外周血指标对鼻息肉患者黏膜中IL-5和金黄色葡萄球菌肠毒素特异性免疫球蛋白E阳性表达的预测价值  

Predictive value of peripheral blood indicators for the positive expression of IL-5 and Staphylococcus aureus enterotoxin-immunoglobulin E in the mucosa of patients with chronic rhinosinusitis with nasal polyps

作　　者：郑铭[1] 司马宇彤 普晓瑜 庄梦岩 王向东[1,2,3] 张罗 ZHENG Ming;SIMA Yutong;PU Xiaoyu;ZHUANG Mengyan;WANG Xiangdong;ZHANG Luo(Department of Otolaryngology Head and Neck Surgery,Beijing Tongren Hospital,Capital Medical University,Beijing,100730,China;Beijing Institute of Otolaryngology,Beijing Laboratory of Allergic Diseases,Beijing Municipal Education Commission,Beijing Key Laboratory of Nasal Diseases,Beijing,100005,China;Research Unit of Diagnosis and Treatment of Chronic Nasal Diseases,Chinese Academy of Medical Sciences,Beijing,100005,China)

机构地区：[1]首都医科大学附属北京同仁医院耳鼻咽喉头颈外科,北京100730 [2]北京市耳鼻咽喉科研究所,过敏性疾病北京实验室(北京市教育委员会),鼻病研究北京市重点实验室,北京100005 [3]中国医学科学院慢性鼻病诊疗策略研究创新单元,北京100005

出　　处：《中国耳鼻咽喉头颈外科》2024年第7期440-445,共6页Chinese Archives of Otolaryngology-Head and Neck Surgery

基　　金：国家重点研发计划(2022YFC2504100);教育部长江学者创新团队(IRT13082);中国医学科学院医学与健康科技创新工程项目(2019-I2M-5-022);首都卫生发展科研专项重点攻关项目(2022-1-1091);国家自然科学基金(81970852、82171110);北京市自然科学基金(7222024);首都医科大学科研培育基金(2020-1210020214)。

摘　　要：目的借助外周血指标预测慢性鼻窦炎伴鼻息肉(CRSwNP)2型生物标志物。方法收集2020年6月~2022年5月在北京同仁医院鼻科住院的CRSwNP患者临床资料,检测外周血中嗜酸粒细胞百分比(Eos%)、Eos计数、骨膜蛋白和总IgE以及CRSwNP黏膜中白细胞介素5(IL-5)和金黄色葡萄球菌肠毒素特异性免疫球蛋白E(Staphylococcus aureus enterotoxinimmunoglobulin E,SE-IgE)。应用受试者工作特征(ROC)曲线评估每个外周血指标对黏膜IL-5/SE-IgE阳性表达预测价值,利用Logistic回归筛选对黏膜IL-5/SE-IgE阳性有预测价值的外周血指标,构建诺模图模型。结果CRSwNP患者哮喘比例、血中Eos%、骨膜蛋白和总IgE在IL-5/SE-IgE阳性和阴性两组之间,均具有统计学差异。ROC曲线单因素分析显示血Eos%、Eos计数、骨膜蛋白和总IgE对黏膜IL-5和SE-IgE阳性预测的AUC分别波动在0.655~0.784和0.721~0.802,Logistic回归确认血中Eos%、总IgE和血中骨膜蛋白、总IgE可分别作为IL-5和SE-IgE阳性的独立预测因素。构建预测CRSwNP黏膜IL-5/SE-IgE阳性的诺模图模型,一致性指数(C-index)为0.804和0.81,提示具有很好的预测准确性。结论血中Eos%、总IgE和血中骨膜蛋白、总IgE分别构建的诺模图,对CRSwNP黏膜IL-5和SE-IgE阳性表达具有很好的预测价值,可以预判CRSwNP内型和表型严重性。OBJECTIVE To predict biomarkers of type 2 inf lammation in chronic rhinosinusitis with nasal polyps(CRSwNP)by employing peripheral blood indicators.METHODS CRSwNP patients admitted to the Rhinology Department of Beijing Tongren Hospital from June 2020 to May 2022 were enrolled and their basic clinical data were collected.The blood percentage of eosinophils(Eos%),Eos count,periostin and total IgE,as well as mucosal interleukin-5(IL-5)and Staphylococcus aureus enterotoxin-immunoglobulin E(SE-IgE)were tested.The receiver operating characteristic(ROC)curve was used to evaluate the predictive value of each blood indicator for positive mucosal expression of IL-5/SE-IgE.The logistic regression was employed to screen multiple blood indicators with predictive value for positive mucosal expression of IL-5/SE-IgE in order to construct a nomogram model.RESULTS The proportion of asthma,blood Eos%,periostin and total IgE in CRSwNP patients showed statistical differences between IL-5/SE-IgE positive and negative subgroups.ROC univariate analysis demonstrated that blood Eos%,Eos count,periostin and total IgE could predict mucosal IL-5 positivity with AUC ranging from 0.655 to 0.784,and mucosal SE-IgE positivity with AUC ranging from 0.721-0.802.The logistic regression confirmed that blood Eos%and total IgE,as well as blood periostin and total IgE were independent predictors for mucosal IL-5 and SE-IgE positivity,respectively.The nomogram models were constructed for predicting IL-5/SE-IgE positivity in CRSwNP mucosa,with consistency incides(C-index)of 0.804 and 0.81,indicating good predictive accuracy.CONCLUSION The nomograms constructed based on blood Eos%and total IgE,as well as blood periostin and total IgE,could have good predictive value for the positive mucosal expression of IL-5 and SE-IgE in the CRSwNP,which help to predict the severity of endotype and phenotype of CRSwNP.

关 键 词：鼻窦炎 鼻息肉 预测 白细胞介素5 金黄色葡萄球菌肠毒素特异性免疫球蛋白E 受试者工作特征 诺模图 

分 类 号：R765.25[医药卫生—耳鼻咽喉科]