High CT attenuation values relative to the brainstem may predict squamous cell carcinoma arising from inverted papilloma

Abstract

Background: A diagnostic indicator for differentiating squamous cell carcinomas (SCCs) from inverted papillomas (IPs) has not been established.

Objectives: This study aimed to evaluate whether CT attenuation values relative to those of the brainstem (relative CT number) could be useful in differentiating IPs from SCCs.

Material and Methods: Consecutive patients who were pathologically diagnosed with IP or SCC between 2007 and 2017 were retrospectively identified. Relative CT numbers were compared between the two patient groups. The factors with predictive power for differentiating IPs from SCCs were identified by univariate and multivariate logistic regression analyses.

Results: Fifty-four sinonasal tumour cases were finally analysed (IP, 25 cases; SCC, 29 cases). Relative CT numbers were significantly higher in SCC than in IP (p < .001). The univariate logistic regression analysis showed BMI, relative CT number, and disease duration to have predictive value for differentiating IPs from SCCs. In the multivariate logistic regression analysis, only the relative CT number had predictive value for distinguishing IP from SCC (odds ratio, 1.97), with a relative CT number of ≥1.4 being significantly associated with SCC.

Conclusions: High relative CT numbers could potentially be used to identify SCCs, and their measurement could provide a basis for differentiating IPs from SCCs.

背景：尚未确定区分鳞状细胞癌（SCCs）和乳头状瘤（IPs）的诊断指标。

目的：本研究旨在评估相对于脑干的CT衰减值（相对CT数）是否可用于区分IP与SCC。

材料与方法：回顾性分析2007年至2017年间病理诊断为IP或SCC的连续患者。比较两个患者组之间的相对CT数。通过单变量和多变量逻辑回归分析确定了区分IP与SCC的预测能力的因素。

结果：最终分析了54例鼻腔鼻窦肿瘤（25例IP；29例SCC）。 SCC中的相对CT数显著高于IP（p <.001）。单变量逻辑回归分析显示BMI、相对CT数和疾病持续时间对于区分SCC的IP具有预测价值。在多变量逻辑回归分析中, 只有相对CT数具有区分IP与SCC的预测值（优势比为1.97）, 相对CT数≥1.4, 与SCC显著相关。

结论：高的相对CT数可能用于识别SCC, 其测数可为SCs和IP的区分提供依据。

Keywords:

• Inverted papilloma
• squamous cell carcinoma
• computed tomography
• brainstem
• diagnosis

Authorship contribution

SA designed the study, collected, analysed, and interpreted the data, wrote the manuscript, and made revisions. SK designed the study, analysed and interpreted the data, wrote the manuscript, and made revisions. MY, MA, KK, and TY made helpful revisions in the manuscript.

Ethical considerations

This study was reviewed and approved by the Institutional Review Board of the University of Tokyo Hospital (#2487).

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This work was supported by a Grant-in-aid for Scientific Research (C) from the Japan Society for Promotion of Science to Shu Kikuta.