Wang Kanghua, Deng Jie, Yang Meng, Chen Yang, Chen Fenghong, Gao Wen-Xiang, Lai Yinyan, Shi Jianbo, Sun Yueqi
Otorhinolaryngology Hospital, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510080, China.
Guangzhou Key Laboratory of Otorhinolaryngology, Guangzhou, 510080, China.
World Allergy Organ J. 2019 Aug 13;12(8):100052. doi: 10.1016/j.waojou.2019.100052. eCollection 2019 Aug.
Eosinophilic inflammation is a major phenotype associated with poorly controlled disease in nasal polyp patients. The difference between systemic and local eosinophilia in relation to disease control is poorly understood.
To explore whether blood and polyp tissue eosinophil numbers are independent risk factors for poor disease control in patients with nasal polyp.
By using the electronic medical records database and manual evaluation, 183 nasal polyp patients who had undergone endoscopic sinus surgery at least one year prior to the study with complete data of tissue specimens, baseline blood routine test, nasal endoscopy and sinus computed tomography, were identified and recruited to assess disease control based on the criteria of a European position paper on rhinosinusitis and nasal polyps 2012 (EPOS 2012). Multiple logistic regression model was used to determine the association between blood and tissue eosinophil numbers and risk of poor disease control by adjusting for demographics and comorbidities.
We broke down the cohort into 4 groups according to blood (0.3 × 10/L) and tissue (10%) eosinophils. The patients without eosinophilic inflammation represented the largest group (41.5%). The group with concordant blood and tissue eosinophilia represented the second largest (31.2%), and the patients with isolated tissue (15.3%) or blood (12.0%) eosinophilia were relatively rare. Multiple logistic regression models found blood eosinophil count and tissue eosinophil percentage were independently associated with increased risk for poor disease control after adjustments for covariates related to poor treatment outcome. Furthermore, subjects with concordant blood and tissue eosinophilia had a higher risk for poor disease control than those with isolated blood or tissue eosinophilia.
Concordant blood and tissue eosinophilia relates to a higher likelihood of poor disease control than isolated blood or tissue eosinophilia after adjustment of potential confounders in nasal polyp patients.
嗜酸性粒细胞炎症是鼻息肉患者疾病控制不佳的主要表型。关于全身和局部嗜酸性粒细胞增多与疾病控制之间的差异，目前了解甚少。
探讨血液和息肉组织中的嗜酸性粒细胞数量是否是鼻息肉患者疾病控制不佳的独立危险因素。
通过使用电子病历数据库并进行人工评估，确定并招募了183例在研究前至少一年接受过鼻内镜鼻窦手术的鼻息肉患者，这些患者具有组织标本、基线血常规检查、鼻内镜检查和鼻窦计算机断层扫描的完整数据，并根据2012年欧洲鼻窦炎和鼻息肉立场文件（EPOS 2012）的标准评估疾病控制情况。采用多因素logistic回归模型，通过调整人口统计学和合并症因素，确定血液和组织嗜酸性粒细胞数量与疾病控制不佳风险之间的关联。
我们根据血液（0.3×10⁹/L）和组织（10%）嗜酸性粒细胞将队列分为4组。无嗜酸性粒细胞炎症的患者组人数最多（41.5%）。血液和组织嗜酸性粒细胞增多一致的组人数第二多（31.2%），孤立的组织（15.3%）或血液（12.0%）嗜酸性粒细胞增多的患者相对较少。多因素logistic回归模型发现，在调整与治疗效果不佳相关的协变量后，血液嗜酸性粒细胞计数和组织嗜酸性粒细胞百分比与疾病控制不佳风险增加独立相关。此外，血液和组织嗜酸性粒细胞增多一致的受试者比孤立的血液或组织嗜酸性粒细胞增多的受试者疾病控制不佳的风险更高。
在调整鼻息肉患者的潜在混杂因素后，血液和组织嗜酸性粒细胞增多一致比孤立的血液或组织嗜酸性粒细胞增多更易导致疾病控制不佳。
