| Objective: By analyzing the proportion of eosinophils in peripheral blood,the number of eosinophils in nasal polyps,the scores of ethmoid sinus,maxillary sinus,bilateral ethmoid sinus total score/bilateral maxillary sinus total score(E/M ratio)and Modified CT olfactory cleft scores.To explore the correlation between sinus CT score and the number of eosinophils in nasal polyps,the proportion of eosinophils in peripheral blood,Gain the number of eosinophils in nasal polyps and the proportion of eosinophils in peripheral blood as the truncation value for the diagnosis of eosinophilic chronic rhinosinusitis with nasal polyps(ECRSwNP),and evaluated their value in the diagnosis,so as to provide reference for the classification and how to develop a personalized treatment strategy of chronic rhinosinusitis with nasal polyps.Methods: From August 2016 to July 2018,263 patients(179 males and 84 females)undergoing endoscopic functional sinus surgery in the Department of Otolaryngology Head and Neck Surgery,the Second Affiliated Hospital of Nanhua University,Who were diagnosed withchronic rhinosinusitis with nasal polyps,their polyps were removed by surgery and HE stained were recruited in this sthudy.Before operation,the patients were reconstructed with three-dimensional nasal sinus CT,and scored for olfactory cleft,anterior ethmoid sinus,posterior ethmoid sinus and maxillary sinus.The E/M ratio(bilateral ethmoid sinus total score/bilateral maxillary sinus total score)was calculated,and the number of previous operations were counted,the proportion of eosinophils in peripheral blood of patients were detected,During the operation,nasal polyps each patient were removed,and HE stained,the number of eosinophils in tissues was observed under high power microscope.263 patients were divided into experimental group and control group according to whether the E/M ratio was>2.The difference between the number of eosinophils in the nasal polyps,the proportion of eosinophils in peripheral blood,the CT score of nasal sinus and the number of previous operations of the two groups were compared.The correlation between the number of eosinophils in nasal polyps and the proportion of eosinophils in peripheral blood was analyzed,then,analyze their relevance to CT score of nasal sinuses,the number of previous operations.Gain the number of eosinophils in nasal polyps and the proportion of eosinophils in peripheral blood as the truncation value for the diagnosis of eosinophilic chronic rhinosinusitis with nasal polyps,and evaluated their value in the diagnosis.Results:(1)The number of EOS in nasal polyps,the proportion of eosinophils in peripheral blood,score of olfactory creft and ethmoid sinus in the experimental group were higher than those in the control group(P<0.05),while the score of maxillary sinus in the control group is higher than that in the experimental group(P<0.05),there was no difference in the number of previous operations between the two groups(P<0.05).(2)The number of EOS in tissues was significant correlated with E/M ratio(r=0.283,P<0.05)olfactory cleft score(r=0.141,P<0.05)and ethmoid sinus score(r=0.145,P<0.05),but not with maxillary sinus score(r=-0.114,P>0.05).(3)The number of EOS in tissues was significantly correlated with the proportion of EOS in peripheral blood(r=0.294,P<0.05).(2)E/M ratio was significantly correlated with the number of EOS in tissues(r=0.283,P<0.05)and the PEP(r=0.213,P<0.05);(4)No correlation was finded between proportion of EOS in peripheral blood and CT scores of ethmoid sinus(r=0.063,P>0.05),olfactory cleft(r=0.012,P>0.05)and maxillary sinus(r=-0.120,P>0.05).While correlation was finded between proportion of EOS in peripheral blood and E/M ratio(0.213,P<0.05).(5)There was no correlation between the number of previous operations and the number of EOS in tissues(r=0.049,P>0.05),PEP(r=0.015,P>0.05)and the ratio of E/M(r=-0.025,P>0.05).(6)When the number of EOS infiltrate in tissues under high power field(10*40)was greater than 109,the sensitivity and specificity for diagnosis of eosinophilic chronic rhinosinusitis with nasalpolyps were 46.4% and 81.6%,and 53.6% and 68.2% when the proportion of EOS in peripheral blood was more than 2.85%.The area under curve of EOS number in nasal polyps as the truncation value for diagnosis of eosinophilic chronic rhinosinusitis with nasal polyps was 0.662,and0.614 the proportion of eosinophils in peripheral blood.Conclusions:(1)The number of EOS infiltration in nasal polyps was significant correlated with the CT score of olfactory cleft and ethmoid sinus.The CT score of nasal sinuses can reflect the degree of EOS infiltration in tissues,and provide reference for the classification of ECRSwNP and its individualized therapy strategies.(2)Peripheral blood EOS ratio can reflect the degree of EOS infiltration in tissues.(3)The number of EOS infiltration in nasal polyps is greater than 109 and/or the proportion of EOS in peripheral blood is greater than 2.85% under high power field(10*40)was helpful for the diagnosis of eosinophilic chronic rhinosinusitis.The degree of EOS infiltration in nasal polyps and the proportion of EOS in peripheral blood were both have a certain value in diagnosing ECRSwNP.What's more,the former is more valuable than the latter. |
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