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. 2001 Nov;54(11):871–876. doi: 10.1136/jcp.54.11.871

Patterns of p21waf1/cip1 expression in non-papillomatous nasal mucosa, endophytic sinonasal papillomas, and associated carcinomas

M Schwerer 1, A Sailer 1, K Kraft 1, K Baczako 1, H Maier 1
PMCID: PMC1731320  PMID: 11684723

Abstract

Aims—To clarify p21waf1/cip1 expression in sinonasal lesions.

Methods—Archived surgical specimens from 38 patients were investigated by means of immunohistochemistry. p21waf1/cip1 staining was evaluated in the different layers of the epithelium. In addition, human papillomavirus (HPV) infection and p53 protein overexpression were assessed and correlated with p21waf1/cip1 expression.

Results—p21waf1/cip1 staining was negative in non-papillomatous nasal mucosa. HPV infection and p53 protein overexpression were not seen. Sixteen of 20 inverted papillomas showed p21waf1/cip1 expression. HPV infection was found in 16 cases and p53 protein overexpression was present in 13 specimens. Expression of p21waf1/cip1 was restricted to surface cells in five cases, but involved basal/parabasal cells in 11 specimens. Immunoreactivity for p21waf1/cip1 in basal/parabasal cells colocalised with p53 protein overexpression. Enhanced expression rates for p21waf1/cip1 were seen in transitional and squamous epithelium compared with columnar epithelium. p21waf1/cip1 expression involved only surface cells in cylindrical cell papillomas. HPV infection and p53 protein overexpression were detected in all specimens. One of five squamous cell carcinomas showed p21waf1/cip1 expression. HPV infection was seen in two cases, and all carcinomas showed p53 protein overexpression.

Conclusions—Expression of p21waf1/cip1 is associated with terminal differentiation in surface cells in inverted papillomas and cylindrical cell papillomas, but not in non-papillomatous nasal mucosa. Overexpression of p53 protein colocalises with p21waf1/cip1 expression in basal/parabasal cells in inverted papillomas but not in cylindrical cell papillomas. Expression of p21waf1/cip1 in squamous cell carcinomas involves a subset of tumours with p53 protein overexpression.

Key Words: p21waf1/cip1 • nasal mucosa • sinonasal papillomas • squamous cell carcinomas

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Figure 1 Columnar epithelium in the invaginating portion of an inverted papilloma from a 45 year old man. Positive staining for p21waf1/cip1 is restricted to surface cells. Negative staining for p21waf1/cip1 in basal/parabasal cells, although human papillomavirus infection and p53 protein overexpression were present in this specimen.

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Figure 2 Squamous epithelium in an inverted papilloma (same specimen as shown in fig 1). Note abundant immunoreactivity for p21waf1/cip1 in basal/parabasal cells. In this case, positive staining in surface cells only (fig 1) together with positive staining in basal/parabasal cells only (fig 4) were found in different regions within the same specimen.

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Figure 3 Transitional epithelium in an inverted papilloma from a 25 year old man. Abundant immunoreactivity for p53 protein is present in the lower half of the epithelium. Human papillomavirus infection was demonstrated in this specimen.

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Figure 4 Immunoreactivity for p21waf1/cip1 in a serial slide from the same lesion shown in fig 3. Note colocalisation of positive staining results for p53 protein and p21waf1/cip1 between figs 2 and 3.

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Figure 5 Cylindrical cell papilloma from a 54 year old man. Positive staining for p21waf1/cip1 is seen only in suprabasal and surface cells of the epithelium.

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Figure 6 Squamous cell carcinoma associated with an inverted papilloma from a 61 year old man. Note immunoreactivity for p21waf1/cip1 on the invasion front of the tumour. Necrotic areas of the tumour were negative for p21waf1/cip1 expression (upper part of the picture). Human papillomavirus infection was not detected in this specimen. Abundant overexpression of the p53 protein was seen in this tumour.

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