Department of Otorhinolaryngology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania.
Department of Radiology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania.
Mol Med Rep. 2019 Apr;19(4):2792-2800. doi: 10.3892/mmr.2019.9932. Epub 2019 Feb 5.
The present study focused on the assessment of the inflammatory infiltrate that characterizes nasal polyps in patients with chronic rhinosinusitis and nasal polyposis. Inflammatory cell type was determined using specific markers. This evaluation was made possible by determining the expression of the following markers: CD20, a marker of B lymphocytes [using activated T cells (ATC) armed with CD20 antibody]; CD3, a marker of T lymphocytes (using ATC armed with anti‑CD3 antibody); CD45, the leukocyte common antigen (using ATC armed with anti‑CD45 antibody; and CD34, for the microvasculature of the nasal polyp (using anti‑CD34 antibody). The diagnosis of chronic rhinosinusitis with nasal polyps (CRSwNP) was made according to current EPOS guidelines based on patient history, clinical examination and nasal endoscopy. We examined surgically resected nasal polyps from 127 patients diagnosed with CRSwNP, who benefited from surgical procedures at the Department of Otorhinolaryngology of our institution. The polyps were analyzed at the Department of Pathology of our institution utilizing histopathological and immunohistochemical methods as follows: Firstly, the tissues were paraffin‑impregnated, sectioned and stained with hematoxylin and eosin. We then examined the expression of CD3, CD20, CD34 and CD45RO by immunohistochemistry with soluble labeled streptavidin biotin (LSAB)/horseradish peroxidase (HRP) complexes. We observed the following histopathological changes: The structure of the epithelium was evidenced by collagenous subjacent stroma with mixed areas, sometimes associated with hyaline zones. In all types of polyps, we also observed a diffuse underlayer or periglandular lymphoplasmacytic in filtrate composed predominantly from T lymphocytes and eosinophils. The histopathological changes suggest the chronic inflammation of the sinus mucosa, which was diffusely distributed in allergic polyps and with nodular distribution in fibro‑inflammatory polyps. The number of B lymphocytes was greater in the fibro‑inflammatory polyps. On the whole, the findings of this study indicate that the inflammatory infiltrate in nasal polyps from patients with CRSwNP is mainly composed of T cells and eosinophils in all types of polyposis. In addition, a diffuse distribution of allergic polyps and the nodular distribution of fibro‑inflammatory polyps, and the hyperplasia of the seromucous glands was observed. The determination of CD20, CD3, CD34 and CD45RO could be used to assess the inflammatory infiltrate of the nasal poplyps in these patients.
本研究旨在评估慢性鼻-鼻窦炎伴鼻息肉患者鼻息肉中的炎症浸润。通过特定的标志物来确定炎症细胞类型。通过确定以下标志物的表达来进行评估:CD20,B 淋巴细胞标志物[使用武装有 CD20 抗体的激活 T 细胞(ATC)];CD3,T 淋巴细胞标志物(使用武装有抗-CD3 抗体的 ATC);CD45,白细胞共同抗原(使用武装有抗-CD45 抗体的 ATC);CD34,用于鼻息肉的微血管(使用抗-CD34 抗体)。根据当前的 EPOS 指南,根据患者病史、临床检查和鼻内窥镜检查,诊断为慢性鼻-鼻窦炎伴鼻息肉(CRSwNP)。我们检查了 127 名在我们机构耳鼻喉科接受手术的 CRSwNP 患者的手术切除鼻息肉。息肉在我们机构的病理科通过组织病理学和免疫组织化学方法进行分析,如下所示:首先,组织用石蜡包埋、切片并染色苏木精和伊红。然后,我们用可溶性标记链霉亲和素生物素(LSAB)/辣根过氧化物酶(HRP)复合物进行免疫组织化学检查,观察 CD3、CD20、CD34 和 CD45RO 的表达。我们观察到以下组织病理学变化:上皮结构由富含混合区的胶原下基质证明,有时与透明带相关。在所有类型的息肉中,我们还观察到弥漫性下层或腺体周围淋巴浆细胞浸润,主要由 T 淋巴细胞和嗜酸性粒细胞组成。组织病理学变化提示鼻窦黏膜慢性炎症,弥漫性分布于过敏性息肉中,结节性分布于纤维-炎性息肉中。纤维-炎性息肉中的 B 淋巴细胞数量较多。总的来说,这项研究的结果表明,在 CRSwNP 患者的鼻息肉中,炎症浸润主要由所有类型息肉中的 T 细胞和嗜酸性粒细胞组成。此外,观察到过敏性息肉弥漫性分布和纤维-炎性息肉结节性分布,以及浆液粘液腺增生。CD20、CD3、CD34 和 CD45RO 的测定可用于评估这些患者鼻息肉的炎症浸润。