Prognostic factors for post-operative outcomes in chronic rhinosinusitis with nasal polyps: a systematic review
Prognostic factors for post-operative outcomes in chronic rhinosinusitis with nasal polyps: a systematic review
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DOI：
10.1080/1744666x.2023.2218089
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发表时间：
2023-05
影响因子：
4.4
通讯作者：
Shiru Cai;H. Lou;Luo Zhang
中科院分区：
文献类型：
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作者：
Shiru Cai;H. Lou;Luo Zhang
摘要引言慢性鼻窦炎伴鼻息肉（CRSwNP）在手术后有很高的复发率，尽管药物治疗是有效的。多种临床和生物学因素与CRSwNP患者的不良术后结局相关。然而，这些因素及其预后价值尚未得到广泛的总结。该系统性综述包括49项队列研究，探讨CRSwNP术后结局的预后因素。共纳入7802名被试和174个因子。根据预测价值和证据质量将所有调查因素分为三类，其中26个因素被认为是术后结局预测的合理因素。在至少两项研究中，既往鼻手术史、筛窦-上颌窦（E/M）比值、呼出气一氧化氮分数、组织嗜酸性粒细胞计数或百分比、组织嗜中性粒细胞计数、组织IL-5、组织嗜酸性粒细胞阳离子蛋白和鼻分泌物中的CLC或IgE为预后提供了更可靠的信息。专家意见通过非侵入性或微创方法采集标本探索预测因子是未来工作的建议。必须建立综合多种因素的模型，因为没有单一因素对整个人口有效。
ABSTRACT Introduction Chronic rhinosinusitis with nasal polyps (CRSwNP) has a high recurrence rate after surgery despite the availability of medical treatments. Multiple clinical and biological factors have been associated with poor post-operative outcomes in patients with CRSwNP. However, these factors and their prognostic values have not yet been extensively summarized. Areas covered This systematic review included 49 cohort studies exploring the prognostic factors for post-operative outcomes in CRSwNP. A total of 7802 subjects and 174 factors were included. All investigated factors were classified into three categories according to their predictive value and evidence quality, of which 26 factors were considered plausible for post-operative outcome prediction. Previous nasal surgery, ethmoid-to-maxillary (E/M) ratio, fractional exhaled nitric oxide, tissue eosinophil count or percentage, tissue neutrophil count, tissue IL-5, tissue eosinophil cationic protein, and CLC or IgE in nasal secretion provided more reliable information for prognosis in at least two studies. Expert opinion Exploring predictors through noninvasive or minimally invasive methods for specimen collection is recommended for future work. Models combining multiple factors must be established, as no single factor is effective for the whole population.