Wu Pei-Wen, Huang Chi-Che, Chang Po-Hung, Lee Ta-Jen, Fan Yu-Hsi, Huang Chien-Chia
Division of Rhinology, Department of Otolaryngology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan.
School of Medicine, Chang Gung University, Taoyuan, Taiwan.
Laryngoscope. 2025 Apr;135(4):1326-1334. doi: 10.1002/lary.31899. Epub 2024 Nov 27.
Severe type 2 eosinophilic chronic rhinosinusitis with nasal polyps (CRSwNP) is challenging to treat and susceptible to recurrence post-surgery. This study aimed to evaluate the relationship between clinical markers and tissue type 2 inflammatory severity in patients with CRSwNP.
Adult patients who underwent endoscopic sinus surgery for bilateral CRSwNP were prospectively enrolled. Tissue eosinophil count (TEC) was evaluated. Expression levels of type 2 cytokines, including IL-5 and IL-13, in nasal polyps were determined using real-time PCR. Correlations between clinical markers and tissue type 2 inflammation were also assessed.
In total, 150 participants were recruited. Ninety-five (63.3%) exhibited type 2 eosinophilic CRSwNP defined by TEC ≥10/high power field. Weak to moderate correlations were observed between clinical and tissue markers of type 2 inflammation. Among the clinical markers, blood eosinophil count (BEC) exhibited the highest correlation with tissue type 2 inflammatory severity, as determined by TEC, IL-5, and IL-13 expression levels in nasal polyps. Comorbid asthma, nonsmoking status, ethmoid/maxillary sinuses (E/M) ratio, and BEC were significant predictors of eosinophilic CRSwNP in the regression analysis.
BEC, a dominant clinical marker, exhibits the highest correlation with tissue type 2 inflammatory severity, as determined by TEC, IL-5, and IL-13 in nasal polyps. Comorbid asthma, nonsmoking status, E/M ratio, and BEC were significant predictors of eosinophilic CRSwNP. This could help clinicians better evaluate the severity of type 2 inflammation in patients with CRSwNP and provide optimal therapeutic strategies.
4 Laryngoscope, 135:1326-1334, 2025.
重度2型嗜酸性粒细胞性慢性鼻-鼻窦炎伴鼻息肉（CRSwNP）治疗具有挑战性，术后易复发。本研究旨在评估CRSwNP患者临床指标与组织2型炎症严重程度之间的关系。
前瞻性纳入因双侧CRSwNP接受鼻内镜鼻窦手术的成年患者。评估组织嗜酸性粒细胞计数（TEC）。采用实时聚合酶链反应测定鼻息肉中2型细胞因子（包括白细胞介素-5和白细胞介素-13）的表达水平。还评估了临床指标与组织2型炎症之间的相关性。
共招募了150名参与者。95名（63.3%）表现为TEC≥10/高倍视野定义的2型嗜酸性粒细胞性CRSwNP。2型炎症的临床指标与组织指标之间观察到弱至中度相关性。在临床指标中，血液嗜酸性粒细胞计数（BEC）与组织2型炎症严重程度的相关性最高，这由鼻息肉中的TEC、白细胞介素-5和白细胞介素-13表达水平确定。在回归分析中，合并哮喘、非吸烟状态、筛窦/上颌窦（E/M）比值和BEC是嗜酸性粒细胞性CRSwNP的显著预测因素。
BEC作为主要临床指标，与鼻息肉中TEC、白细胞介素-5和白细胞介素-13所确定的组织2型炎症严重程度的相关性最高。合并哮喘、非吸烟状态、E/M比值和BEC是嗜酸性粒细胞性CRSwNP的显著预测因素。这有助于临床医生更好地评估CRSwNP患者2型炎症的严重程度，并提供最佳治疗策略。
4《喉镜》，135:1326 - 1334，2025年。
