Evidence map›Paper›PMID 40843631›Full record

ArticleThe Laryngoscope2026

MMP11 as a Prognostic Indicator for Inverted Papilloma Histologic Grade and Recurrence.

Kush Panara, Jadyn Wilensky, Alan D Workman, David K Lerner, Alexandria L Irace, Jennifer E Douglas, James N Palmer, Nithin D Adappa, Jalal Jalaly, Charles C L Tong and 2 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in The Laryngoscope, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Kush PanaraDepartment of Otorhinolaryngology-Head and Neck Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Jadyn WilenskyDepartment of Otorhinolaryngology-Head and Neck Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Alan D WorkmanDepartment of Otolaryngology, Massachusetts Eye and Ear/Harvard Medical School, Boston, Massachusetts, USA.
David K LernerDepartment of Otolaryngology, University of Miami, Miami, Florida, USA.
Alexandria L IraceDepartment of Otorhinolaryngology-Head and Neck Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Jennifer E DouglasDepartment of Otorhinolaryngology-Head and Neck Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.ORCID 0000-0002-3634-2067
James N PalmerDepartment of Otorhinolaryngology-Head and Neck Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Nithin D AdappaDepartment of Otorhinolaryngology-Head and Neck Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Jalal JalalyDepartment of Pathology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Charles C L TongDepartment of Otolaryngology- Head and Neck Surgery, Lenox Hill Hospital/Long Island Jewish Hospital, New York, New York, USA.ORCID 0000-0002-4471-5134
Noam A CohenDepartment of Otorhinolaryngology-Head and Neck Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Michael A KohanskiDepartment of Otorhinolaryngology-Head and Neck Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

Funding

American Rhinologic Society 1060942
6 · The paper itself

Abstract

objectivesInverted papilloma (IP) is a benign, but locally aggressive sinonasal tumor with a high recurrence rate and potential for malignant transformation into squamous cell carcinoma ex-IP (SCC). Currently, no reliable biomarkers exist to predict recurrence or severity. Matrix metalloproteinase-11 (MMP11) has been implicated in tumor progression and extracellular matrix remodeling in various malignancies and has been shown to be progressively upregulated in IP transformation. This study investigates the relationship between MMP11 expression and IP histologic severity and recurrence risk.

methodsPatient demographics and tumor characteristics were collected retrospectively at a tertiary care center from 2008 to 2023. Patient specimens were categorized into normal sinus tissue (NST), IP without dysplasia (IPND), IP with severe dysplasia (IPSD), and SCC. Immunohistochemical staining for MMP11 was performed, and quantitative analysis was conducted using DAB-Quant software.

resultsA total of 52 patients were included, with a mean follow-up of 68.8 months. MMP11 expression was significantly elevated in IPSD and SCC compared to IPND (36.7% and 36.5% vs. 21.1%, p = 0.02 and p = 0.01). Patients with recurrence exhibited higher MMP11 expression in their initial resection specimens compared to non-recurrent cases (31.1% vs. 18.1%, p < 0.01). High MMP11 expression (> 50%) was associated with a shorter time to recurrence (17.5 vs. 32 months, p = 0.03), independent of histologic grade.

conclusionMMP11 expression correlates with increased IP histologic grade, risk of recurrence, and shorter time to recurrence. Elevated MMP11 expression may identify patients at higher risk for recurrence, allowing for targeted surveillance strategies and treatment options. LEVEL OF EVIDENCE: 3:

Indexed as

Matrix Metalloproteinase 11Neoplasm Recurrence, LocalPapilloma, InvertedParanasal Sinus NeoplasmsAdultAgedBiomarkers, TumorFemaleHumansMaleMiddle AgedNeoplasm GradingPrognosisRetrospective StudiesBiomarkers, TumorMatrix Metalloproteinase 11MMP11 protein, humaninverted papillomamatrix metalloproteinase‐11recurrence

Identifiers

PMID40843631
PMCPMC12770796

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.