Periostin and fibronectin in nasal lesions: Key players in polyps and inverted papillomas

Abstract

Background Sinonasal lesions are common benign masses with overlapping cli nical and histopathological features. Extracellular matrix proteins such as periostin, fibronectin, and tenascin-C play key roles in tissue remodeling and inflammation, yet their distinct expression profiles in these lesions remain poorly defined. Aim This study aimed to compare the immunohistochemical staining patterns of periostin, fibronectin, and tenascin-C in sinonasal lesions to elucidate their roles in pathogenesis and enhance differential diagnosis. Methods In this retrospective study, pathological specimens from 70 patients who underwent surgery for sinonasal polyps were analyzed. Immunohistochemical expression of periostin, fibronectin, and tenascin-C was assessed separately in epithelial and stromal compartments using a semi-quantitative scoring system. Associations between staining patterns and lesion types were evaluated using multinomial logistic regression. Results The cohort had a male-to-female ratio of 5:2 with a mean age of approximately 40 years. Nasal polyps demonstrated significantly higher stromal periostin staining compared to both antrochoanal polyps and inverted papillomas. Conversely, antrochoanal polyps exhibited significantly elevated epithelial periostin expression relative to inverted papillomas. Fibronectin expression was markedly increased in nasal polyps, especially in the stroma, supporting its role in inflammatory tissue remodeling. Tenascin-C expression did not differ significantly among the lesion types. Conclusions Differential expression of periostin and fibronectin suggests distinct pathogenic mechanisms in sinonasal lesions. The compartment-specific staining patterns of periostin, along with the prominent fibronectin expression in nasal polyps, suggest these biomarkers could serve as valuable diagnostic tools and potential therapeutic targets. Further research is needed to explore these pathways in sinonasal disease management.