Nasal and sinonasal inverted papilloma (NSIP) is a benign tumor in which surface epithelial cells grow downward into the underlying supportive tissue with varying degrees of metaplasia.Human papillomavirus (HPV) has been proposed as the causal agent in the pathogenesis of this disease.Many studies have shown that HPV can activate the Akt/mechanistic target of rapamycin (mTOR) signaling pathway,but the role of this pathway in HPV-associated NSIP is largely unknown.In this study,we enrolled 40 control tissue samples and 80 NSIP tissue samples.HPV genotyping showed that 47 of the 80 examined cases of NSIP were HPV-positive (58.8％),and the most common subtype was HPV11 (20/53,37.7％).The immunohistochemistry showed statistically significant differences in phosphorylated Akt and phosphorylated S6 ribosomal protein staining among control samples,HPV-positive NSIP and HPV-negative NSIP.The HPV11 L1-L2 plasmid increased the proliferation of normal human nasopharyngeal epithelial NP69-SV40T cells and human nasopharyngeal cancer CNE1 cells.Meanwhile,rapamycin,an mTOR inhibitor,reversed the increased cell proliferation induced by the HPV11 L1-L2 plasmid.Weste blot analysis showed that Akt/mTOR/S6 were overexpressed in NP69-SV40T cells and CNE1 cells infected with the HPV11 L1-L2 plasmid.These data demonstrate that HPV promotes cell proliferation through the Akt/mTOR signaling pathway in NSIP.