Terna Emma, Luukkainen Annika, Seppälä Miia, Renkonen Risto, Huhtala Heini, Tommola Satu, Paavonen Timo, Kauppi Paula, Tynninen Olli, Jeskanen Leila, Toppila-Salmi Sanna
a Haartman Institute, University of Helsinki , Helsinki , Finland.
b HUSLAB , Helsinki University Hospital , Helsinki , Finland.
Acta Otolaryngol. 2016 Nov;136(11):1173-1179. doi: 10.1080/00016489.2016.1195918. Epub 2016 Jun 27.
The study suggests that cancerous inhibitor of protein phosphatase 2A (CIP2A) expression and eosinophilia associate with chronic rhinosinusitis with nasal polyps with aspirin exacerbated respiratory disease (CRSwNP + AERD). Further studies with a larger sample size are needed to evaluate further the role of CIP2A and related pathways in CRSwNP + AERD.
Low prostaglandin E2 levels putatively associate with CRSwNP + AERD and decreased c-Myc levels. The aim of this study was to evaluate the expression and revision-predictive role of oncoprotein CIP2A, another c-Myc modulator, in CRSwNP with/without AERD, and in antrochoanal polyps.
Ninety retrospective archival objective glasses of nasal polyp tissue from CRSwNP or ACP patients were used for assessing mucosal eosinophilia. Of this population, 90 archival nasal polyp specimens were available for immunohistochemical staining with a polyclonal anti-CIP2A antibody, together with 19 control nasal mucosa specimens. CIP2A staining intensity and tissue eosinophilia were assessed by two blinded observers with a light microscope. Subject characteristics from 90 patients and 19 controls were obtained from patient records and additionally by a questionnaire from controls. The follow-up data was available from patient records of 84 patients and 16 controls.
The expression of epithelial CIP2A was detected both in control inferior turbinate mucosa and nasal polyps. The expression was significantly lower in the CRSwNP + AERD group compared to controls and CRSwNP without AERD (p < 0.01). High mucosal eosinophilia associated with CRSwNP (p < 0.01). Neither CIP2A nor eosinophilia predicted the need for revision surgery (p > 0.05), whereas previous surgery, allergic rhinitis, and use of corticosteroids did predict the need for revision surgery (p < 0.05).
该研究表明，蛋白磷酸酶2A的癌性抑制剂（CIP2A）表达及嗜酸性粒细胞增多与伴有阿司匹林加重性呼吸道疾病的慢性鼻-鼻窦炎伴鼻息肉（CRSwNP+AERD）相关。需要开展更大样本量的进一步研究，以进一步评估CIP2A及相关通路在CRSwNP+AERD中的作用。
低水平的前列腺素E2可能与CRSwNP+AERD及c-Myc水平降低相关。本研究的目的是评估另一种c-Myc调节剂——癌蛋白CIP2A在伴或不伴AERD的CRSwNP以及鼻内翻性乳头状瘤中的表达及对翻修手术的预测作用。
采用90例来自CRSwNP或鼻内翻性乳头状瘤（ACP）患者的鼻息肉组织回顾性存档病理切片评估黏膜嗜酸性粒细胞增多情况。在这组人群中，90份存档鼻息肉标本与19份对照鼻黏膜标本一起用于用多克隆抗CIP2A抗体进行免疫组织化学染色。由两名盲法观察者用光学显微镜评估CIP2A染色强度和组织嗜酸性粒细胞增多情况。90例患者和19例对照的受试者特征来自患者记录，另外通过对对照者的问卷调查获得。随访数据来自84例患者和16例对照的患者记录。
在对照下鼻甲黏膜和鼻息肉中均检测到上皮CIP2A的表达。与对照组和不伴AERD的CRSwNP相比，CRSwNP+AERD组的表达显著降低（p<0.01）。高黏膜嗜酸性粒细胞增多与CRSwNP相关（p<0.01）。CIP2A和嗜酸性粒细胞增多均未预测翻修手术的必要性（p>0.05），而既往手术、变应性鼻炎和使用皮质类固醇确实可预测翻修手术的必要性（p<0.05）。
