Kong Weifeng, Wu Qingwu, Chen Yubin, Ren Yong, Wang Weihao, Zheng Rui, Deng Huiyi, Yuan Tian, Qiu Huijun, Wang Xinyue, Luo Xin, Huang Xuekun, Yang Qintai, Zhang Gehua, Zhang Yana
Department of Otolaryngology-Head and Neck Surgery, the Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, People's Republic of China.
Guangdong Provincial Key Laboratory of Digestive Cancer Research, the Seventh Affiliated Hospital of Sun Yat-Sen University, Shenzhen, People's Republic of China.
J Asthma Allergy. 2022 Mar 15;15:341-352. doi: 10.2147/JAA.S350837. eCollection 2022.
Histopathologic characterizations of central compartment atopic disease (CCAD) by whole-slide imaging remains lacking. We aim to study clinical presentations and cellular endotyping diagnosis of Chinese CCAD using artificial intelligence (AI).
A total of 72 patients diagnosed with chronic rhinosinusitis with nasal polyps (CRSwNP) were enrolled. CCAD was defined by positive result of serology specific IgE, endoscopic and radiological findings. The aeroallergen sensitization status, endoscopic results, radiological findings, and symptoms were evaluated and compared between patients with CCAD (n=14), eosinophilic CRSwNP (ENP, n=32) and non-eosinophilic CRSwNP (NENP, n=26). The cellular endotypes including eosinophils, neutrophils, lymphocytes, and plasma cells were analyzed by the AI chronic rhinosinusitis evaluation platform 2.0.
CCAD was most common in male (71.43%). The positive rate of aeroallergen in patients with CCAD is 100%, which is much higher than those in patients with ENP (40.63%) and NENP (23.08%). Allergic rhinitis incidence was found to be 57.14% in Chinese CCAD subjects, which is obviously higher when compared with those in patients with ENP (21.88%) or NENP (0.00%). The presence of asthma was not significantly different between groups. Chinese CCAD population demonstrated mild symptoms and lower endoscopic and radiological scores than those in patients with ENP and NENP. For cellular endotypes in CCAD subjects, the median of eosinophils, neutrophils, lymphocytes, and plasma cells was 26.55%, 0.49%, 60.85%, and 7.33%, respectively. The proportion of eosinophils in nasal tissue and peripheral blood mononuclear cells from the CCAD group is between the proportions in those patients with ENP and NENP.
Chinese CCAD was associated with aeroallergen sensitivity, and displayed an eosinophil-dominant inflammatory pattern. Thus, proper management with allergy control and topical steroids could be recommended for CCAD treatment.
通过全切片成像对中央区特应性疾病（CCAD）进行组织病理学特征描述的研究仍较为缺乏。我们旨在利用人工智能（AI）研究中国CCAD的临床表现和细胞内型诊断。
共纳入72例诊断为慢性鼻窦炎伴鼻息肉（CRSwNP）的患者。CCAD通过血清特异性IgE、内镜和影像学检查结果阳性来定义。对CCAD患者（n = 14）、嗜酸性粒细胞性CRSwNP（ENP，n = 32）和非嗜酸性粒细胞性CRSwNP（NENP，n = 26）患者的气传变应原致敏状态、内镜检查结果、影像学检查结果和症状进行评估和比较。通过AI慢性鼻窦炎评估平台2.0分析包括嗜酸性粒细胞、中性粒细胞、淋巴细胞和浆细胞在内的细胞内型。
CCAD在男性中最为常见（71.43%）。CCAD患者的气传变应原阳性率为100%，远高于ENP患者（40.63%）和NENP患者（23.08%）。在中国CCAD患者中，变应性鼻炎的发病率为57.14%，与ENP患者（21.88%）或NENP患者（0.00%）相比明显更高。各组间哮喘的发生率无显著差异。中国CCAD患者群体表现出的症状较轻，内镜和影像学评分低于ENP和NENP患者。对于CCAD患者的细胞内型，嗜酸性粒细胞、中性粒细胞、淋巴细胞和浆细胞的中位数分别为26.55%、0.49%、60.85%和7.33%。CCAD组鼻组织和外周血单个核细胞中嗜酸性粒细胞的比例介于ENP和NENP患者之间。
中国CCAD与气传变应原敏感性相关，并表现出以嗜酸性粒细胞为主的炎症模式。因此，对于CCAD的治疗，建议采取适当的变应性疾病控制措施和局部使用类固醇药物。
