Miman Murat Cem, Uzun Onder, Gurses Iclal, Kuku Irfan, Ozturan Orhan, Akarcay Mustafa
Otorhinolaryngology Department, Inonu University, Malatya, Turkey.
Eur Arch Otorhinolaryngol. 2007 Sep;264(9):1013-8. doi: 10.1007/s00405-007-0310-4. Epub 2007 Apr 28.
Evaluation of nasal epithelial samples is a part of clinical allergy practice. The aim of this study is to reveal the sensitivity of the nasal eosinophilia using Rhino-probe and Wright-Giemsa staining by means of all available nasal eosinophilia scoring systems. In 30 patients (12 males, 18 females; mean age = 31.6 years) with clinical diagnosis of allergic rhinitis, both sides of the nose were sampled. The content of the cupped tip of the probe has been prepared and stained for nasal cytological examination under oil immersion by light microscopy. Nasal eosinophilia has been assessed by scoring systems. The sensitivity of nasal eosinophilia has been revealed. The nasal eosinophilia scores have been compared between nasal sides (right or left nose) and also between the examiners' observations for the same sample. Sensitivity values of nasal eosinophilia according to previously described criteria in the literature have been found to be between 13.33 and 80%. As the agreements for the nasal eosinophilia diagnosis between the sides of the nasal cavity and between the blinded examiners, the criteria of nasal eosinophilia such as the ratio of eosinophils to neutrophils or to all inflammatory cells rendered different diagnoses between the examiners (P < 0.01). The results of nasal cavity sides and Meltzer-scoring yielded no differences (P > 0.05). The substantial intraindividual variations when comparing the results obtained from the nasal sides and low sensitivity reveal that the nasal cytology needs more objective and standardized methods for a better differential diagnosis of chronic rhinitis.
鼻上皮样本评估是临床过敏实践的一部分。本研究的目的是通过所有可用的鼻嗜酸性粒细胞评分系统,揭示使用鼻探头和瑞氏-吉姆萨染色法检测鼻嗜酸性粒细胞增多的敏感性。对30例临床诊断为过敏性鼻炎的患者(12例男性,18例女性;平均年龄 = 31.6岁)双侧鼻腔进行采样。将探头杯状尖端的内容物制备好并进行染色,以便在油镜下通过光学显微镜进行鼻细胞学检查。通过评分系统评估鼻嗜酸性粒细胞增多情况。揭示了鼻嗜酸性粒细胞增多的敏感性。比较了双侧鼻腔(右鼻或左鼻)之间以及同一样本不同检查者观察结果之间的鼻嗜酸性粒细胞增多评分。根据文献中先前描述的标准,鼻嗜酸性粒细胞增多的敏感性值在13.33%至80%之间。由于鼻腔两侧之间以及盲法检查者之间在鼻嗜酸性粒细胞增多诊断方面的一致性,如嗜酸性粒细胞与中性粒细胞或与所有炎症细胞的比例等鼻嗜酸性粒细胞增多标准在检查者之间得出了不同的诊断结果(P < 0.01)。鼻腔两侧的结果与梅尔策评分结果无差异(P > 0.05)。比较双侧鼻腔获得的结果时存在显著的个体内差异以及低敏感性表明,鼻细胞学需要更客观和标准化的方法来更好地鉴别诊断慢性鼻炎。