Department of Otolaryngology-Head and Neck Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China.
Department of Clinical Laboratory, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China.
Rhinology. 2020 Aug 1;58(4):314-322. doi: 10.4193/Rhin19.275.
Chronic rhinosinusitis with nasal polyps (CRSwNP) is a heterogeneous disease with different clinical characteristics and different treatment responsiveness. The aims of this study were to compare the nasal fluid cytology and cytokines between eosinophilic CRSwNP (eCRSwNP) and non-eosinophilic CRSwNP (neCRSwNP) and establish a new multivariate model to predict eCRSwNP before surgery to improve personalized treatment for CRSwNP patients.
Eighty-six consecutive patients with CRSwNP and sixteen healthy controls were recruited in this study. Nasal fluid (NF) was collected from all subjects and nasal polyp tissue was collected during the surgery. The differential cell counts and concentrations of IL-6, IL-8, TNF-77; and IL-10 in NF were measured. Univariate and multivariate logistic regression were used to identify predictors for eCRSwNP.
There were more inflammatory cells in NF of CRSwNP than controls. The eosinophil percentage was significantly higher in eCRSwNP than neCRSwNP and controls. The level of IL-8 was significantly higher in neCRSwNP than in eCRSwNP and controls. Blood eosinophilia, nasal fluid eosinophilia, higher total ethmoid score / total maxillary score (E/M ratio) and higher visual analogue scale (VAS) score of CRS were associated with eCRSwNP, the area under receiver operating characteristic curve (AUC) was 0.800, 0.755, 0.703 and 0.648, respectively. Using the coefficients of multivariate regression, we set up a scoring system to predict eCRSwNP with three of the variates and the AUC was 0.883.
ECRSwNP, neCRSwNP and healthy controls demonstrated different cytology and cytokine profiles in NF. A new preoperational multivariate prediction model for eCRSwNP with NF eosinophilia, blood eosinophilia and higher E/M ratio was established.
伴有鼻息肉的慢性鼻-鼻窦炎（CRSwNP）是一种具有不同临床特征和不同治疗反应的异质性疾病。本研究旨在比较嗜酸性粒细胞性 CRSwNP（eCRSwNP）和非嗜酸性粒细胞性 CRSwNP（neCRSwNP）之间的鼻分泌物细胞学和细胞因子，并建立一个新的多元模型来预测术前 eCRSwNP，以改善 CRSwNP 患者的个体化治疗。
本研究纳入了 86 例连续的 CRSwNP 患者和 16 名健康对照者。所有受试者均采集鼻分泌物（NF），并在手术中采集鼻息肉组织。测量 NF 中的白细胞分类计数和细胞因子 IL-6、IL-8、TNF-α 和 IL-10 的浓度。采用单变量和多变量逻辑回归分析来识别预测 eCRSwNP 的因素。
CRSwNP 患者的 NF 中炎症细胞数量多于对照组。eCRSwNP 患者的嗜酸性粒细胞百分比明显高于 neCRSwNP 患者和对照组。neCRSwNP 患者的 IL-8 水平明显高于 eCRSwNP 患者和对照组。血液嗜酸性粒细胞增多、NF 嗜酸性粒细胞增多、总筛窦评分/总上颌窦评分（E/M 比值）较高和慢性鼻-鼻窦炎患者视觉模拟量表（VAS）评分较高与 eCRSwNP 相关，其受试者工作特征曲线（ROC）下面积（AUC）分别为 0.800、0.755、0.703 和 0.648。使用多元回归分析的系数，我们建立了一个预测 eCRSwNP 的评分系统，该系统使用三个变量，AUC 为 0.883。
NF 中 eCRSwNP、neCRSwNP 和健康对照组的细胞学和细胞因子特征不同。建立了一个新的术前多元预测模型，使用 NF 嗜酸性粒细胞、血液嗜酸性粒细胞和较高的 E/M 比值预测 eCRSwNP。
