Correlation Analysis Between Modified Nasal Endoscopic Score And ELR Value And Subtype Of Chronic Rhinosinusitis With Nasal Polyps

Objective: To analyze the correlations between related examination indexes such as modified nasal endoscopy score,ELR value,absolute eosinophil value,eosinophil percentage,and NLR value,and subtype of chronic rhinosinusitis with nasal polyps,to find the best prediagnostic indicators of it’s endotype.The aim is to make a clear diagnosis before invasive pathological examination,and to provide a reliable theoretical basis for the development of personalized treatment plans based on the characteristics of the subtype of the disease.Methods: A retrospective analysis was performed on 119 patients with chronic rhinosinusitis with nasal polyps(CRSw NP)who were treated at our hospital from January 2016 to December 2018.According to the postoperative pathological results,they were divided into two groups: eosinophilic chronic rhinosinusitis with nasal polyps(e CRSw NP)and non-eosinophilic chronic rhinosinusitis with nasal polyps(ne CRSw NP).All patients’ age,gender,whether there was secretion and hyposmia,whether with allergic rhinitis,asthma and other medical history were recorded,The percentage of eosinophils(EO%),the absolute value of eosinophils(EO#),the absolute value of neutrophil(N),the absolute value of lymphocyte(L),total Ig E were collected;and the ELR value and NLR value were calculated: Meanwhile,all patients were scored with modified nasal endoscopy,combined with clinical and anatomical features,divided into middle nasal meatus area and olfactory fissure area.Scoring separately for the two area: SPSS 19.0 was used to statistically calculate the relevant data to analyze whether there were statistical differences between the two groups of indicators.The indicators with significant differences between the two groups were subjected to binary logistic regression analysis to construct two regression models;Combined with the AUC value,cut-off value,sensitivity and specificity calculated by ROC curve,the pre-diagnostic value of each index for the subtype of the disease was analyzed.Results:(1)In terms of whether CRSw NP was associated with asthma and allergic rhinitis,the two groups have statistical differences(P <0.05).The incidence of associated diseases in the e CRSw NP group was significantly higher than that in the control group.(2)In terms of ELR value,NLR value,EO%,EO#,and N value,the differences between the two groups were statistically significant(P <0.05);ELR value,EO%,and EO # in the e CRSw NP group were significantly higher than those in the control group,while the NLR and N values were opposite and higher in the ne CRSw NP group.(3)According to the modified nasal endoscopic score standard,the score of olfactory fissure area in e CRSw NP group was higher than that in ne CRSw NP group,especially the polyp score of olfactory fissure area(P <0.05);while the score of middle nasal meatus area was significantly lower than that in ne CRSw NP group.(4)The Logistic regression analysis results indicated that the OR value of ELR value,the absolute value of eosinophils,and polyp score in olfactory fissure area were significantly high and positively affected the occurrence of e CRSw NP.(5)There was no statistical difference between e CRSw NP and ne CRSw NP in terms of age,gender,absolute value of lymphocytes(L),and total Ig E(P> 0.05).(6)The ROC curve analysis results indicated that the reliable index of the pre-diagnostic value evaluation with the highest AUC value and the highest specificity was polyp in olfactory fissure area(0.745,72.5%);the total score of olfactory fissure area had the highest sensitivity(91.4%);the AUC value of absolute value of eosinophils(0.717)was slightly higher than that of the ELR value(0.695),but the ELR value had higher stability and sensitivity(79.4%).Conclusion: Modified nasal endoscopic score and ELR value were significantly related to subtype of CRSw NP.Nasal polyps occur in the olfactory fissure area,increased ELR value,higher absolute eosinophil value,decreased NLR value,and the clinical features of more likely to accompany with allergic rhinitis and asthma can be used as preferred indicators for pre-diagnosis of e CRSw NP before invasive pathology and CT examination.