Li Handa, Xi Yang, Chen Jin, Chen Jianjun, Deng Yuqin, Tao Zezhang
Department of Otolaryngology Head and Neck Surgery,Renmin Hospital of Wuhan University,Wuhan,430060,China.
Department of Otolaryngology Head and Neck Surgery,Union Hospital of Tongji Medical College,Huazhong University of Science and Technology.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2022 Jun;36(6):407-413. doi: 10.13201/j.issn.2096-7993.2022.06.001.
To explore the diagnostic value of a novel test paper, which detect eosinophil cationic protein(ECP) of nasal secretion in allergic rhinitis(AR). Nasal secretion and serum samples from 107 patients with allergic rhinitis(AR group) and 40 healthy volunteers(control group) were selected. The nasal symptoms were also evaluated in AR group. The degree of ECP coloration was evaluated by nasal secretion eosinophil cationic protein-myeloperoxid(ECP-MPO) test paper, and the concentration of ECP in nasal secretion and the concentration of cytokines in serum were detected at the same time. The difference and correlation among these indexes were analyzed. The best cutoff value and test efficiency of ECP chromogenic grade and concentration of nasal secretion were calculated by receiver operating characteristic curve(ROC). The concentration of ECP in nasal secretion of AR patients was significantly higher than that of healthy controls(<0.05). The color grade of nasal secretion detected by the test paper was positively correlated with the concentration of ECP in nasal secretion(<0.05), and there was significant difference among different grades(<0.05). There was a satisfying symmetry between the ECP color grade of nasal secretion and the serum specific IgE(sIgE) level as well as a high diagnostic consistency between them(<0.05). The area under the curve(AUC) of ECP concentration ROC in nasal secretion was 0.807 2, corresponding to 64% sensitivity and 85% specificity when the cutoff value was set at 0.980 5; when the cutoff value was set at 1, the AUC of nasal secretion ECP color grading was 0.941 9, corresponding to 92% sensitivity and 94% specificity. No clear correlation between the concentration of ECP in nasal secretion and serum cytokines was found(>0.05). The results of this novel test paper is in good agreement with those of serological allergens. It could serve as a preliminary test to evaluate the severity of allergy with satisfactory sensitivity and specificity, and is especially suitable in clinical practice for primary hospital.
为探讨一种新型检测试纸检测变应性鼻炎(AR)鼻分泌物中嗜酸性粒细胞阳离子蛋白(ECP)的诊断价值。选取107例变应性鼻炎患者(AR组)和40例健康志愿者(对照组)的鼻分泌物及血清样本。对AR组患者的鼻部症状也进行了评估。采用鼻分泌物嗜酸性粒细胞阳离子蛋白-髓过氧化物酶(ECP-MPO)试纸评估ECP显色程度,同时检测鼻分泌物中ECP浓度及血清中细胞因子浓度。分析这些指标之间的差异及相关性。通过受试者工作特征曲线(ROC)计算ECP显色分级及鼻分泌物浓度的最佳截断值和检测效能。AR患者鼻分泌物中ECP浓度显著高于健康对照(<0.05)。试纸检测的鼻分泌物颜色分级与鼻分泌物中ECP浓度呈正相关(<0.05),不同分级之间差异有统计学意义(<0.05)。鼻分泌物ECP颜色分级与血清特异性IgE(sIgE)水平之间具有良好的对称性,且二者诊断一致性较高(<0.05)。鼻分泌物中ECP浓度ROC曲线下面积(AUC)为0.807 2,当截断值设定为0.980 5时,灵敏度为64%,特异度为85%;当截断值设定为1时,鼻分泌物ECP颜色分级的AUC为0.941 9,灵敏度为92%,特异度为94%。未发现鼻分泌物中ECP浓度与血清细胞因子之间存在明显相关性(>0.05)。这种新型试纸的检测结果与血清学过敏原检测结果高度一致。它可作为一种初步检测方法,以令人满意的灵敏度和特异度评估过敏严重程度,尤其适用于基层医院的临床实践。