Bahattin ERDOĞAN, Vural FİDAN, Gözde KURTULUŞ
Eskisehir Medical Journal - 2026;7(3):417-425
Introduction: Chronic rhinosinusitis with nasal polyps (CRSwNP ) is marked by persistent mucosal inflammation and frequent postoperative recurrence, even after surgical intervention. The identification of reliable biomarkers for predicting recurrence could enhance individualized management strategies. This study aimed to assess the immunohistochemical expression and correlations of p53, Ki67, S100A8, and PD -L1 in nasal polyps and their association with recurrence. Methods: A retrospective analysis was conducted on 52 cases, comprising 30 primary nasal polyps, 13 recurrent nasal polyps, and 9 normal control tissues. Formalin -fixed, paraffin -embedded sections were immunohistochemically stained for p53, Ki67, S100A8, and PD -L1. Expression levels were semi -quantitatively scored across epithelial, stromal, and inflammatory compartments. Statistical analyses included Chi -square, Kruskal -Wallis, and Spearman's correlation (p<0.05). Results: Control mucosa exhibited minimal marker expression, whereas nasal polyp tissues showed significantly elevated staining intensities. Recurrent polyps demonstrated increased epithelial p53, stromal Ki67, and epithelial S100A8 positivity, along with heightened PD -L1 expression in inflammatory cells (p<0.05). Significant correlations were observed between stromal S100A8 and Ki67 (r=0.437, p<0.01), and between PD -L1 (inflammatory) and Ki67 (r=0.487, p<0.01). The combined expression of S100A8, Ki67, and PD -L1 offered superior predictive discrimination for recurrence compared to individual markers. Conclusion: The overexpression of p53, Ki67, S100A8, and PD -L1, particularly in recurrent cases, reflects complex interactions among epithelial proliferation, inflammation, and immune regulation in CRSwNP. A combined biomarker panel may enhance the prediction of postoperative recurrence and facilitate personalized follow -up and therapeutic strategies. Prospective validation in larger cohorts is recommended.
