Department of Otolaryngology-Head and Neck Surgery, Renmin Hospital of Wuhan University, 238 Jiefang Rd., Wuhan, 430060, China.
Research Institute of Otolaryngology-Head and Neck Surgery, Renmin Hospital of Wuhan University, Wuhan, China.
Eur Arch Otorhinolaryngol. 2023 Aug;280(8):3707-3720. doi: 10.1007/s00405-023-07903-3. Epub 2023 Mar 20.
To explore associations between inflammatory endotypes and clinical presentations in CRS. To investigate the value of secretions myeloperoxidase (MPO) and eosinophilic cationic protein (ECP) detections in the diagnosis of endotypes of chronic rhinosinusitis (CRS), so as to provide guidance for the clinical application of MPO and ECP detection in secretions.
We collected clinical symptom scores from patients with CRS and examined the differences between endotypes in clinical features. Patients' nasal secretions and polyps (or middle turbinate for control) were collected and their NEU number, EOS%, MPO and ECP levels were measured. Correlation analysis was performed for these biomarkers in secretions and tissues, respectively. Receiver operating characteristic curves were used to assess the predictive potential of the biomarkers mentioned above in nasal secretions.
Patients with Eos+Neu+ and Eos+Neu-CRS scored highest in most clinical symptom scores, while Eos-Neu+ and Eos-Neu-CRS scored lowest. Correlation analysis showed that tissues NEU number was correlated with NEU number and MPO level in nasal secretions (R = 0.4088; 0.6613); tissues EOS % was correlated with EOS% and ECP level in nasal secretions (R = 0.2344; 0.5774). To diagnose Neu+CRS, the highest area under the curve (AUC) (0.8961) was determined for MPO in secretions; the highest AUC (0.7400) was determined for NEU number in secretions. To diagnose Eos+Neu-CRS from Eos-Neu-CRS in Neu-CRS, the highest AUC (0.8801) was determined for ECP in secretions.
Clinical presentations are directly associated with CRS endotypes. Measurement of MPO and ECP in nasal secretions is useful for the endotypes diagnosis of CRS.
探讨 CRS 中炎症表型与临床特征的相关性。研究分泌物髓过氧化物酶（MPO）和嗜酸性阳离子蛋白（ECP）检测在慢性鼻-鼻窦炎（CRS）表型诊断中的价值，为 MPO 和 ECP 检测在分泌物中的临床应用提供指导。
收集 CRS 患者的临床症状评分，并比较不同表型的临床特征差异。采集患者的鼻腔分泌物和息肉（或中鼻甲作为对照），检测中性粒细胞（NEU）计数、EOS%、MPO 和 ECP 水平。分别对这些生物标志物在分泌物和组织中的相关性进行分析。采用受试者工作特征曲线（ROC）评估上述生物标志物在鼻腔分泌物中的预测潜力。
Eos+Neu+和 Eos+Neu-CRS 患者的大多数临床症状评分最高，而 Eos-Neu+和 Eos-Neu-CRS 患者的评分最低。相关性分析显示，组织 NEU 计数与分泌物中的 NEU 计数和 MPO 水平呈正相关（R=0.4088；0.6613）；组织 EOS%与分泌物中的 EOS%和 ECP 水平呈正相关（R=0.2344；0.5774）。诊断 Neu+CRS 时，分泌物中 MPO 的曲线下面积（AUC）最高（0.8961）；诊断 Neu-CRS 中的 Eos+Neu-CRS 时，分泌物中 NEU 计数的 AUC 最高（0.7400）。
临床表型与 CRS 表型直接相关。测量分泌物中的 MPO 和 ECP 有助于 CRS 表型的诊断。
