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中国南方嗜酸性粒细胞性慢性鼻-鼻窦炎的临床特征及替代标志物

Clinical characteristics and surrogate markers of eosinophilic chronic rhinosinusitis in Southern China.

作者信息

Zuo Kejun, Guo Jiebo, Chen Fenghong, Xu Rui, Xu Geng, Shi Jianbo, Li Huabin

机构信息

Allergy and Cancer Center, Otorhinolaryngology Hospital, The First Affiliated Hospital of Sun Yat-sen University, No. 58, Zhongshan 2nd Road, Guangzhou, 510080, China.

出版信息

Eur Arch Otorhinolaryngol. 2014 Sep;271(9):2461-8. doi: 10.1007/s00405-014-2910-0. Epub 2014 Feb 4.

Abstract

The surrogate markers for subclassifying eosinophilic chronic rhinosinusitis (ECRS) and non-ECRS remain elusive. We herein performed a cross-sectional study to assess the clinical implication of clinical symptoms, CT findings, blood eosinophil (EOS) examination based on histological examination of tissue eosinophilia in 105 adult CRS patients (including 72 with nasal polyps and 33 without nasal polyps) in southern China. We found the mean score of smell loss was significantly higher in ECRS subgroup than those in non-ECRS subgroup (p < 0.05), whereas the average ethmoid osteitis index in non-ECRS subgroup was significantly higher than that in ECRS subgroup (p < 0.05). Moreover, we found both the mean blood EOS number and ratio were significantly higher in ECRS subgroup than those in non-ECRS subgroup (p < 0.05). By applying receiver operating characteristic (ROC) curve analysis, we found blood EOS number had a sensitivity of 84.9 % and specificity of 84.4 % [area under the curve (AUC): 0.873] at the cutoff level of 0.16 × 10(9)/L, and blood EOS ratio had a sensitivity of 89.0 % and specificity of 84.4 % (AUC: 0.863) at the cutoff level of 2.05 % in this cohort. Our findings indicated that smell loss score, ethmoid osteitis index and blood EOS number and ratio may be used for the differential diagnosis of ECRS as the surrogate markers.

摘要

嗜酸性粒细胞性慢性鼻-鼻窦炎(ECRS)和非ECRS亚分类的替代标志物仍不明确。我们在此进行了一项横断面研究,以评估在中国南方105例成年慢性鼻-鼻窦炎患者(包括72例有鼻息肉和33例无鼻息肉)中,基于组织嗜酸性粒细胞增多的组织学检查,临床症状、CT表现、血液嗜酸性粒细胞(EOS)检查的临床意义。我们发现,ECRS亚组的嗅觉丧失平均评分显著高于非ECRS亚组(p<0.05),而非ECRS亚组的筛窦骨炎指数平均值显著高于ECRS亚组(p<0.05)。此外,我们发现ECRS亚组的血液EOS平均数量和比例均显著高于非ECRS亚组(p<0.05)。通过应用受试者工作特征(ROC)曲线分析,我们发现在该队列中,血液EOS数量在截断水平为0.16×10⁹/L时,敏感性为84.9%,特异性为84.4%[曲线下面积(AUC):0.873],血液EOS比例在截断水平为2.05%时,敏感性为89.0%,特异性为84.4%(AUC:0.863)。我们的研究结果表明,嗅觉丧失评分、筛窦骨炎指数以及血液EOS数量和比例可作为替代标志物用于ECRS的鉴别诊断。

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