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Hello! This is probably a somewhat crazy question pertaining to

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Posted on Fri, 22 Feb 2019
Question: Hello! This is probably a somewhat "crazy" question pertaining to some tests ordered by my surgeon, but I made the mistake of googling (plus I suffer from some health anxiety) and was wondering if you can put it into perspective for me. Five days ago, I had surgery for removal of a nasal papilloma, which turned out to be an exophytic Schneiderian papilloma upon pathology -- I have attached a copy of the pathology report. As you will see, my surgeon also ordered studies for low risk and high risk HPV (I understand that for the most part, this type of schneiderian papilloma is caused by low risk HPV). I also saw that a P16 test will be performed. Of course, I couldn't resist the urge to google P16 and I understand that it is a protein that acts as a tumor suppressor and that if it is present and the test is positive, that HPV is usually implicated as the causative agent. I guess what scared me is that I saw reference to the fact that if there is complete absence of P16 it is abnormal and could indicate a gene silencing mutation -- with my health anxiety that has me worried that if that turns out to be the case with the results, I will have some crazy gene mutation and inability to fight off tumor growth (yes, I know my question is really "out there" lol). I am still waiting to see the results of the HPV and P16 testing, but can you shed any light on this for me, in terms of what positive or negative P16 results may mean in this context, and hopefully some reassurance that I am worrying needlessly?? Thank you so much!
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Answered by Dr. Rajat Basak (2 hours later)
Brief Answer:
HPV detection is done to see the causative agent. P 16 postive means benign.

Detailed Answer:
Hello and welcome to Ask A Doctor service.

I have reviewed your query and here is my advice.

No need to worry. HPV detection is done to see the causative agent. Inverted papilloma is itself benign and not malignant but it involves a wide region.p 16 is done to see whether any potential for malignancy is present or not. p16 positive is indicative of benign lesion or low chance of malignancy potential. p16 negative is indicative of high chance of malignancy potential. p53 positive is indicative of high chance of malignancy. Mutation of p16 can be detected if the malignancy potential is present but this p16 mutation need not to be present in all the parts of body,it may be a localised incident of the tissue involved by the papilloma. And many diseases of the body are associated with gene mutations specific to that body part. It is always better to check for malignancy potential of a papilloma but inverted papilloma is benign generally but it recurs multiple times. No need to worry. Maintain healthy life.

Hope this helps. Review if any queries.
Above answer was peer-reviewed by : Dr. Vaishalee Punj
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Follow up: Dr. Rajat Basak (36 hours later)
Thanks so much for that information Dr. Basak, and for explaining it to me (I REALLY need to stop googling these things!). So just to clarify, my nasal papilloma turned out to be the schneiderian exophytic type, which I understand almost always has low risk HPV As its etiology. So presuming the HPV testing on it shows it was low risk, is it likely then that the P16 will show as being negative? And if the P16 happens to come
back as positive, is that anything to worry about (my surgeon is confident he removed to entire mass). Thank you again!!
doctor
Answered by Dr. Rajat Basak (1 hour later)
Brief Answer:
Hii. p16 positive has low risk of malignancy and negative has risk of malig

Detailed Answer:
Hii. p16 positive has low risk of malignancy and negative has risk of malignancy. Inverted papilloma generally has less tendency of malignancy. It p16 comes negative then wide excision of the papilloma decrease the chances of spread of tumor. So don't worry.Wait for the reports.
Above answer was peer-reviewed by : Dr. Prasad
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Dr. Rajat Basak

ENT Specialist

Practicing since :2011

Answered : 609 Questions

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Hello! This is probably a somewhat crazy question pertaining to

Brief Answer: HPV detection is done to see the causative agent. P 16 postive means benign. Detailed Answer: Hello and welcome to Ask A Doctor service. I have reviewed your query and here is my advice. No need to worry. HPV detection is done to see the causative agent. Inverted papilloma is itself benign and not malignant but it involves a wide region.p 16 is done to see whether any potential for malignancy is present or not. p16 positive is indicative of benign lesion or low chance of malignancy potential. p16 negative is indicative of high chance of malignancy potential. p53 positive is indicative of high chance of malignancy. Mutation of p16 can be detected if the malignancy potential is present but this p16 mutation need not to be present in all the parts of body,it may be a localised incident of the tissue involved by the papilloma. And many diseases of the body are associated with gene mutations specific to that body part. It is always better to check for malignancy potential of a papilloma but inverted papilloma is benign generally but it recurs multiple times. No need to worry. Maintain healthy life. Hope this helps. Review if any queries.