Umeda Miki, Kuroki Masashi, Kato Hiroki, Shibata Hirofumi, Yamada Nansei, Okuda Hiroshi, Terazawa Kosuke, Iinuma Ryota, Ohkoshi Akira, Wakamori Shun, Kojima Ikuho, Katori Yukio, Matsuo Masayuki, Ogawa Takenori
Department of Otolaryngology-Head and Neck Surgery, Gifu University Graduate School of Medicine, Gifu, Japan.
Department of Radiology, Gifu University Graduate School of Medicine, Gifu, Japan.
Eur Arch Otorhinolaryngol. 2025 May;282(5):2533-2538. doi: 10.1007/s00405-024-09107-9. Epub 2024 Dec 12.
To distinguish squamous cell carcinoma in inverted papilloma (IP-SCC) from IP, the utility of CT scoring system was investigated.
We extracted cases histopathologically diagnosed with IP and IP-SCC of the sinonasal cavity from June 2004 to May 2021. Preoperative unenhanced CT images were used to evaluate the presence or absence of bone destruction and erosion: Score 1 = positive for bone destruction and/or erosion; Score 0 = negative for bone destruction and erosion. The CT scores in 10 sites of the sinonasal cavity and their adjacent areas were calculated.
Fifty-six cases of IP and 20 cases of IP-SCC were enrolled in this study. Bone destruction and/or erosion was more frequently observed in IP-SCC than in IP at the sites of the skull base (p = 0.0001), orbital wall (p < 0.0001), maxillary sinus (p < 0.0001), nasal septum (p < 0.0001), inferior nasal concha (p = 0.0046), ethmoid sinus (p < 0.0001), pterygoid process (p = 0.0031), and frontal sinus (p = 0.0009). The total CT scores at the 10 sites for diagnosing IP-SCC had sensitivity and specificity of 70% and 87.5% (AUC: 0.810, p < 0.001); furthermore, those at the eight sites excluding fontanelle and middle nasal concha improved sensitivity and specificity of 75% and 83.9% (optimal threshold of 2, AUC: 0.862, p < 0.001).
The CT scoring system evaluating bone destruction and erosion could accurately differentiate IP-SCC from IP.
为鉴别鼻窦内翻性乳头状瘤伴鳞状细胞癌（IP-SCC）与鼻窦内翻性乳头状瘤（IP），研究了CT评分系统的实用性。
我们提取了2004年6月至2021年5月间经组织病理学诊断为鼻窦IP和IP-SCC的病例。术前未增强CT图像用于评估是否存在骨质破坏和侵蚀：评分1 = 骨质破坏和/或侵蚀阳性；评分0 = 骨质破坏和侵蚀阴性。计算鼻窦及其相邻区域10个部位的CT评分。
本研究纳入56例IP和20例IP-SCC。在颅底（p = 0.0001）、眶壁（p < 0.0001）、上颌窦（p < 0.0001）、鼻中隔（p < 0.0001）、下鼻甲（p = 0.0046）、筛窦（p < 0.0001）、翼突（p = 0.0031）和额窦（p = 0.0009）部位，IP-SCC比IP更常观察到骨质破坏和/或侵蚀。诊断IP-SCC的10个部位的总CT评分的敏感性和特异性分别为70%和87.5%（AUC：0.810，p < 0.001）；此外，排除囟门和中鼻甲的8个部位的总CT评分的敏感性和特异性分别提高到75%和83.9%（最佳阈值为2，AUC：0.862，p < 0.001）。
评估骨质破坏和侵蚀的CT评分系统可准确区分IP-SCC与IP。
