Peripheral blood eosinophil levels in chronic rhinosinusitis and its predictive value in eosinophilic chronic rhinosinusitis

Abstract

Background

The prevalence of eosinophilic CRSwNP in China has increased significantly over the last 20 years, noninvasive methods that could assist in diagnosis are urgently needed.

Aims

The aim of this study is to explore the clinical significance of peripheral blood eosinophil in diagnosing ECRS.

Materials and methods

We conducted a prospective study of 221 patients diagnosed with CRS. Lund–Mackay score, peripheral blood eosinophil absolute count, peripheral blood eosinophil percentage were detection to compare the clinical features with ECRS and non-ECRS. ROC curve was performed to assess the efficiency of clinical index to predict ECRS.

Results

The ECRS group of patients had significantly higher scores compared with those of the non-ECRS group. Different extent and severity of mucosal thickening on total Lund–Mackay scores, anterior ethmoidal, posterior ethmoidal and ostiomeatal complex have confirmed different blood eosinophil levels in CRS patients. The combination of peripheral blood eosinophil percentage and posterior ethmoidal score to predict ECRS was 0.807.

Conclusions and significance

The increase in peripheral blood eosinophil percent indicates the deterioration the inflammation of chronic rhinosinusitis and the level of posterior ethmoidal score and peripheral blood eosinophil percentage have a positive predictive value regarding ECRS identification.

Chinese abstract

背景：过去20年来, 中国的嗜酸性CRSwNP患病率显着上升, 迫切需要无创性有助诊断的方法。

目的：本研究的目的是探讨外周血嗜酸性粒细胞对诊断ECRS的临床意义。

材料和方法：我们对221名诊断为CRS的患者进行了前瞻性研究。检测了Lund–Mackay评分、外周血嗜酸性粒细胞绝对计数以及外周血嗜酸性粒细胞百分比, 以比较ECRS和非ECRS的临床特征。进行了ROC曲线以评估用临床指数预测ECRS的效率。

结果：ECRS组患者的得分明显高于非ECRS组。 Lund–Mackay总评分所代表的黏膜增厚程度和严重程度, 以及前筛网、后筛网和眼膜窦复合物已证实CRS患者的不同血液嗜酸性粒细胞水平。预测ECRS的外周血嗜酸性粒细胞百分数和后筛窦评分的综合分为0.807。

结论和意义：外周血嗜酸性粒细胞百分比的增加表明慢性鼻窦炎的炎症的加重。后筛窦评分和外周血嗜酸性粒细胞百分比对ECRS诊断具有良好的预测价值。

Keywords:

• Chronic rhinosinusitis
• disease severity
• biomarker
• computed tomography
• eosinophilic rhinitis and nasal polyposis

Acknowledgments

We thank the Pathology Department and clinical laboratory of Renji hospital for technical assistance.

Disclosure statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.