To Study The Value Of Jesrec Score,Eosinophils And Related Factors In Predicting The Classification Of Chronic Rhinosinusitis With Nasal Polyps

Objective:To explore three factors: The diagnostic value of peripheral blood eosinophil Percentage(EOS%),Posterior ethmoid sinus score and olfactory cleft area score in the diagnosis of ECRSw NP in this retrospective study was analyzed.And the Japanese epidemiological survey of refractory eosinophilic chronic rhinosinusitis,the Japanese Epidemiological Survey of Refractory Eosinophilic Chronic Rhinosinusitis,The predictive value of the JESREC(JESREC)scale score diagnostic criteria for ECRSw NP.Methods:Patients who were diagnosed with CRSw NP and underwent functional endoscopic sinus surgery in the Department of Otorhinolaryngology,the First Affiliated Hospital of Dali University from September 2018 to September 2021 were collected.A total of 157 patients who met the inclusion and exclusion criteria were screened,and the following relevant case data were recorded: The patient’s gender,age,history of smoking,history of asthma,scores of maxillary sinus,posterior ethmoid sinus,olfactory cleft area in preoperative paranasal sinus CT,and the percentage of eosinophils in preoperative blood routine.According to the postoperative pathological examination results,the patients were divided into eosinophilic chronic rhinosinusitis with nasal polyps group(ECRSw NP)and non-eosinophilic chronic rhinosinusitis with nasal polyps group(n ECRSw NP).The relevant clinical data of the two groups were analyzed,and the JESREC scores of each group were calculated.The diagnostic value of its predictors in the diagnosis of ECRSw NP was evaluated.Results:In this study,157 CRSw NP patients who met the inclusion and exclusion criteria were divided into ECRSw NP group(65 cases)and n ECRSw NP group(92cases)according to postoperative pathological examination.There was no significant difference in age distribution,gender,unilateral and bilateral disease,smoking,maxillary sinus score,posterior ethmoid sinus score and olfactory cleft score between the two groups,but there was no significant difference in whether the patients had asthma(ECRSw NP group 26.15% vs.n ECRSw NP group 9.78%,t =2.709,P > 0.05).P = 0.007] and the proportion of peripheral blood inflammatory cells [eosinophils 2.1%(0.85%,6.05%)vs 1.1%(0.5%,2.075%),χ~2value was 3.583,P = 0.05].At the same time,157 CRSw NP patients were divided into asthma group(26 cases)and non-asthma group(131 cases)according to whether they were accompanied by asthma.The difference in peripheral blood EOS% between the two groups was statistically significant(asthma group: peripheral blood EOS%3.65±3,35;Non-asthma group EOS% 2.11±2.33,t value was 2.237,P=0.033 < 0.05).According to the JESREC scale diagnostic criteria,there were 36 ECRSw NP cases and 121 n ECRSw NP cases among the 157 cases.Compared with the gold standard of pathological diagnosis,the overall accuracy of the JESREC diagnostic criteria was 67.5% [(81+25)/157)],the sensitivity was 38.5%(25/65),and the specificity was 88%(81/92).The JESREC score of patients in the ECRSw NP group was significantly higher than that in the n ECRSw NP group.The differences were statistically significant(P<0.001).The sensitivity of the JESREC scale was too low due to its cut-off value of 11.The ROC curve showed that the JESREC diagnostic criteria had the best diagnostic effect at 8,with an overall accuracy of70.9%,a sensitivity of 62.3%,and a specificity of 82.6%.The optimal cut-off value of EOS% in peripheral blood was 1.75%,with an overall accuracy of 66.8%,a sensitivity of 63.1%,and a specificity of 69.6%.The combination of three factors:peripheral blood eosinophil percentage(EOS%),posterior ethmoid sinus score and olfactory cleft score could be used for the combined diagnosis of ECRSw NP,with an overall accuracy of 68.2%,a sensitivity of 56.9%,and a specificity of 79.3%.Conclusions:(1)The combination of EOS%≥5% in peripheral blood,posterior ethmoid sinus score ≥1 and olfactory cleft score ≥1 in paranasal sinus CT score could be used to diagnose ECRSw NP with a sensitivity of 56.9% and a specificity of 79.3%.(2)The JESREC score can be used to predict ECRSw NP,with the best sensitivity and specificity at a cut-off value of 8.(3)There is a certain correlation between asthma and the classification of chronic rhinosinusitis with nasal polyps,and asthma is related to the degree of peripheral blood EOS% infiltration.(4)Peripheral blood EOS% can be used to diagnose ECRSw NP,and the diagnostic efficiency is best when the value of EOS% is 1.75%.