Department of Otolaryngology-Head and Neck Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, Minnesota.
Am J Rhinol Allergy. 2024 Jul;38(4):264-271. doi: 10.1177/19458924241251387. Epub 2024 Apr 28.
The primary aim of this study was to assess disparities in nasal nitric oxide (NO) levels between individuals diagnosed with eosinophilic chronic rhinosinusitis (ECRS) and those without ECRS. The second aim was to ascertain the comparative predictive efficacy of these nasal NO levels for the presence of ECRS.
A systematic analysis was conducted on relevant studies that compared nasal NO levels in individuals with ECRS and those without. Furthermore, the discriminatory capacity of nasal NO in distinguishing ECRS from non-ECRS cohorts was quantified. The risk of bias across studies was evaluated utilizing the Newcastle-Ottawa scale.
The comprehensive review encompassed a total of 5 studies involving 470 participants. Findings revealed that patients diagnosed with ECRS exhibited significantly higher levels of nasal NO, as measured in parts per billion (ppb), compared to their non-ECRS patients. The mean difference was 130.03 ppb (95% confidence interval: [66.30, 193.75], I2 = 58.7%). The diagnostic odds ratio for nasal NO in identifying ECRS was 9.29 ([5.85, 14.75], I2 = 26.4%). The area under the summary receiver operating characteristic curve was 0.82. The correlation between sensitivity and false positive rate was 0.53, suggesting a lack of heterogeneity. Sensitivity, specificity, negative predictive value, and positive predictive value were 69% ([0.55, 0.79], I2= 77.0%), 83% ([0.73, 0.90], I = 68.5%), 77% ([0.69, 0.83], I= 50.1%), and 75% ([0.67, 0.82], I= 41.5%), respectively.
Nasal NO has the potential as a noninvasive diagnostic measure and endotype tool for ECRS.
本研究的主要目的是评估诊断为嗜酸细胞性慢性鼻-鼻窦炎（ECRS）的个体与无 ECRS 的个体之间鼻一氧化氮（NO）水平的差异。第二个目的是确定这些鼻 NO 水平对 ECRS 存在的比较预测效能。
对比较 ECRS 患者和非 ECRS 患者鼻 NO 水平的相关研究进行系统分析。此外，还量化了鼻 NO 区分 ECRS 与非 ECRS 队列的区分能力。使用纽卡斯尔-渥太华量表评估研究的偏倚风险。
综合评价共纳入 5 项研究，共计 470 名参与者。研究结果表明，与非 ECRS 患者相比，诊断为 ECRS 的患者的鼻 NO 水平明显更高，以十亿分之几（ppb）表示。平均差异为 130.03 ppb（95%置信区间：[66.30, 193.75]，I2=58.7%）。鼻 NO 对识别 ECRS 的诊断优势比为 9.29（[5.85, 14.75]，I2=26.4%）。综合受试者工作特征曲线下面积为 0.82。敏感性与假阳性率之间的相关性为 0.53，表明异质性低。敏感性、特异性、阴性预测值和阳性预测值分别为 69%（[0.55, 0.79]，I2=77.0%）、83%（[0.73, 0.90]，I=68.5%）、77%（[0.69, 0.83]，I=50.1%）和 75%（[0.67, 0.82]，I=41.5%）。
鼻 NO 具有作为 ECRS 的非侵入性诊断手段和表型工具的潜力。
