Department of Otorhinolaryngology, University of Insubria and ASST Sette Laghi, Varese, Italy.
Department of Biotechnology and Life Sciences, University of Insubria, Varese, Italy.
Acta Otorhinolaryngol Ital. 2020 Oct;40(5):368-376. doi: 10.14639/0392-100X-N0711.
Characterising the eosinophilic profile represents the main step in chronic rhinosinusitis (CRS) endotyping. The aim of the study is to verify the correlation between different methods for tissue eosinophilia quantification.
33 CRS patients undergoing endoscopic sinus surgery and 30 controls undergoing non-CRS surgeries were enrolled. Blood venous sampling, nasal biopsy on uncinate process (UP), nasal cytology on inferior turbinate (IT) and middle meatus (MM) were performed.
Differences in eosinophil count in blood (P=0.0001), UP (P#x003C;0.0001), IT (P = 0.01) and MM (P = 0.0006) were significant between CRS cases and controls. A weak correlation was found between UP and blood eosinophil count (r = 0.34, P = 0.006) and between UP and IT eosinophil count (r = 0.30, P = 0.017). Moderate correlation between UP and MM (r = 0.51, P #x003C; 0.0001) was shown. ROC analysis predicted eosinophilic CRS with an overall low sensitivity. Once allergic patients were excluded from the analysis, the sensitivity decreased for sampling on IT and increased for MM sampling.
This study suggests that MM cytology gives more accurate information on the degree of tissue eosinophilia. Replication in wide and unbiased cohorts is necessary to verify these results and define accurate thresholds.
描述嗜酸性粒细胞表型是慢性鼻-鼻窦炎（CRS）分型的主要步骤。本研究旨在验证组织嗜酸性粒细胞定量的不同方法之间的相关性。
纳入 33 例接受鼻内镜鼻窦手术的 CRS 患者和 30 例接受非 CRS 手术的对照者。对钩突（UP）进行鼻组织活检，对下鼻甲（IT）和中鼻甲（MM）进行鼻细胞学检查，同时采集静脉血样。
CRS 病例与对照组之间血液（P=0.0001）、UP（P#x003C;0.0001）、IT（P = 0.01）和 MM（P = 0.0006）中的嗜酸性粒细胞计数存在显著差异。UP 与血液嗜酸性粒细胞计数（r = 0.34，P = 0.006）和 UP 与 IT 嗜酸性粒细胞计数（r = 0.30，P = 0.017）之间存在弱相关性。UP 与 MM 之间存在中度相关性（r = 0.51，P #x003C; 0.0001）。ROC 分析预测嗜酸性粒细胞性 CRS 的总体敏感性较低。一旦从分析中排除过敏患者，IT 采样的敏感性降低，而 MM 采样的敏感性增加。
本研究表明 MM 细胞学可提供更准确的组织嗜酸性粒细胞程度信息。需要在广泛且无偏倚的队列中进行复制，以验证这些结果并定义准确的阈值。
