Differences in Clinical and Immunological Characteristics According to the Various Criteria for Tissue Eosinophilia in Chronic Rhinosinusitis With Nasal Polyps
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Objectives. Several criteria exist for classifying chronic rhinosinusitis with nasal polyps (CRSwNP) as eosinophilic or non-eosinophilic. This study attempted to evaluate several criteria for defining eosinophilic CRSwNP from clinical andimmunological perspectives. Methods. A cohort of 84 patients (73 patients with CRSwNP and 11 control patients) was retrospectively analyzed. Patientswere divided into eosinophilic and non-eosinophilic CRSwNP based on four different criteria: eosinophils (EOS) ac-counting for more than 20% of the total inflammatory cells; ≥70 EOS per high-power field (HPF); >55 EOS/HPF;and ≥10 EOS/HPF. Preoperative clinical characteristics, the immunological profiles of 14 cytokines from nasal tissue,and postoperative outcomes were compared between eosinophilic and non-eosinophilic CRSwNP based on each cri-terion. These criteria were immunologically validated by using 14 cytokines to predict the performance of tissue eo-sinophilia with a random forest model. Results. Patients with eosinophilic CRSwNP were significantly older when the criterion of ≥10 EOS/HPF or EOS >20%was used. The number of patients with aspirin intolerance was significantly higher in eosinophilic CRSwNP based onthe criterion of EOS >20%. From an immunological perspective, non-type 2 inflammatory cytokines were significantlyhigher in non-eosinophilic CRSwNP with the criterion of EOS >20% of the total inflammatory cells. In addition, thecriterion of EOS >20% of the total inflammatory cells resulted in the best prediction of eosinophilic CRSwNP, withan accuracy of 88.10% and area under the curve of 0.94. Conclusion. Clinical and immunological characteristics were different between eosinophilic and non-eosinophilic CRSwNPdepending on a variety of criteria, and the results of this study should be taken into account when choosing the crite-rion for defining eosinophilic CRSwNP and interpreting the data accordingly.
Abstract
Objectives. Several criteria exist for classifying chronic rhinosinusitis with nasal polyps (CRSwNP) as eosinophilic or non-eosinophilic. This study attempted to evaluate several criteria for defining eosinophilic CRSwNP from clinical andimmunological perspectives. Methods. A cohort of 84 patients (73 patients with CRSwNP and 11 control patients) was retrospectively analyzed. Patientswere divided into eosinophilic and non-eosinophilic CRSwNP based on four different criteria: eosinophils (EOS) ac-counting for more than 20% of the total inflammatory cells; ≥70 EOS per high-power field (HPF); >55 EOS/HPF;and ≥10 EOS/HPF. Preoperative clinical characteristics, the immunological profiles of 14 cytokines from nasal tissue,and postoperative outcomes were compared between eosinophilic and non-eosinophilic CRSwNP based on each cri-terion. These criteria were immunologically validated by using 14 cytokines to predict the performance of tissue eo-sinophilia with a random forest model. Results. Patients with eosinophilic CRSwNP were significantly older when the criterion of ≥10 EOS/HPF or EOS >20%was used. The number of patients with aspirin intolerance was significantly higher in eosinophilic CRSwNP based onthe criterion of EOS >20%. From an immunological perspective, non-type 2 inflammatory cytokines were significantlyhigher in non-eosinophilic CRSwNP with the criterion of EOS >20% of the total inflammatory cells. In addition, thecriterion of EOS >20% of the total inflammatory cells resulted in the best prediction of eosinophilic CRSwNP, withan accuracy of 88.10% and area under the curve of 0.94. Conclusion. Clinical and immunological characteristics were different between eosinophilic and non-eosinophilic CRSwNPdepending on a variety of criteria, and the results of this study should be taken into account when choosing the crite-rion for defining eosinophilic CRSwNP and interpreting the data accordingly.
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