A prospective analysis evaluating tissue biopsy location and its clinical relevance in chronic rhinosinusitis with nasal polyps.
A prospective analysis evaluating tissue biopsy location and its clinical relevance in chronic rhinosinusitis with nasal polyps.
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DOI：
10.1002/alr.22005
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发表时间：
2017-11
影响因子：
6.4
通讯作者：
Tan BK
中科院分区：
文献类型：
--
作者：
Weibman AR;Huang JH;Stevens WW;Suh LA;Price CPE;Lidder AK;Conley DB;Welch KC;Shintani-Smith S;Peters AT;Grammer LC;Kato A;Kern RC;Schleimer RP;Tan BK
慢性鼻窦炎伴鼻息肉（CRSwNP）有很高的复发倾向。研究表明嗜酸性粒细胞增多会影响疾病的严重程度和手术结果，但选择鼻窦部位测量嗜酸性粒细胞增多还没有被研究过。本研究的目的是研究区域特异性组织嗜酸性粒细胞增多症如何影响鼻窦手术后的影像学严重程度、共病发生率和息肉复发风险。采用酶联免疫吸附试验（ELISA）检测116例CRSwNP患者钩骨组织（UT）和鼻息肉（NP）匀浆中嗜酸性阳离子蛋白（ECP）水平。从电子健康记录中获得临床病史、影像学严重程度和息肉复发时间。比较UT和NP ECP水平的基线Lund-Mackay评分与合并症之间的相关性。然后进行Cox回归和Kaplan-Meier分析来评估UT或NP ECP是否能更好地预测复发。如果没有内镜诊断复发性息肉，则在4年或最后随访时进行检查。Lund-Mackay评分与UT、NP ECP显著相关（r分别为0.46、0.26,p < 0.05）。哮喘（p < 0.01）和阿斯匹林加重呼吸系统疾病（AERD）患者的UT高于NP （p < 0.05）。只有嗜酸性UT组织的息肉复发风险显著高于嗜酸性UT组织（风险比[HR] = 2.84, p = 0.025）。当NP测量时，嗜酸性粒细胞不能预测复发。尽管NP组织中的ECP高于UT组织，但UT组织中的嗜酸性粒细胞比NP组织中的嗜酸性粒细胞是基线放射学严重程度、共病哮喘和AERD以及前瞻性息肉复发风险的临床更一致的生物标志物。
Chronic rhinosinusitis with nasal polyps (CRSwNP) has a high propensity for recurrence. Studies suggest that eosinophilia influences disease severity and surgical outcomes, but the selection of sinonasal site for measuring eosinophilia has not been examined. The aim of this study was to investigate how region-specific tissue eosinophilia affects radiographic severity, comorbidity prevalence, and polyp recurrence risk following sinus surgery. Eosinophil cationic protein (ECP) levels in uncinate tissue (UT) and nasal polyp (NP) homogenates from 116 CRSwNP patients were measured using enzyme-linked immunosorbent assay (ELISA). Clinical history, radiographic severity, and time to polyp recurrence were obtained from electronic health records. The correlations between baseline Lund-Mackay scores and comorbidities were compared between UT and NP ECP levels. Cox regression and Kaplan-Meier analysis were then performed to assess whether UT or NP ECP better predicted recurrence. Censoring occurred at 4 years or at last follow-up if there was no endoscopic diagnosis of recurrent polyps. Lund-Mackay scores were significantly correlated with UT and NP ECP (r = 0.46 and 0.26 respectively, p < 0.05). UT but not NP ECP was significantly higher in patients with asthma (p < 0.01) and aspirin-exacerbated respiratory disease (AERD) (p < 0.05). Polyp recurrence risk was only significantly higher for patients with eosinophilic UT tissue (hazard ratio [HR] = 2.84, p = 0.025). When measured in NP, eosinophilia did not predict recurrence. Although ECP in NP was higher than in UT tissue, eosinophilia in UT tissue was a more clinically coherent biomarker of baseline radiographic severity, comorbid asthma and AERD, and prospective polyp recurrence risk than NP eosinophilia.
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影响因子：
12.4
作者：
Tokunaga T;Sakashita M;Haruna T;Asaka D;Takeno S;Ikeda H;Nakayama T;Seki N;Ito S;Murata J;Sakuma Y;Yoshida N;Terada T;Morikura I;Sakaida H;Kondo K;Teraguchi K;Okano M;Otori N;Yoshikawa M;Hirakawa K;Haruna S;Himi T;Ikeda K;Ishitoya J;Iino Y;Kawata R;Kawauchi H;Kobayashi M;Yamasoba T;Miwa T;Urashima M;Tamari M;Noguchi E;Ninomiya T;Imoto Y;Morikawa T;Tomita K;Takabayashi T;Fujieda S
通讯作者：
Fujieda S
影响因子：
12.4
作者：
Hirsch AG;Stewart WF;Sundaresan AS;Young AJ;Kennedy TL;Scott Greene J;Feng W;Tan BK;Schleimer RP;Kern RC;Lidder A;Schwartz BS
通讯作者：
Schwartz BS
影响因子：
120.7
作者：
Bachert, Claus;Mannent, Leda;Sutherland, E. Rand
通讯作者：
Sutherland, E. Rand
影响因子：
14.2
作者：
Baroody, Fuad M.;Mucha, Samantha M.;Naclerio, Robert M.
通讯作者：
Naclerio, Robert M.
影响因子：
12.4
作者：
Hastan, D.;Fokkens, W. J.;Burney, P.
通讯作者：
Burney, P.