Tănase Mihai I, Cosgarea Marcel, Hendea Raluca Maria, Ujvary Peter L, Dindelegan Maximilian, Radeanu Gheorghe Doinel, Maniu Alma A, Stan Constantin
Department of ENT, "Iuliu Haţieganu" University of Medicine and Pharmacy, Cluj-Napoca, ROU.
Department of Otolaryngology, "Iuliu Haţieganu" University of Medicine and Pharmacy, Cluj-Napoca, ROU.
Cureus. 2025 Feb 27;17(2):e79748. doi: 10.7759/cureus.79748. eCollection 2025 Feb.
Introduction Nasal and paranasal sinus inflammation, specifically chronic rhinosinusitis with nasal polyps (CRSwNP), is a prevalent condition often addressed through endoscopic sinus surgery (ESS). Despite the commonality of this surgical intervention, recurrence rates post-ESS remain significant. This study explores the relationship between the expression of KI67, a protein indicating cell proliferation, and the likelihood of recurrence in CRSwNP patients who have undergone ESS. Methods Thirty patients undergoing ESS for CRSwNP were enrolled in this prospective study conducted between January 2023 and December 2023. Nasal polyp tissue samples, obtained during the surgical procedure, were subjected to immunohistochemical analysis to determine KI67 expression levels. Post-surgical follow-up was conducted for a period of six months to monitor for recurrence, indicated by the reappearance of nasal polyps upon endoscopic examination. Results The average number of KI67-positive cells per high-powered field (HPF) was 63.7 (range, 21-82). Nasal polyp recurrence was observed in 9 patients (30%) within 6 months following ESS. A statistically significant difference in mean KI67 expression was found between patients experiencing recurrence and those who did not (74.3 ± 11.1 vs. 53.1 ± 11.6, p=0.003). Furthermore, a positive correlation emerged between KI67 expression and Sino-Nasal Outcome Test-22 (SNOT-22) scores (Pearson correlation coefficient, r=0.42, p=0.02). Conclusion The results of this study indicate that KI67 expression could potentially serve as a predictor of recurrence and disease severity in CRSwNP patients following ESS. Confirmation of these findings and determination of the clinical utility of KI67 as a prognostic marker will necessitate further investigation with an expanded sample size and extended follow-up period.
引言 鼻腔和鼻窦炎症，特别是伴有鼻息肉的慢性鼻-鼻窦炎（CRSwNP），是一种常见疾病，通常通过鼻内镜鼻窦手术（ESS）进行治疗。尽管这种手术干预很常见，但ESS后的复发率仍然很高。本研究探讨了KI67（一种指示细胞增殖的蛋白质）的表达与接受ESS的CRSwNP患者复发可能性之间的关系。方法 本前瞻性研究纳入了2023年1月至2023年12月期间接受ESS治疗CRSwNP的30例患者。手术过程中获取的鼻息肉组织样本进行免疫组化分析，以确定KI67表达水平。术后进行为期6个月的随访，以监测复发情况，通过鼻内镜检查发现鼻息肉再次出现来判断复发。结果 每个高倍视野（HPF）中KI67阳性细胞的平均数量为63.7（范围为21 - 82）。9例患者（30%）在ESS后6个月内出现鼻息肉复发。复发患者与未复发患者之间的平均KI67表达存在统计学显著差异（74.3±11.1 vs. 53.1±11.6，p = 0.003）。此外，KI67表达与鼻-鼻窦结局测试-22（SNOT-22）评分之间呈正相关（Pearson相关系数，r = 0.42，p = 0.02）。结论 本研究结果表明，KI67表达可能作为ESS后CRSwNP患者复发和疾病严重程度的预测指标。要证实这些发现并确定KI67作为预后标志物的临床实用性，需要进一步扩大样本量和延长随访期进行研究。
