한국 환자를 대상으로 한 비용종이 있는 호산구 및 중성구성 만성 비부비동염의 임상적 특징 및치료 후 예후 분석
Analysis of Clinical Characteristics and Post-Treatment Prognosis of Eosinophilic and Neutrophilic Chronic Rhinosinusitis With Nasal Polyps in Korean Patients
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Background and Objectives The aim of this study was to examine the clinical characteristics and prognosis of chronic rhinosinusitis with nasal polyps (CRSwNP) following endoscopic sinus surgery (ESS), focusing on distinct histological endotypes characterized by eosinophil and neutrophil infiltration. Subjects and Method A total of 207 patients diagnosed with CRSwNP who underwent ESSbetween August 2014 and September 2018 were included in the study. Patients were categorized into different groups based on eosinophil and neutrophil counts in the tissues. The demographic data, Lund-Mackay score, Lund-Kennedy (L-K) endoscopic score, Sino-Nasal Outcome Test-22 and Kaplan-Meier estimation were analyzed according to different histologicendotypes. Results The histologic types were divided into four groups: the eosinophilic polyp (EP)+neutrophlic polyp (NP) group, the EP group, the NP group, and the nonEP+nonNP group. Among the groups, the highest level of inflammation (L-K score, p<0.05) was observed in theEP+NP group, and the worst prognosis was observed in the EP+NP group according to theresults of the Kaplan-Meier analysis (p<0.001). Conclusion Compared to non-neutrophil-infiltration polyps, neutrophil infiltration was associated with worse outcome when it was accompanied with eosinophilic infiltration. Thisdiscovery underlines how crucial it is to take neutrophils in nasal polyps into account in orderto better understand their clinical behavior and maybe design customized treatments for betterpatient outcomes.
Abstract
Background and Objectives The aim of this study was to examine the clinical characteristics and prognosis of chronic rhinosinusitis with nasal polyps (CRSwNP) following endoscopic sinus surgery (ESS), focusing on distinct histological endotypes characterized by eosinophil and neutrophil infiltration. Subjects and Method A total of 207 patients diagnosed with CRSwNP who underwent ESSbetween August 2014 and September 2018 were included in the study. Patients were categorized into different groups based on eosinophil and neutrophil counts in the tissues. The demographic data, Lund-Mackay score, Lund-Kennedy (L-K) endoscopic score, Sino-Nasal Outcome Test-22 and Kaplan-Meier estimation were analyzed according to different histologicendotypes. Results The histologic types were divided into four groups: the eosinophilic polyp (EP)+neutrophlic polyp (NP) group, the EP group, the NP group, and the nonEP+nonNP group. Among the groups, the highest level of inflammation (L-K score, p<0.05) was observed in theEP+NP group, and the worst prognosis was observed in the EP+NP group according to theresults of the Kaplan-Meier analysis (p<0.001). Conclusion Compared to non-neutrophil-infiltration polyps, neutrophil infiltration was associated with worse outcome when it was accompanied with eosinophilic infiltration. Thisdiscovery underlines how crucial it is to take neutrophils in nasal polyps into account in orderto better understand their clinical behavior and maybe design customized treatments for betterpatient outcomes.
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