Department of Otolaryngology, Head and Neck Surgery, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan.
Department of Otolaryngology, Head and Neck Surgery, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan; Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
Rhinology. 2024 Feb 1;62(1):111-118. doi: 10.4193/Rhin23.170.
Serum eosinophil cationic protein (ECP) levels affect the surgical outcome of chronic rhinosinusitis (CRS) with nasal polyps. Primary CRS can be classified into type 2 (T2) and non-T2. We aimed to differentiate the role of serum ECP levels in surgical outcomes between the distinct endotypes of primary CRS.
We prospectively enrolled patients with bilateral primary CRS who underwent surgical treatment with postoperative follow-up for at least 12 months. Endotyping and serum parameter measurements were completed within 1 week before surgery.
In total, 113 patients were enrolled, including 65 with T2 CRS and 48 with non-T2 CRS. Patients in the T2 CRS group with uncontrolled CRS had significantly higher serum ECP levels than those in patients in the non-T2 CRS group. An optimal cut-off value was obtained at 17.0 μg/L using the receiver operating characteristic curve, attaining a sensitivity of 91.7% and specificity of 56.6%. Multivariate logistic regression analysis showed that a higher serum ECP level was an independent factor for postoperative uncontrolled disease. The hazard ratio was 11.3 for the T2 group, with serum ECP levels over 17.0 μg/L. In the non-T2 group, no parameters were significantly correlated with postoperative uncontrolled CRS.
Serum ECP levels appear to be a feasible predictor of postoperative uncontrolled disease in patients with T2 CRS as preoperative serum ECP levels >17.0 μg/L in these patients have an approximately 16.7-fold increased risk of postoperative uncontrolled disease and should be closely monitored.
血清嗜酸性粒细胞阳离子蛋白 (ECP) 水平影响鼻息肉慢性鼻-鼻窦炎 (CRSwNP) 的手术结果。原发性 CRS 可分为 2 型 (T2) 和非 T2 型。我们旨在区分血清 ECP 水平在原发性 CRS 不同表型的手术结果中的作用。
我们前瞻性招募了双侧原发性 CRS 患者，这些患者接受了手术治疗，并在术后至少随访 12 个月。在手术前 1 周内完成表型分型和血清参数测量。
共纳入 113 例患者，其中 T2 CRS 患者 65 例，非 T2 CRS 患者 48 例。未控制的 CRS 患者的 T2 CRS 组的血清 ECP 水平明显高于非 T2 CRS 组。使用受试者工作特征曲线获得最佳截断值为 17.0 μg/L，其灵敏度为 91.7%，特异性为 56.6%。多变量逻辑回归分析表明，较高的血清 ECP 水平是非 T2 组术后疾病未得到控制的独立因素。T2 组的危险比为 11.3，血清 ECP 水平超过 17.0 μg/L。在非 T2 组，没有参数与术后未控制的 CRS 显著相关。
血清 ECP 水平似乎是 T2 CRS 患者术后未控制疾病的一个可行预测指标，因为这些患者术前血清 ECP 水平 >17.0 μg/L 时，术后未控制疾病的风险增加约 16.7 倍，应密切监测。
