De Corso Eugenio, Corbò Marco, Montuori Claudio, Furno Daniela, Seccia Veronica, Di Cesare Tiziana, Pipolo Carlotta, Baroni Silvia, Mastrapasqua Rodolfo, Rizzuti Alberta, D'Agostino Giuseppe, D'Auria Leandro Maria, Pacilli Maria Clara, Galli Jacopo
Unit of Otorhinolaryngology and Head-Neck Surgery; "A. Gemelli" Hospital Foundation IRCCS, Rome, Italy.
Department of Head-Neck and Sensory Organs; Catholic University of Sacred Heart, Rome, Italy.
Acta Otorhinolaryngol Ital. 2025 Feb;45(1):39-46. doi: 10.14639/0392-100X-N2877.
The aim of this study was to evaluate the clinical relevance of absolute eosinophil blood count and eosinophil count by nasal cytology in the context of real-life clinical practice and to determine if they correlate with the severity of symptoms in patients with chronic rhinosinusitis with nasal polyps (CRSwNP).
We enrolled 425 patients with CRSwNP followed between January 2015 and April 2023 at the A. Gemelli Hospital Foundation-IRCCS, Rome, Italy. We gathered data on blood and local eosinophil count and correlated the results with clinical features. All patients underwent endoscopy, Visual Analogical Scale (VAS) for main symptoms, and SinoNasal Outcome Test 22 (SNOT-22).
We observed significantly higher mean levels of eosinophils in serum and at nasal cytology in patients with CRSwNP and comorbidities (asthma, non-steroidal anti-inflammatory drugs - exacerbated respiratory disease and allergy) compared to those without. Blood eosinophilia was not associated with severity of symptoms, whereas patients with nasal eosinophil count > 5 eosinophils per high-power field at nasal cytology had a significantly higher median specific VAS for nasal symptoms and significantly higher SNOT 22 scores.
We demonstrated that blood eosinophil count and nasal cytology may represent useful tools in routine clinical practice to define Type 2 inflammation and that their levels are usually higher in patients with comorbidities. We also showed that blood eosinophilia was not correlated with severity of symptoms, whereas local eosinophil count was associated with high severity of symptoms and high burden on quality of life.
本研究旨在评估在实际临床实践中，绝对嗜酸性粒细胞计数和鼻细胞学嗜酸性粒细胞计数的临床相关性，并确定它们是否与伴有鼻息肉的慢性鼻-鼻窦炎（CRSwNP）患者的症状严重程度相关。
我们纳入了2015年1月至2023年4月在意大利罗马的A. Gemelli医院基金会-IRCCS随访的425例CRSwNP患者。我们收集了血液和局部嗜酸性粒细胞计数的数据，并将结果与临床特征相关联。所有患者均接受了内镜检查、主要症状的视觉模拟量表（VAS）以及鼻窦结局测试22（SNOT-22）。
我们观察到，与无合并症的患者相比，CRSwNP合并症（哮喘、非甾体抗炎药诱发的呼吸道疾病和过敏）患者的血清和鼻细胞学嗜酸性粒细胞平均水平显著更高。血液嗜酸性粒细胞增多与症状严重程度无关，而在鼻细胞学检查中每高倍视野嗜酸性粒细胞计数>5个的患者，其鼻症状的特异性VAS中位数显著更高，SNOT 22评分也显著更高。
我们证明，血液嗜酸性粒细胞计数和鼻细胞学检查可能是常规临床实践中定义2型炎症的有用工具，并且合并症患者的这些指标水平通常更高。我们还表明，血液嗜酸性粒细胞增多与症状严重程度无关，而局部嗜酸性粒细胞计数与症状的高严重程度和生活质量的高负担相关。
