or synchronous SCC of the sinus and also in the complete removal of the lesions due to their anatomical location. An association with HPV infection has been debated and this meta-analysis from Seoul, Republic of Korea, aims to look at HPV-related recurrence of SNIP. Fourteen studies met the PICOS inclusion criteria of patients with pathologically confirmed SNIP, detection of HPV DNA, SNIP patients with and without HPV infection, odds ratio of tumour recurrence and type of study. Data extraction was performed for 592 patients involved in the worldwide studies, which were all hospital based. HPV DNA was found in 32.6% (193) of 592 patients and tumour recurrence found in 24.3% (144 patients). HPV positivity was significantly associated with an increased risk of SNIP recurrence. A subgroup analysis was performed on the groups divided into HPV DNA diagnosis by PCR or in vitro hybridisation, geographical location and timing of the study. This found that the odds ratio for development of recurrence was higher in studies using PCR, from Western countries and risk maintained over longer-term studies. The results suggest that HPV testing and typing should be considered in the management of SNIP. HPV infection may also be associated with the progression of SNIP to SCC as reported in another meta-analysis study.

Association of the human papillomavirus infection with the recurrence of sinonasal inverted papilloma: a systematic review and meta-analysis.
Rha MS, Kim CH, Yoon JH, Cho HJ.
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Suki Ahluwalia

Cairns Hospital / James Cook University, Queensland, Australia.

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