Supplementary Material for: Aberrant Inflammatory Cells of Peripheral Blood in Nasal Inverted Papilloma

Introduction: Nasal inverted papilloma (NIP) is a common nasal benign tumor, with a complex pathogenesis closely linked to inflammatory response. It can be classified into Grade-I and Grade-II phenotypes based on nasal epithelium abnormality. Our objective is to investigate potential inflammatory biomarkers in peripheral blood of NIP patients for preoperative assessment of disease severity. Methods: We retrospectively analyzed inflammatory cells in the peripheral blood of 63 healthy controls and 82 NIP patients, while distinguishing different phenotypes of NIP through immunofluorescent and H&E staining. Using receiver operating characteristic curve analysis, we assessed the predictive value of monocytes%-to-lymphocytes% ratio (M%L%R) for peripheral blood abnormalities in NIP and explored its correlation with clinical data by Spearman r characteristic. Results: We observed an increase in monocytes% and decrease in lymphocytes% proportion, while the level of M%L%R was upregulated in the peripheral blood of NIP patients (all p < 0.05). Immunofluorescent staining revealed basal cell proliferation and squamous metaplasia, along with inhibited differentiation of ciliated and goblet cells in nasal epithelium of NIP. Correlation analysis demonstrated a positive correlation between M%L%R and degree of nasal epithelial deterioration (r = 0.2999, p = 0.0062). Finally, M%L%R level was significantly increased in both Grade-I and Grade-II patients (all p < 0.05). Conclusion: The expression level of M%L%R in the peripheral blood of patients with NIP can serve as a potential biomarker for preoperative evaluation of the severity of nasal epithelial lesions.