Cellular phenotyping of chronic rhinosinusitis with nasal polyps
Cellular phenotyping of chronic rhinosinusitis with nasal polyps
复制标题
慢性鼻窦炎伴鼻息肉的细胞表型。
DOI：
10.4193/rhin15.271
复制
发表时间：
2016-06-01
期刊：
影响因子：
7.2
通讯作者：
Zhang, Luo
中科院分区：
文献类型：
--
作者：
Lou, Hongfei;Meng, Yifan;Zhang, Luo
背景
定义慢性鼻窦炎鼻息肉（CRSwNP）的表型与预后可能会导致个性化治疗的交付。本研究旨在使用聚类分析识别CRSwNP的细胞表型，并定义与息肉复发相关的不同聚类的算法。
方法
总体而言，366例CRSwNP患者入组了这项回顾性分析。选取18个变量进行因子分析，包括临床特征和组织/外周炎性细胞评估。在变量减少和标准化后进行无监督聚类分析，并在聚类之间分析随访至少24个月期间息肉复发的差异。判别分析被进一步用于开发用于预测聚类的临床有用的算法。
结果
鉴定了五个表型簇。聚类1和聚类2分别为浆细胞占优势和淋巴细胞占优势的表型。第3组显示混合性炎症模式。簇4的特征在于主要是中性粒细胞浸润。第5组的特点是显著的组织嗜酸性粒细胞增多和最高的复发率为98.5%。临床算法预测聚类的准确率为93.7%。
结论
根据息肉中主要存在浆细胞、淋巴细胞、中性粒细胞、嗜酸性粒细胞或混合炎性细胞，中国CRSwNP患者可分为5种具有不同息肉复发率的表型。
BACKGROUND
Defining the phenotypes of chronic rhinosinusitis with nasal polyps (CRSwNP) with prognosis may lead to delivery of personalized treatment. This study aimed to identify cellular phenotypes of CRSwNP using cluster analysis and define an algorithm for different clusters associated with polyp recurrence.
METHODS
Overall, 366 patients with CRSwNP were enrolled in this retrospective analysis. Eighteen variables, including clinical characteristics and tissue/peripheral inflammatory cells assessments, were selected for factor analysis. Unsupervised cluster analysis was performed after variables reduction and standardization and differences in polyp recurrence during follow-up for a minimum of 24 months were analysed among clusters. Discriminant analysis was further used to develop a clinically useful algorithm for predicting clustering.
RESULTS
Five phenotypic clusters were identified. Clusters 1 and 2 were plasma cell-dominant and lymphocyte-dominant phenotypes, respectively. Cluster 3 revealed a mixed inflammatory pattern. Cluster 4 was characterized by infiltration of predominantly neutrophils. Cluster 5 was characterized by a marked tissue eosinophilia and highest recurrence rate of 98.5%. The clinical algorithm predicted clustering with 93.7% accuracy.
CONCLUSIONS
Chinese CRSwNP patients may be classified into five phenotypes with different polyp recurrence rates, based on the presence of predominantly plasma cells, lymphocytes, neutrophils, eosinophils or mixed inflammatory cells in polyps.