Abstract BACKGROUND hyperplasia IP IP-SCC). Transformation from normal epithelium to IP revealed loss of ciliary characteristics, with enrichment of processes involved in epithelium differentiation and keratinization (NES=3. 30, p-adj=9. 76x10-21), while dis-enriched in processes governing synthesis and function of cilium components (NES=-3. 12, p-adj=1. 89x10-49). In silico immune deconvolution revealed a pro-inflammatory shift, characterized by significant loss of trans-epithelial mast cells and a concomitant increase neutrophil infiltration. From IP to IP-SCCs, we identified 758 upregulated and 893 downregulated differential expressed genes (DEGs), with enrichment of pro-tumorigenic MYC (NES=3. 07, p-adj=1. 89x10-28) and E2F (NES=2. 81, p-adj=5. 97x10-20) signaling pathways. CONCLUSION: Our study provided comprehensive characterization of biological processes involved in IP-SCC pathogenesis and identified genes that may be associated with malignant transformation. We also demonstrated the potential use of FFPE RNA-Seq as a clinical tool for precision medicine that can accurately identify patients at risk of malignancy. Citation Format: Shen Kai Ng, Shahana R, Jaslyn Lee, Jing Liu, Joseph W Foley, Wei Keat Teo, Serene Siow, Xinni Xu, De Yun Wang, Mark Thong, Ming Liang Oon, Joshua K Tay. From Papilloma to Carcinoma: Unravelling the Transcriptomic Reprogramming in Malignant Transformation of Sinonasal Inverted Papilloma abstract. In: Proceedings of Frontiers in Cancer Science 2025; 2025 Nov 5-7; Singapore. Philadelphia (PA): AACR; Cancer Res 2026;86 (13Suppl): Abstract nr P72.
Ng et al. (Thu,) studied this question.