Almaghrabi Amal A, Alnoury Khaled I, Alkhulaifi Ahmed K
Otolaryngology, Security Forces Hospital Program, Makkah, SAU.
Otolaryngology, King Abdulaziz University, Jeddah, SAU.
Cureus. 2023 Oct 5;15(10):e46558. doi: 10.7759/cureus.46558. eCollection 2023 Oct.
This study aims to investigate the significance of eosinophils in the progression and prognosis of destructive non-invasive fungal rhinosinusitis.
This was a retrospective study of 126 patients who were operated on for a nasal sinus disease between 2010 and 2017; of these, 56 met the inclusion criteria These were divided into two groups: (i) Group 1, with only the destructive non-invasive sinus polyposis type, and (ii) Group 2, with all types of nasal polyposis other than the destructive non-invasive sinus fungal polyposis type. Data including demographic data, paranasal sinuses (PNS) CT scans, pre- and post-operative eosinophils count, histopathology of polyps, and fungal cultures were collected from medical records from King Abdulaziz University Hospital, Jeddah, Saudi Arabia. A nonparametric Wilcoxon signed-rank test was used to determine a significant difference of p< 0.05. We performed multivariate analysis using repeated measure analysis of covariance (ANCOVA) and adjusted for confounders such as age, sex, pre- and post-operative IgE, fungal culture, and histopathology of the disease. Interaction between age, sex, IgE, and proportion of eosinophils was assessed at a p-value of 0.05.
A significant difference was found between pre-and post-operative blood eosinophils levels in Group 1 (p= 0.01) after adjusting for confounders such as age, sex, fungal culture, pre and post IgE, and histopathology of the disease. However, no significant difference was found in Group 2 (p= 0.663) even after adjusting for age, sex, fungal culture, pre and post IgE, and histopathology of the disease. We did not find any significant interaction (P>0.05) between pre- and post-operative levels of eosinophils with age, sex, and fungal culture among Group 1 and Group 2.
There is a statistically significant difference in blood eosinophils between pre- and post-operative levels in studied cases of destructive non-invasive fungal polyposis, a difference is not seen in nasal sinus polyp cases other than destructive non-invasive fungal polyposis types. High pre-operative eosinophils levels in destructive non-invasive fungal sinus polyposis types demonstrated the importance of eosinophils in the pathogenesis of this disease. The blood eosinophils can therefore be considered an important factor in the disease process and an indicator of the disease prognosis and destructive behavior.
本研究旨在探讨嗜酸性粒细胞在侵袭性非侵袭性真菌性鼻窦炎的进展和预后中的意义。
这是一项对2010年至2017年间因鼻窦疾病接受手术的126例患者的回顾性研究；其中56例符合纳入标准。这些患者被分为两组：（i）第1组，仅为侵袭性非侵袭性鼻窦息肉型；（ii）第2组，为除侵袭性非侵袭性鼻窦真菌息肉型以外的所有鼻息肉类型。从沙特阿拉伯吉达阿卜杜勒阿齐兹国王大学医院的病历中收集数据，包括人口统计学数据、鼻窦（PNS）CT扫描、术前和术后嗜酸性粒细胞计数、息肉组织病理学以及真菌培养。使用非参数Wilcoxon符号秩检验确定p<0.05的显著差异。我们使用重复测量协方差分析（ANCOVA）进行多变量分析，并对年龄、性别、术前和术后IgE、真菌培养以及疾病组织病理学等混杂因素进行了调整。在p值为0.05时评估年龄、性别、IgE和嗜酸性粒细胞比例之间的相互作用。
在对年龄、性别、真菌培养、术前和术后IgE以及疾病组织病理学等混杂因素进行调整后，第1组术前和术后血液嗜酸性粒细胞水平存在显著差异（p=0.01）。然而，即使在对年龄、性别、真菌培养、术前和术后IgE以及疾病组织病理学进行调整后，第2组也未发现显著差异（p=0.663）。在第1组和第2组中，我们未发现术前和术后嗜酸性粒细胞水平与年龄、性别和真菌培养之间存在任何显著相互作用（P>0.05）。
在侵袭性非侵袭性真菌性息肉病的研究病例中，术前和术后血液嗜酸性粒细胞存在统计学上的显著差异，而在除侵袭性非侵袭性真菌息肉病类型以外的鼻窦息肉病例中未发现差异。侵袭性非侵袭性真菌性鼻窦息肉病类型术前嗜酸性粒细胞水平较高，表明嗜酸性粒细胞在该疾病发病机制中的重要性。因此，血液嗜酸性粒细胞可被视为疾病过程中的一个重要因素以及疾病预后和侵袭性行为的一个指标。
