基于CT的骨炎严重程度用于识别伴鼻息肉的慢性鼻窦炎中的嗜酸性内型
CT-Based Osteitis Severity for Identifying Eosinophilic Endotype in Chronic Rhinosinusitis With Nasal Polyps.
文献信息
| PMID | 42779542 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Thu Thi Anh Le |
| 作者单位 | Department of Otolaryngology Head and Neck Surgery, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam. |
| 期刊 | Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery |
| SCI 分区 | Q1 |
| IF | 2.9 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 鼻科 |
中文摘要
目的： 确定基于计算机断层扫描的骨炎严重程度是否反映嗜酸性内型，并比较其与传统黏膜影像学评分的判别性能。
研究设计： 前瞻性队列研究。
地点： 越南胡志明市一家三级转诊耳鼻喉科医院。
方法： 前瞻性纳入154例伴鼻息肉的慢性鼻窦炎患者。使用Kennedy骨炎评分评估骨炎严重程度。通过组织病理学定量组织嗜酸性粒细胞密度，嗜酸性内型定义为每高倍视野≥10个嗜酸性粒细胞。使用Spearman相关和多变量回归分析关联。受试者工作特征分析评估该评分和Lund-Mackay评分识别嗜酸性疾病的能力。
结果： 骨炎严重程度与组织嗜酸性粒细胞密度（rs = 0.45，P < .001）和Lund-Mackay评分（rs = 0.42，P < .001）相关。在多变量分析中，组织嗜酸性粒细胞（β = 0.31，P < .001）和Lund-Mackay评分（β = 0.31，P < .001）仍与骨炎严重程度独立相关。受试者工作特征分析显示Kennedy骨炎评分对嗜酸性内型具有良好的判别能力（AUC = 0.777），优于Lund-Mackay评分（AUC = 0.661）。阈值≥1产生69.6%的敏感性和83.3%的特异性。
结论： 基于计算机断层扫描的骨炎严重程度反映组织嗜酸性粒细胞增多，并优于传统黏膜影像学评分，支持其作为术前内型分层的无创影像标志物的潜力。
英文摘要
OBJECTIVE: To determine whether computed tomography-based osteitis severity reflects the eosinophilic endotype and to compare its discriminatory performance with conventional mucosal radiologic scoring.
STUDY DESIGN: Prospective cohort study.
SETTING: A tertiary referral otolaryngology hospital in Ho Chi Minh City, Vietnam.
METHODS: A total of 154 patients with chronic rhinosinusitis with nasal polyps were prospectively included. Osteitis severity was assessed using the Kennedy Osteitis Score. Tissue eosinophil density was quantified histopathologically, and eosinophilic endotype was defined as ≥10 eosinophils per high-power field. Associations were analyzed using Spearman correlation and multivariable regression. Receiver operating characteristic analysis evaluated the ability of this score and Lund-Mackay score to identify eosinophilic disease.
RESULTS: Osteitis severity correlated with tissue eosinophil density (rs = 0.45, P < .001) and Lund-Mackay score (rs = 0.42, P < .001). In multivariable analysis, tissue eosinophils (β = 0.31, P < .001) and Lund-Mackay score (β = 0.31, P < .001) remained independently associated with osteitis severity. Receiver Operating Characteristic analysis showed good discrimination of eosinophilic endotype by Kennedy Osteitis Score (AUC = 0.777), outperforming Lund-Mackay score (AUC = 0.661). A threshold ≥1 yielded 69.6% sensitivity and 83.3% specificity.
CONCLUSIONS: Computed tomography-based osteitis severity reflects tissue eosinophilia and outperforms conventional mucosal radiologic scoring, supporting its potential as a noninvasive imaging marker for preoperative endotype stratification.