[Study on subtle morphological characteristics of sinonasal inverted papilloma under high-definition white light...

Objective:To explore the diagnostic value of subtle endoscopic morphological characteristics in sinonasal inverted papilloma（SIP）. Methods:High-definition white light endoscopy（WLE） videos of patients with SIP and unilateral nasal polyp（NP） were analyzed retrospectively in a blinded fashion. The occurrence rates of the papillary sign, microvascular sign, and lobulated sign were evaluated and compared between the two groups. Using any of the aforementioned signs as the endoscopic diagnostic criterion for SIP, with postoperative pathological diagnosis as the gold standard, we calculated the accuracy, sensitivity, specificity, positive predictive value（PPV）, and negative predictive value（NPV） of high-definition WLE in diagnosing SIP. Results:A total of 32 patients with SIP and 30 with NP were enrolled in this study. The papillary, microvascular, and lobulated signs were detected in both groups. The occurrence rates of these three signs in the SIP group were 62.5%（20/32）, 59.4%（19/32）, and 90.6%（29/32）, respectively, while those in the NP group were 6.7%（2/30）, 16.7%（5/30）, and 10.0%（3/30）, respectively. Statistically significant differences were observed in the occurrence rates of all three signs between the two groups（all P<0.01）. High-definition WLE achieved correct diagnosis in 29 SIP cases and 24 NP cases. The accuracy, sensitivity, specificity, PPV, and NPV of high-definition WLE for diagnosing SIP were 85.5%（53/62）, 90.6%（29/32）, 80.0%（24/30）, 82.9%（29/35）, and 88.9%（24/27）, respectively. Conclusion:The three subtle endoscopic morphological characteristics（papillary sign, microvascular sign, and lobulated sign） can serve as the core diagnostic basis for SIP, which facilitates the differentiation from NP and the improvement of diagnostic accuracy.