变应性生物标志物对接受功能性鼻内镜鼻窦手术的慢性鼻-鼻窦炎患者的影响。
The Influence of Allergic Biomarkers in Chronic Rhinosinusitis Patients Who Underwent Functional Endoscopic Sinus Surgery.
作者信息
Tsuei Lin-Hsin, Jiang Rong-San
机构信息
Department of Anesthesiology, Department of Medical Education Taichung Veterans General Hospital Taichung Taiwan.
School of Medicine National Yang Ming Chiao Tung University Taipei Taiwan.
出版信息
OTO Open. 2025 Jun 6;9(2):e70138. doi: 10.1002/oto2.70138. eCollection 2025 Apr-Jun.
OBJECTIVE
This study investigates the roles of allergy, serum IgE, serum eosinophils, and tissue eosinophils in chronic rhinosinusitis (CRS) patients undergoing functional endoscopic sinus surgery (FESS). The study aims to evaluate these biomarkers in predicting disease severity and postoperative outcomes.
STUDY DESIGN
A retrospective cohort study.
SETTING
A single academic institution.
METHODS
This retrospective study enrolled patients from 2017 to 2023. Preoperative evaluations included blood tests, sinus computed tomography, nasal endoscopy, questionnaires, olfactory tests, acoustic rhinometry, saccharine transit test, and nasal bacterial culture. The number of eosinophils was counted in the surgical specimens. Postoperative evaluations were performed 3 months after surgery. The severity and outcomes of CRS were compared between allergy-positive and -negative groups, IgE-positive and -negative groups, serum eosinophil-positive and -negative groups, and eosinophilic and noneosinophilic CRS groups.
RESULTS
Ninety-six CRS patients who underwent bilateral primary FESS were enrolled. Allergy and serum IgE showed limited predictive value for CRS outcomes. In contrast, serum eosinophils and tissue eosinophils were significantly associated with worse preoperative CRS severity, especially in olfactory dysfunction. Both biomarkers demonstrated greater postoperative improvements, with serum eosinophils showing predictive potential for ECRS (sensitivity 73.5%, specificity 78.7%).
CONCLUSION
Our results show that allergy testing and serum IgE levels were not reliable tools for CRS severity or outcomes, while elevated serum and tissue eosinophils were associated with worse preoperative CRS severity, particularly in olfactory dysfunction. FESS provided effective improvements in olfactory outcomes in eosinophilic CRS patients. Serum eosinophils could serve as a reliable noninvasive biomarker for predicting disease severity and surgical outcomes in ECRS patients.
LEVEL OF EVIDENCE
目的
本研究调查过敏、血清免疫球蛋白E（IgE）、血清嗜酸性粒细胞和组织嗜酸性粒细胞在接受功能性鼻内镜鼻窦手术（FESS）的慢性鼻-鼻窦炎（CRS）患者中的作用。该研究旨在评估这些生物标志物在预测疾病严重程度和术后结果方面的价值。
研究设计
一项回顾性队列研究。
研究地点
一家学术机构。
方法
这项回顾性研究纳入了2017年至2023年的患者。术前评估包括血液检查、鼻窦计算机断层扫描、鼻内镜检查、问卷调查、嗅觉测试、声反射鼻测量、糖精转运试验和鼻细菌培养。在手术标本中计数嗜酸性粒细胞的数量。术后评估在手术后3个月进行。比较过敏阳性和阴性组、IgE阳性和阴性组、血清嗜酸性粒细胞阳性和阴性组以及嗜酸性CRS组和非嗜酸性CRS组之间CRS的严重程度和结果。
结果
96例接受双侧初次FESS的CRS患者被纳入研究。过敏和血清IgE对CRS结果的预测价值有限。相比之下，血清嗜酸性粒细胞和组织嗜酸性粒细胞与术前CRS严重程度较差显著相关，尤其是在嗅觉功能障碍方面。这两种生物标志物在术后均有更大改善，血清嗜酸性粒细胞对嗜酸细胞性慢性鼻-鼻窦炎（ECRS）显示出预测潜力（敏感性73.5%，特异性78.7%）。
结论
我们的结果表明，过敏检测和血清IgE水平不是评估CRS严重程度或结果的可靠工具，而血清和组织嗜酸性粒细胞升高与术前CRS严重程度较差相关，尤其是在嗅觉功能障碍方面。FESS对嗜酸性CRS患者的嗅觉结果有有效的改善作用。血清嗜酸性粒细胞可作为预测ECRS患者疾病严重程度和手术结果的可靠无创生物标志物。
证据级别
3级。
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