| Objective:To study the clinical and histological features of patients with CRSwNP in Beijing over time,and to seek an accurate diagnostic criteria for ECRSwNP;to verify the predictive value of ECRSwNP and the stability in peripheral blood eosinophils.Methods:A total of 229 patients with CRSwNP were included in the year of 2003-2005 and 2014-2016 periods.The clinical and histopathological features of the two groups were compared statistically.Using receiver operating curve(ROC)to assess the predictive value of eosinophil absolute,eosinophil percentage,eosinophil/neutrocyte ratio,and eosinophil/lymphocyte ratio in ECRSwNP patients,and verify the stability of its predictive value at two time periods;stratify the total samples according to the degree of eosinophil infiltration,and study the correlation of eosinophils in blood and tissue.Results:Compared to 2003-2005 periods,the percentage of eosinophils in nasal polyp tissues increased in 2014 to 2016,and the percentage of neutrophils and total inflammatory cell counts decreased.The prevalence of ECRSwNP in Beijing increased significantly from 59.13%to 73.68%in 11 years.The eosinophil/neutrophil ratio in blood was the best predictor of ECRSwNP(AUC=0.817),and the percentage of eosinophils was comparable;this predictive value was not different between two time periods(|U|<1.96 and p>0.05).Eosinophils in the blood and tissues are not numerically dependent.When 10%<tEOS<27%,they have a valuable correlation(r-0.4,p<0.05).Conclusions:ECRSwNP has become a major histopathological phenotype of CRSwNP in Asia over time,and is more refractory than NECRSwNP.Therefore,Chinese otolaryngologists should pay more attention to the diagnosis and treatment of ECRSwNP.The percentage of eosinophils in the blood has better predictive value and facilitates clinical implementation.Therefore,it is recommended as an early predictor of ECRSwNP with a clinical cutoff value of 4.1%. |
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