慢性鼻窦炎伴鼻息肉中SNOT-22问卷、客观评估与组织病理学发现之间的差异

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中文摘要

背景： 鼻腔鼻窦结局测试-22（SNOT-22）广泛用于评估慢性鼻窦炎伴鼻息肉（CRSwNP）的症状负担，但其与客观疾病指标、病理特征及特定内型的关系仍不明确。
目的： 评估接受内镜鼻窦手术（ESS）的CRSwNP患者中SNOT-22评分（包括各子域）与临床、影像学及组织病理学特征之间的相关性。
方法： 我们回顾性审查了2018年至2024年间在一家三级医疗中心接受ESS治疗的83例成人CRSwNP患者的记录。所有患者均完成了SNOT-22问卷并接受了术前计算机断层扫描成像。记录了鼻息肉评分（NPS）、Lund-Mackay分期及组织病理学特征。使用适当的统计检验分析了SNOT-22各域与人口学、临床、客观参数及组织病理学发现之间的相关性。
结果： 术前SNOT-22总评分平均为55.9±23.5。未观察到SNOT-22总评分与Lund-Mackay分期、NPS或临床内型之间存在显著关联。女性与较高的鼻科子域评分相关（P=0.037）。较高的NPS与更大的情绪负担相关（Pearson相关系数=0.249，P=0.038）。在组织病理学特征中，组织嗜酸性粒细胞计数显示出与较高情绪子域评分的非显著趋势（P=0.081）。未发现其他显著相关性。
结论： 在该队列中，SNOT-22评分及其子域与疾病严重程度的客观指标、影像学负担、内型分类及组织病理学发现的相关性有限。这些发现强调了CRSwNP中主观症状感知与客观疾病标志物之间复杂的相互作用。

英文摘要

BackgroundThe Sinonasal Outcome Test-22 (SNOT-22) is widely used to evaluate symptom burden in chronic rhinosinusitis with nasal polyps (CRSwNP), yet its relationship with objective disease measures, pathological features, and specific endotypes remains unclear.ObjectiveTo assess correlations between SNOT-22 scores, including subdomains, and clinical, radiologic, and histopathologic features in patients undergoing endoscopic sinus surgery (ESS) for CRSwNP.MethodsWe retrospectively reviewed records of 83 adult patients with CRSwNP treated with ESS at a single tertiary medical center between 2018 and 2024. All patients completed the SNOT-22 questionnaire and underwent preoperative computed tomography imaging. Nasal polyp scores (NPS), Lund-Mackay staging, and histopathologic characteristics were documented. Correlations between SNOT-22 domains and demographic, clinical, objective parameters, and histopathological findings were analyzed using appropriate statistical tests.ResultsThe mean preoperative SNOT-22 total score was 55.9 ± 23.5. No significant associations were observed between total SNOT-22 scores and Lund-Mackay staging, NPS, or clinical endotypes. Female sex correlated with higher rhinologic subdomain scores (P = .037). Higher NPS demonstrated an association with greater emotional burden (Pearson correlation coefficient = 0.249, P = .038). Among histopathologic features, tissue eosinophil count showed a nonsignificant trend toward higher emotional subdomain scores (P = .081). No other significant correlations were identified.ConclusionsIn this cohort, SNOT-22 scores and their subdomains showed limited correlation with objective measures of disease severity, radiologic burden, endotype classification, and histopathologic findings. These findings underscore the complex interplay between subjective symptom perception and objective disease markers in CRSwNP.