Distinctive immunohistopathologic features of nasal polyps and their clinical significance

Purpose: Nasal polyps are a process that based on inflammation. Main pathogenesis of the polyps are due to edema following inflammation resulting from chemical mediators, cytokins, growth factors as well as endothelial receptors. Neutrophils, lymphocytes, plasma cells, macrophages and mast cells involve in that inflammation, but the most important and the significant component is eosinophils. There are number of mediators that causes edema are secreted by these cells. İn this study, 28 patients were recruited and seperated into two groups regarding their recurrence (a recurrent polyps group, and a non-recurrent group). We compared these two groups to the following parameters: age, gender, tissue eosinophil number and concentration; staining with CD4, CD8, TGF-ß, NF-kB, TNF-?, VEGF and their staining grade. We, therefore aimed to aid to the relatively few polyp recurrence studies. Material&Method: Pathology sections of 73 cases which were undergone endoscopic sinus surgery due to nasal polyps (NP) in between june 2007 and april 2011. We obtained all the paraffin blocks and materials of the cases. İmmunohistochemical (IHC)staining of primary antibodies; CD4, CD8, TGF-ß, NF-kB, TNF-?, VEGF were performed for all sections. We evaluated CD4 and CD4 IHC stains for nuclear staining; on the hand for TGF-ß, NF-kB, TNF-?, VEGF IHC stains, membrane or cytoplasmic staining were evaluated. We also assessed all materials according to their eosinophillic infiltration. During IHC staining, 12 cases (7 recurrent, 5 non-recurrent) were exluded from the study because of the failure of IHC staining.Results: There were 28 recurrent (group 1) and 33 non-recurrent cases (group 2). İn group 1, patients were usually in the middle age and the median age was 49,75 (range 19-75). İn group 2, the median age was 44,39 (range 13-75). There were no statistically difference for age between two groups. Males and females had 47,4% and 43,5% of recurrent polyps, respectively. Polyps with eosinophils had 53,3% of recurrence, whereas only 25% of recurrence was detected with the absence of eosinophils. İf number of eosinophils was low, the recurrence rate was 33,3%; if high, the rate was 58,1%. All cases were CD4 positive. The cases in which had faint CD4 staining, the recurrence rate were %43,8; if CD4 staining were significant, the recurrence rate were 46,7%. There were 45% of recurrence when there were CD8 staining, but if not; recurrence rate was 100%. Faint CD8 stained cases had 45,8% of recurrence, whereas 46,2% of recurrence rate in significant CD8 stained cases. There were 44,2% of recurrence when there were Nf-kB staining, in the abcence of staining; recurrence rate was 55,6%.The cases in which had faint NF-kB staining, the recurrence rate were %43,8; if NF-kB staining were significant, the recurrence rate were 42,9%. There were 42,9% of recurrence when there were TGF-ß staining, but if not; recurrence rate was 80%. Faint TGF-ß stained cases had 57,1% of recurrence, whereas 40% of recurrence rate in significant TGF-ß stained cases. There were 43,9% of recurrence when there were TNF-? staining,but if not; recurrence rate was 50%. Faint TNF-? stained cases had 44,4% of recurrence, whereas 57,1% of recurrence rate in significant TNF-? stained cases. There were 45,8% of recurrence when there were VEGF staining, but if not; recurrence rate was 50%. Faint VEGF stained cases had 48,8% of recurrence, whereas 38,9% of recurrence rate in significant VEGF stained cases.Conclusions: The presence and the number of eosinophils and the presence and concentration of CD4, CD8, TGF-ß, NF-?B, TNF-?, VEGF immunomediators do not effect the rate of recurrence in nasal polyps.Key Words: Nazal polyp, eosinofil, CD4, CD8, TGF-ß, NF-?B, TNF-?, VEGF.