Impact of allergic airway diseases on definition of eosinophilic nasal polyps' inflammatory subtypes / 中国耳鼻咽喉头颈外科

ABSTRACT

OBJECTIVE To compare the clinical characteristics between eosinophilic and noneosinophilic CRSwNP and identify the predictors of eosinophilic CRSwNP. The impact of comorbidity (allergic rhinitis-AR, bronchial asthma-BA) on the predictors was also studied. METHODS Histologic characteristics of surgical samples were analyzed in 182 CRSwNP patients, who were classified into eosinophilic CRSwNP (ECRSwNP) group and noneosinophilic CRSwNP (non-ECRSwNP) group. Factors associated with ECRSwNP were selected by correlation analyses. The optimal cutoff points of the predictors were determined by a receiver operating characteristic curve. Based upon the different comorbidity, four groups were divided to study the impact of comorbidity on the optimal cutoff points of the predictors. RESULTS Patients with ECRSwNP had significant higher rate of revision FESS, significant higher concurrent rate of allergic rhinitis and bronchial asthma than non-ECRSwNP patients (all P<0.05). There were significant differences in Ratio of Lund-Mackay scores, peripheral blood eosinophil percentage and serum total IgE between ECRSwNP group and non-ECRSwNP group except the peripheral blood neutrophilic percentage (U value were 1028.00, 1143.50, 800.00 respectively, all P<0.05). Peripheral blood eosinophilic percentage had the highest significant correlation with degree of infiltration of eosinophils in nasal polyps (r =0.538, 0.568, both P<0.05) and there also existed significant correlation between degree of infiltration of eosinophils in nasal polyps and Lun-Mackay score (r =0.419, P<0.05). Comorbidity of AR and BA could impact the peripheral blood eosinophil percentage. According to the different combination of comorbidity, the range of the optimal cutoff points of peripheral blood eosinophil percentage was 3.05%-4.8%. CONCLUSION ECRSwNP and non-ECRSwNP displayed significant differences in certain clinical features. Comorbidity of AR and BA could increase the peripheral blood eosinophil percentage, that may impact the diagnosis of the subtype of ECRSwNP.