Department of Otolaryngology, Shantou Central Hospital, Shantou, China.
Department of Otolaryngology, The Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen, China.
Ear Nose Throat J. 2024 Jun;103(6):NP331-NP339. doi: 10.1177/01455613211051311. Epub 2021 Nov 23.
Our previous study revealed that serum amyloid A (SAA) levels in polyp tissues could serve as a biomarker for the prediction of corticosteroid insensitivity in patients with chronic rhinosinusitis with nasal polyps (CRSwNP). However, their association with disease control status in the patients after endoscopic sinus surgery remains to be assessed.
Polyp tissues and control uncinate process mucosa were collected from 48 patients with CRSwNP and 10 healthy control subjects. SAA expression was examined using immunohistochemistry and enzyme-linked immunosorbent assay. Receiver operating characteristic (ROC) curves were performed to determine the predictive value of SAA in nasal polyps. The clinical characteristics of 2 CRSwNP subtypes (SAA and SAA) were evaluated.
The SAA expression levels in polyp tissues were significantly elevated both in non-eosinophilic and eosinophilic CRSwNP as compared to the healthy controls. In patients with CRSwNP, the tissue SAA level was significantly higher in the disease-controlled patients than those of the partly controlled and uncontrolled. ROC curve analysis revealed that a cut-off value of 114.9 ng/mL for the tissue SAA level predicted the patients with disease-controlled status with 93.33% sensitivity and 63.64% specificity (AUC = .8727, < .001). Furthermore, The SAA subgroup showed higher tissue eosinophil numbers and percentage of the disease-controlled patients compared to the SAA subgroup.
Our findings suggest that measurements of SAA in polyp tissues may provide useful information for evaluating CRSwNP conditions, especially identifying the CRSwNP patients with disease-controlled status after endoscopic sinus surgery.
我们之前的研究表明，鼻息肉组织中的血清淀粉样蛋白 A（SAA）水平可以作为预测慢性鼻-鼻窦炎伴鼻息肉（CRSwNP）患者对皮质类固醇不敏感的生物标志物。然而，它们与内镜鼻窦手术后患者疾病控制状态的相关性仍有待评估。
收集 48 例 CRSwNP 患者和 10 例健康对照者的息肉组织和对照钩突黏膜。采用免疫组织化学和酶联免疫吸附试验检测 SAA 表达。绘制受试者工作特征（ROC）曲线，以确定 SAA 在鼻息肉中的预测价值。评估 2 种 CRSwNP 亚型（SAA 和 SAA）的临床特征。
与健康对照组相比，非嗜酸性和嗜酸性 CRSwNP 患者的息肉组织中 SAA 表达水平均显著升高。在 CRSwNP 患者中，疾病控制患者的组织 SAA 水平明显高于部分控制和未控制患者。ROC 曲线分析显示，组织 SAA 水平的截断值为 114.9ng/ml 时，预测疾病控制状态的敏感性为 93.33%，特异性为 63.64%（AUC=0.8727，<0.001）。此外，SAA 亚组中疾病控制患者的组织嗜酸性粒细胞数和百分比均高于 SAA 亚组。
我们的研究结果表明，测量鼻息肉组织中的 SAA 可能为评估 CRSwNP 提供有用的信息，特别是有助于识别内镜鼻窦手术后疾病控制状态的 CRSwNP 患者。
