| Objective:To observe the expression of cystethione leukotriene receptor 1（Cys LTR1）and eosinophils（EOS）in adenoid tissues of children with adenoid hypertrophy（AH）.To explore the mechanism of adenoid hypertrophy and the diagnostic value of EOS in children with AH and allergic rhinitis（AR）.It provides new ideas for clinical treatment.Methods:A total of 71 patients who underwent adenoidectomy in the Depart ment of Otorhinolaryngology,Weihai Municipal Hospital from October 1,2020 to October 1,2021 were collected,including 54（76.1%）male children and 17（23.9%）female children.There were 32（45.1%）cases of simple adenoidectomy（tonsi l hypertrophy belowⅠ）,39（54.9%）cases of adenoidectomy（tonsil hypertrophy a boveⅡ）,aged 1～14 years old,17（23.9%）cases aged 1～3 years old,36（50.7%）cases aged 4～6 years old,and 18（25.4%）cases aged 7～14 years old.The m edian was 5.45 years old,and the course of disease ranged from 1 month to 24months.38（53.5%）cases were less than 3 months,19（26.8%）cases were 3-6 m onths,and 14（19.7%）cases were>6 months.The degree of adenoid obstruction o f the nostrils can be divided into four degrees:Ⅰdegree（<25%）,Ⅱdegree（25%-50%）,Ⅲdegree（50%-75%）,Ⅳdegree（>75%）.Among them,gradeⅢwas moderate hypertrophy,gradeⅣwas severe hypertrophy.There were 28 cases（39.4%）with moderate hypertrophy and 43 cases（60.6%）with severe hypertrophy.Th ere were 37（52.1%）children with AR and 34（47.9%）children without AR.In a ddition,49（69.0%）of the 71 patients had other complications,including sinusitis（confirmed by coronal CT of the sinus）,secretary otitis media（confirmed by electr ootoscope and acoustic impedances）,and respiratory sleep syndrome(in accordance with the diagnostic criteria of the draft Guidelines for Diagnosis and Treatment o f Children OSAHS（Urumqi）[33]).However,because a patient usually has multiple complications at the same time,they cannot be counted separately,so they are c ollectively referred to as other complications.Adenoid tissue sections were stained with HE and Cys LTR1 immunohistochemical staining,and the pathological results of all specimens were adenoid lymphoid hyperplasia.The expression of Cys LTR1and EOS in adenoid tissue was observed.Collect all children with gender,age,de gree of adenoid hypertrophy,allergic rhinitis,presence of other complications such as data and comparison,SPSS25 statistical software was used to analyze the expr ession differences of Cys LTR1 and EOS in different groups.Multivariate logistic re gression model was used to analyze the risk factors of Cys LTR1 expression in chi ldren with AH.The count and percentage of eosinophil in peripheral blood and the expression of eosinophil in tissues of children with AR were investigated,and the predictive value of eosinophil in children with AR+AH was evaluated using the r eceiver working characteristic curve.Results:1.Cys LTR1 was expressed in adenoid tissues of each group.The higher the degree of adenoid hypertrophy,the more significant is the expression of Cys LTR1 in the tissue.The difference was statistically significant（P<0.05）,and the expression of Cys LTR1 in the adenoid tissue of the children with AR and other complications was significantly higher than that of the children with AH alone（P<0.05）.2.Logistic regression analysis showed that the degree of adenoid hypertrophy,presence or absence of allergic rhinitis,and presence or absence of other complications were risk factors affecting the expression of Cys LTR1 in children with AH（P<0.05）.3.The total number and percentage of EOS in peripheral blood and the total number of EOS in tissues of AH patients were not different in gender,age and surgical method（P?0.05）.The total number and percentage of EOS in peripheral blood of AH patients were significantly different in different course of disease,different degree of adenoid hypertrophy,and with or without allergic rhinitis（P<0.05）.The total number of EOS in adenoid tissue of AH patients was significantly different in different degrees of adenoid hypertrophy,with or without allergic rhinitis,and with or without other complications（P<0.05）.4.ROC curve was drawn for peripheral blood eosinophil number,peripheral blood eosinophil percentage and tissue eosinophil number of AR+AH children.When the cut-off value of peripheral blood eosinophil absolute value was 0.13×10 9/L,and the cut-off value of peripheral blood eosinophil percentage was 2.4%,The cut-off value of tissue eosinophilic granulocyte absolute value of 2/10HP was of diagnostic value for allergy in children with AR+AH（P<0.001）.The AUC area under the calculated curve was 0.847,0.880 and0.743,respectively.The larger the AUC value,the higher the predictive value of allergy in AR+AH children.Therefore,the diagnostic value of peripheral blood eosinophil percentage was higher than that of peripheral blood eosinophil number and tissue eosinophil number.Conclusion:1 Both Cys LTR1 and EOS are important factors involved in the formation of adenoid hypertrophy in children.2 The expression of Cys LTR1 and EOS in adenoid tissues of children with AH is related to the degree of adenoid hypertrophy,allergic rhinitis and other co morbidities,and the above three indexes are risk factors for high expression of Cy s LTR1.3 EOS has diagnostic significance for allergic factors in children with AH. |
