华中地区成人鼻息肉组织病理学变化的回顾性研究。

A retrospective study of changes of histopathology of nasal polyps in adult Chinese in central China.

机构信息

Department of Otolaryngology - Head and Neck Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, P.R. China; Department of Otolaryngology - Head and Neck Surgery, Affiliated Eye, Ear, Nose and Throat Ho.

Department of Otolaryngology - Head and Neck Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, P.R. China.

出版信息

Rhinology. 2019 Aug 1;57(4):261-267. doi: 10.4193/Rhin18.070.

DOI:10.4193/Rhin18.070

PMID:30801072

Abstract

BACKGROUND

The factors contributing to the eosinophilic inflammation in chronic rhinosinusitis with nasal polyps (CRSwNP) remain elusive. This study was designed to investigate the inflammatory patterns and tissue remodeling of CRSwNP in patients from central China at two time points over 14 years apart and the influence of age.

METHODS

One hundred and eight CRSwNP patients enrolled in 2000 and 2001 (group A), and 134 CRSwNP patients enrolled in 2014 and 2015 (group B) were retrospectively studied. Hematoxylin-eosin stained tissue sections were used to study characteristics of inflammation and tissue remodeling. Immunohistochemistry was used to further evaluate the cells positive for eosinophil cationic protein (ECP), IL-5, IgE, tryptase or myeloperoxidase (MPO). Time- and age-related difference was analyzed.

RESULTS

The number of eosinophils and proportion of eosinophilic CRSwNP were increased, whereas the numbers of total inflammatory cells and lymphocytes were decreased in group B as compared with group A. Group B had severer epithelial squamous metaplasia and basement membrane thickening, and a lower number of mucosal glands than group A. Higher numbers of ECP plus, IL-5 plus and IgE plus cells were detected in group B than those in group A. The elderly (60 yrs or older) and non-elderly (less than 60 yrs) had a comparable number of eosinophils and ratio of eosinophilic CRSwNP.

CONCLUSION

Eosinophilic inflammation has been significantly augmented over time, which is associated with increased Th2 response and IgE production, and accompanied by exaggerated epithelium remodeling in CRSwNP patients from central China. Age has no significant influence on eosinophilic inflammation.

摘要

背景

导致慢性鼻-鼻窦炎伴鼻息肉（CRSwNP）中嗜酸性粒细胞炎症的因素仍不清楚。本研究旨在研究中国中部地区 14 年以上的两组患者的 CRSwNP 炎症模式和组织重塑情况及其受年龄的影响。

方法

回顾性研究了 2000 年和 2001 年（A 组）的 108 例 CRSwNP 患者和 2014 年和 2015 年（B 组）的 134 例 CRSwNP 患者。苏木精-伊红染色组织切片用于研究炎症和组织重塑的特征。免疫组化用于进一步评估嗜酸性粒细胞阳离子蛋白（ECP）、IL-5、IgE、类胰蛋白酶或髓过氧化物酶（MPO）阳性细胞。分析了时间和年龄相关的差异。

结果

与 A 组相比，B 组的嗜酸性粒细胞数量和嗜酸性粒细胞性 CRSwNP 的比例增加，而总炎症细胞和淋巴细胞的数量减少。B 组的上皮鳞状化生和基底膜增厚更为严重，黏膜腺体数量也少于 A 组。B 组的 ECP 阳性、IL-5 阳性和 IgE 阳性细胞数量高于 A 组。老年（60 岁或以上）和非老年（60 岁以下）患者的嗜酸性粒细胞数量和嗜酸性粒细胞性 CRSwNP 比例相当。