반전성 유두종에서 PCNA와 세포고사체의 발현

Background and Objectives: Inverted papilloma of the nasal cavity and paranasal sinuses is uncommon benign lesion, in which there is a inversion of the neoplastic epithelium into the underlying stroma. Proliferating cell nuclear antigen (PCNA) indicates the cellular kinetic activity during the late G1 and S phase. Among the various approaches for evaluating the proliferative activity, PCNA has been recently introduced as an antigenic marker of cellular proliferation. Programmed cell death (apoptosis) is distinctive form of cell death manifested by characteristic chromatin condensation and DNA fragmentation, whose function is the deletion of cells in normal development, organogensis, immune function, and tissue growth, but which can also be induced by pathologic stimuli. The purpose of this study was to detect expression of PCNA and ap- optotic bodies, and to understand the mechanism of pathogenesis of nasal inverted papilloma. Materials and Methods: Twenty-nine cases of nasal inverted papilomas, 5 squamous cell carcinomas, 10 nasal polyps and 10 inferior turbinate mucosas were analyzed for the detection of PCNA and apoptotic bodies by immunohistochemical technique. Results: PCNA indices were 22.5 ±7.7%, 45.4±2.6%, 7.9±3.9% and 0% in inverted papillomas, squamous cell carcinomas, nasal polyps and inferior turbinate mucosas. PCNA index of inverted papillomas with dysplasia was higher (31.4±5.4%) than inverted papilloma without dysplasia (18.5 ±4.6%). Apoptotic indices were 7.8±3.8%, 13.4±3.5%, 0.9±1.5% and 0.4±0.8% in inverted papillomas, squamous cell carcinomas, nasal polyps and inferior turbinate mucosas. Apoptotic index of inverted papillomas with dysplasia was higher (10.0±3.2%) than inverted papilloma without dysplasia (6.8±3.7%). Conclusion: These results showed that cellular proliferation and apoptosis play a role in development of nasal inverted papilloma. Also cellular proliferation is more important factor than apoptosis in development of nasal inverted papilloma. (J Clinical Otolaryngol 2000;11:230–236)