Department of Otolaryngology-Head and Neck Surgery, Renmin Hospital of Wuhan University, Wuhan, China.
Research Institute of Otolaryngology-Head and Neck Surgery, Renmin Hospital of Wuhan University, Wuhan, China.
Int Arch Allergy Immunol. 2020;181(11):853-861. doi: 10.1159/000509211. Epub 2020 Jul 20.
A hallmark of eosinophilic chronic rhinosinusitis with nasal polyps (eCRSwNP) is mucosal eosinophil-predominant inflammation. Nasal nitric oxide (nNO) is a known biomarker of eosinophilic inflammation in the upper airway. However, the utility of nNO measurement in the upper airway remains controversial. The present study aimed to compare the use of other clinical parameters with nNO to prediagnose patients with eCRSwNP from Central China.
From June 2019 to December 2019, 70 patients with CRSwNP undergoing endoscopic sinus surgery and 30 healthy subjects were enrolled. nNO measurements were performed in all of these subjects. Computed tomography scans, full blood count with differential analysis, and determination of total immunoglobulin E (total IgE) and plasma cytokines were performed before surgery. Receiver operating characteristic curves and logistic regression analysis were used to assess the predictive potential of the clinical parameters.
We recruited 24 patients with eCRSwNP and 46 with noneosinophilic CRSwNP (non-eCRSwNP). In patients with eCRSwNP, nNO levels were significantly higher than those in patients with non-eCRSwNP (p < 0.0001). Blood eosinophil percentages and counts, total IgE, and CT-derived ethmoid sinus and maxillary sinus ratio (E/M ratio) were all significantly higher compared with those in patients with non-eCRSwNP (p < 0.05). To diagnose eCRSwNP, the highest area under the curve (0.803) was determined for nNO. At a cutoff of >329 parts per billion (ppb), the sensitivity was 83.30% and the specificity was 71.70%. However, the levels of plasma cytokines Th1/Th2 were not significantly different between the histological types of CRSwNP (p > 0.05).
Measurement of nNO is useful for the early diagnosis of eCRSwNP.
伴有鼻息肉的嗜酸性慢性鼻-鼻窦炎（eCRSwNP）的一个标志是鼻黏膜嗜酸性粒细胞占优势的炎症。鼻一氧化氮（nNO）是上呼吸道嗜酸性粒细胞炎症的已知生物标志物。然而，nNO 测量在上呼吸道的应用仍然存在争议。本研究旨在比较其他临床参数与 nNO 在预测来自中国中部的 eCRSwNP 患者方面的作用。
从 2019 年 6 月至 2019 年 12 月，对 70 例接受内镜鼻窦手术的 CRSwNP 患者和 30 例健康受试者进行了研究。对所有受试者均进行了 nNO 测量。所有患者均在术前进行了计算机断层扫描、全血细胞计数和分类分析，以及总免疫球蛋白 E（total IgE）和血浆细胞因子的测定。采用受试者工作特征曲线和逻辑回归分析评估临床参数的预测潜力。
我们共招募了 24 例 eCRSwNP 患者和 46 例非嗜酸性 CRSwNP（非-eCRSwNP）患者。eCRSwNP 患者的 nNO 水平明显高于非-eCRSwNP 患者（p<0.0001）。与非-eCRSwNP 患者相比，eCRSwNP 患者的血嗜酸性粒细胞百分比和计数、总 IgE 以及 CT 衍生的筛窦和上颌窦比值（E/M 比值）均明显更高（p<0.05）。为诊断 eCRSwNP，nNO 的曲线下面积最高（0.803）。当截断值>329 部分/十亿（ppb）时，灵敏度为 83.30%，特异性为 71.70%。然而，CRSwNP 组织学类型之间的血浆细胞因子 Th1/Th2 水平没有显著差异（p>0.05）。
nNO 的测量对 eCRSwNP 的早期诊断有用。
