Evaluation of systemic inflammation in sinonasal inverted papilloma using hematological and biochemical markers

OBJECTIVE: This study aimed to evaluate systemic inflammatory markers in patients with sinonasal inverted papilloma (IP) and to investigate the diagnostic performance of composite indices. METHODS: This retrospective study included 41 patients with histologically confirmed IP and 41 age- and sex-matched healthy controls, conducted at a tertiary care center in Istanbul, Turkey, between 2017 and 2022. Hematological and biochemical inflammatory markers, including neutrophil-to-lymphocyte ratio (NLR), platelet count, platelet-to-lymphocyte ratio (PLR), eosinophil-to-lymphocyte ratio (ELR), systemic immune-inflammation index (SII), and C-reactive protein-to-albumin ratio (CAR), were compared between groups. ROC analysis was performed to assess discriminative performance. RESULTS: CAR was higher in the IP group (median 0.53, IQR 0.36-0.85) compared with controls (median 0.34, IQR 0.16-0.51; p = 0.001, r = 0.37, 95% CI 0.17-0.54). Similarly, SII was higher in the inverted papilloma group (median 435.3, IQR 351.06-641.19) compared to the control group (median 361.88, IQR 256.4-517.6; p = 0.027, r = 0.24, 95% CI [0.03, 0.43]).No significant differences were detected in NLR, PLR, and ELR (p > 0.05). ROC analysis demonstrated that CAR had an AUC of 0.717 (95% CI: 0.606-0.829), with a sensitivity of 73.2% and specificity of 61.0% at a cut-off value of 0.41. SII showed a lower AUC of 0.642 (95% CI: 0.521-0.762). CONCLUSION: Systemic inflammation appears to be associated with sinonasal inverted papilloma. CAR demonstrated better discriminative performance than SII, while traditional indices such as NLR and PLR were not informative. Composite inflammatory indices may provide additional value in the assessment of IP.