Tecimer S Hancer, Kasapoglu F, Demir U L, Ozmen O A, Coskun H, Basut O
Department of Otolaryngology and Head and Surgery, Uludag University Medical School, 16059 Gorukle, Nilufer, Bursa, Turkey.
Eur Arch Otorhinolaryngol. 2015 Apr;272(4):915-921. doi: 10.1007/s00405-014-3174-4. Epub 2014 Jul 10.
Chronic rhinosinusitis with nasal polyps (CRSwNP) is a frequent disease which can be classified as eosinophilic or neutrophilic based on dominant inflammatory cell type at tissue. The aim of this study was to evaluate the clinical relevance of classifying nasal polyps as eosinophilic or neutrophilic on treatment outcomes. The study was conducted with 40 patients who underwent either surgical or medical treatment with the diagnosis of CRSwNP. The patients were classified into two groups for further assessment up to eosinophil intensity at polyp tissue. All patients were examined by nasal endoscopy and paranasal computed tomography (CT). Before treatment, subjective symptom score, nasal endoscopy score, and CT score were measured. Subsequently, they were reevaluated by similar diagnostic tests after either medical or surgical treatment at sixth month. The preoperative subjective symptom score, endoscopy score, and paranasal CT score were compared between chronic rhinosinusitis (CRS) with eosinophilic nasal polyps (E-NP) (CRSwE-NP) group and CRS with neutrophilic nasal polyps group and there was no difference between the two groups (p = 0.369, p = 0.310 and p = 0.494 respectively). Although after treatment in both groups symptom score and endoscopy score were significantly improved but not the CT score, we found no difference in between the groups at sixth month. In most of the previous studies, patients with CRSwE-NP were assumed to have poor prognosis and high recurrence rate despite surgical or medical treatment. However, we did not find any association between eosinophilic or neutrophilic nature of nasal polyp tissue and disease severity.
伴鼻息肉的慢性鼻-鼻窦炎(CRSwNP)是一种常见疾病,可根据组织中占主导地位的炎症细胞类型分为嗜酸性粒细胞性或中性粒细胞性。本研究的目的是评估将鼻息肉分类为嗜酸性粒细胞性或中性粒细胞性对治疗结果的临床相关性。该研究对40例诊断为CRSwNP并接受手术或药物治疗的患者进行。根据息肉组织中嗜酸性粒细胞强度将患者分为两组进行进一步评估。所有患者均接受鼻内镜检查和鼻窦计算机断层扫描(CT)。治疗前,测量主观症状评分、鼻内镜评分和CT评分。随后,在药物或手术治疗6个月后,通过类似的诊断测试对他们进行重新评估。比较嗜酸性粒细胞性鼻息肉(E-NP)慢性鼻-鼻窦炎(CRSwE-NP)组和中性粒细胞性鼻息肉慢性鼻-鼻窦炎组的术前主观症状评分、内镜评分和鼻窦CT评分,两组之间无差异(分别为p = 0.369、p = 0.310和p = 0.494)。尽管两组治疗后症状评分和内镜评分均显著改善,但CT评分未改善,我们发现在6个月时两组之间无差异。在大多数先前的研究中,尽管进行了手术或药物治疗,但CRSwE-NP患者被认为预后较差且复发率较高。然而,我们未发现鼻息肉组织的嗜酸性或中性粒细胞性质与疾病严重程度之间存在任何关联。