Zhang Qing, Li Hui, Xie Di, Fan SiJian
Department of Otolaryngology, YongKang Maternity and Child Health Hospital, Jinhua, Zhejiang, China.
Department of Otolaryngology, Pei County People's Hospital, Xuzhou, Jiangsu, China.
Front Surg. 2025 Jan 13;11:1516981. doi: 10.3389/fsurg.2024.1516981. eCollection 2024.
This study was undertaken to assess the association between the likelihood of surgical recurrence and serum ECP and TIgE levels in chronic rhinosinusitis with nasal polyps (CRSwNP).
Clinical information was gathered retrospectively from 166 cases of surgically treated CRSwNP as well as 60 cases of chronic rhinosinusitis without nasal polyps (CRSsNP). A comparative analysis on serum levels of total immunoglobulin E (TIgE) and eosinophil cationic protein (ECP) was carried out between the two groups. The CRSwNP patients were assigned into recurrence and non-recurrence groups based on the absence/presence of disease recurrence after a 2-year follow-up. An analysis was conducted on the correlation between the patients' clinical data and their serum ECP and TIgE levels. Receiver operating characteristic (ROC) curves were utilized to assess the clinical utility of these two biomarkers.
The CRSwNP participants had higher serum levels of ECP and TIgE (4.28 ± 0.81 > 3.58 ± 0.77 ng/L, < 0.001; 52.99 ± 8.62 > 15.65 ± 3.25 KU/L, < 0.001) compared to CRSsNP participants. Univariate analysis indicated that neutrophil ratio, lymphocyte ratio, Lund-Kennedy score, Lund-Mackay score, SNOT-22 score, olfactory function score, and postoperative recurrence were significantly correlated with serum ECP and TIgE levels. Higher serum levels of TIgE and ECP (4.89 ± 0.79 < 4.11 ± 0.72, < 0.001; 58.74 ± 8.27 < 51.40 ± 8.04, < 0.001) were detected in the recurrence groups vs. the non-recurrence group. Multivariate analysis showed that serum ECP and TIgE were independent risk factors for recurrence of CRSwNP. Serum ECP and TIgE levels were found to be predictive of postoperative recurrence risk in CRSwNP patients (AUC: 0.77, 0.74, 0.84; < 0.05) according to ROC curve analysis. Significant differences were not observed in any general clinical data.
The findings suggest that elevated serum ECP and TIgE levels in patients with CRSwNP can be as good predictors for the risk of recurrence after endoscopic sinus surgery.
本研究旨在评估慢性鼻-鼻窦炎伴鼻息肉（CRSwNP）患者手术复发可能性与血清嗜酸性粒细胞阳离子蛋白（ECP）及总免疫球蛋白E（TIgE）水平之间的关联。
回顾性收集166例接受手术治疗的CRSwNP患者以及60例无鼻息肉的慢性鼻-鼻窦炎（CRSsNP）患者的临床资料。对两组患者的血清总免疫球蛋白E（TIgE）和嗜酸性粒细胞阳离子蛋白（ECP）水平进行比较分析。根据CRSwNP患者2年随访后疾病复发情况，将其分为复发组和未复发组。分析患者临床资料与其血清ECP和TIgE水平之间的相关性。采用受试者工作特征（ROC）曲线评估这两种生物标志物的临床应用价值。
与CRSsNP患者相比，CRSwNP患者血清ECP和TIgE水平更高（4.28±0.81＞3.58±0.77 ng/L，P＜0.001；52.99±8.62＞15.65±3.25 KU/L，P＜0.001）。单因素分析表明，中性粒细胞比例、淋巴细胞比例、Lund-Kennedy评分、Lund-Mackay评分、SNOT-22评分、嗅觉功能评分及术后复发与血清ECP和TIgE水平显著相关。复发组患者血清TIgE和ECP水平高于未复发组（4.89±0.79＜4.11±0.72，P＜0.001；58.74±8.27＜51.40±8.04，P＜0.001）。多因素分析显示，血清ECP和TIgE是CRSwNP复发的独立危险因素。根据ROC曲线分析，血清ECP和TIgE水平可预测CRSwNP患者术后复发风险（AUC：0.77、0.74、0.84；P＜0.05）。在任何一般临床资料方面均未观察到显著差异。
研究结果表明，CRSwNP患者血清ECP和TIgE水平升高可作为内镜鼻窦手术后复发风险的良好预测指标。
