鼻分泌物中骨桥蛋白对嗜酸性粒细胞型慢性鼻窦炎伴鼻息肉的诊断价值  

Value of osteopontin in nasal secretions in diagnosis of eosinophilic chronic rhinosinusitis with nasal polyps

作　　者：刘佩强 许昱[1] LIU Peiqiang;XU Yu(Department of Otorhinolaryngology-Head and Neck Surgery,Renmin Hospital of Wuhan University,Hubei 430060,China)

机构地区：[1]武汉大学人民医院耳鼻咽喉头颈外科,湖北430060

出　　处：《中国临床新医学》2024年第11期1232-1237,共6页CHINESE JOURNAL OF NEW CLINICAL MEDICINE

基　　金：国家自然科学基金项目(编号:82071017,82271134,82401322);湖北省自然科学基金项目(编号:2023AFB229)。

摘　　要：目的分析鼻分泌物中骨桥蛋白(OPN)对嗜酸性粒细胞型慢性鼻窦炎伴鼻息肉(CRSwNP)的诊断价值。方法招募2023年1月至6月于武汉大学人民医院接受鼻内镜手术的80例CRSwNP患者以及30例接受鼻中隔成形术的患者(对照组),根据组织中嗜酸性粒细胞计数将CRSwNP患者分为嗜酸性粒细胞型CRSwNP(eCRSwNP)组(嗜酸性粒细胞占上皮下浸润免疫细胞的比例≥10%)和非嗜酸性粒细胞型CRSwNP(neCRSwNP)组(嗜酸性粒细胞占上皮下浸润免疫细胞的比例<10%),每组40例。检测患者鼻息肉/鼻甲组织和鼻分泌物中OPN水平,收集CRSwNP患者临床资料,采用Pearson相关性分析探讨CRSwNP患者鼻分泌物中OPN水平与临床特征的相关性。采用受试者工作特征(ROC)曲线分析OPN对eCRSwNP的诊断价值。结果与对照组相比,eCRSwNP组和neCRSwNP组的鼻息肉组织和鼻分泌物中OPN水平显著升高,且eCRSwNP组的OPN水平高于neCRSwNP组,差异有统计学意义(P<0.05)。CRSwNP患者鼻分泌物中OPN水平与外周血嗜酸性粒细胞计数(r=0.715,P<0.001)、外周血嗜酸性粒细胞百分比(r=0.571,P<0.001)、鼻息肉组织中嗜酸性粒细胞计数(r=0.521,P<0.001)、Lund-Mackay评分(r=0.421,P=0.006)以及Lund-Kennedy评分(r=0.386,P=0.013)呈正相关。eCRSwNP组外周血嗜酸性粒细胞计数、外周血嗜酸性粒细胞百分比、Lund-Mackay评分、Lund-Kennedy评分高于neCRSwNP组,差异有统计学意义(P<0.05),两组血清总IgE、鼻呼出气一氧化氮(FnNO)和视觉模拟量表(VAS)评分比较差异无统计学意义(P>0.05)。ROC曲线分析结果显示,鼻分泌物中OPN水平、外周血嗜酸性粒细胞计数、外周血嗜酸性粒细胞百分比、Lund-Mackay评分、Lund-Kennedy评分均有助于诊断eCRSwNP,且鼻分泌物中OPN水平的诊断效能更高[AUC(95%CI)=0.837(0.763~0.997),P<0.001],灵敏度和特异度分别为95.42%和65.37%。结论鼻分泌物中OPN水平可作为诊断eCRSwNP的生物标志物。Objective To analyse the value of osteopontin(OPN)in nasal secretions in diagnosis of eosinophilic chronic rhinosinusitis with nasal polyps(CRSwNP).Methods A total of 80 patients with CRSwNP who underwent endoscopic sinus surgery and 30 patients who underwent nasal septoplasty(control group)in Renmin Hospital of Wuhan University from January to June 2023 were recruited.The CRSwNP patients were divided into eosinophilic CRSwNP(eCRSwNP)group(eosinophils to subepithelial infiltrating immune cells ratio≥10%)and non-eosinophilic CRSwNP(neCRSwNP)group(eosinophils to subepithelial infiltrating immune cells ratio<10%)according to eosinophilic granulocyte count in tissues,with 40 cases in each group.OPN levels in the patients′nasal polyp/turbinate tissues and nasal secretions[LM]were detected,and the clinical data of the CRSwNP patients were collected,and the correlation between the OPN level in nasal secretions and the clinical feature was investigated by using Pearson correlation analysis.Receiver operating characteristic(ROC)curve was used to analyze the diagnostic value of OPN in eCRSwNP.Results Compared to the control group,both the eCRSwNP group and the neCRSwNP group exhibited significantly elevated levels of OPN in nasal polyp tissues and nasal secretions,and the eCRSwNP group had higher OPN levels than the neCRSwNP group,and the differences were statistically significant(P<0.05).The OPN levels in the CRSwNP patients′nasal secretions were positively correlated with peripheral blood eosinophil count(r=0.715,P<0.001),percentage of peripheral blood eosinophils(r=0.571,P<0.001),eosinophil count in nasal polyp tissues(r=0.521,P<0.001),Lund-Mackay scores(r=0.421,P=0.006)and Lund-Kennedy scores(r=0.386,P=0.013).The eCRSwNP group had higher peripheral blood eosinophil count,percentage of peripheral blood eosinophils,Lund-Mackay scores and Lund-Kennedy scores than the neCRSwNP group,and the differences were statistically significant(P<0.05).However,there were no significant differences in serum total IgE,nasal fracti

关 键 词：慢性鼻窦炎伴鼻息肉 骨桥蛋白 内在型 生物标志物 

分 类 号：R765[医药卫生—耳鼻咽喉科]