Article record

结构化组织病理学可区分AFRS与eCRSwNP

Structured Histopathology Distinguishes AFRS From eCRSwNP.

临床研究鼻科IF 2.3Q2

文献信息

PMID	42823651
原文	在 PubMed 查看原文 ↗
发表日期	2026
作者	Ali G Alrashidi 查看其他 10 位作者 Nasir Magboul；Ali M Alsudays；Ali J Asiry；Abdulrahman K Badghaish；Rimah F Alsalem；Ahmad Alroqi；Saud Alromaih；Abdulaziz S Alrasheed；Yousif Alammar；Saad Alsaleh
作者单位	Department of Otorhinolaryngology, Head & Neck Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia. 查看其他 5 条单位信息 Department of Otorhinolaryngology, Head & Neck Surgery, King Salman Specialized Hospital, Hail, Saudi Arabia.；Department of Otorhinolaryngology-Head and Neck Surgery, Jazan Armed Forces Hospital, Jazan, Saudi Arabia.；Department of Otorhinolaryngology-Head and Neck Surgery, King Fahad Specialist Hospital, Buraidah, Saudi Arabia.；Department of Otorhinolaryngology, Head and Neck Department, Aseer Central Hospital, Abha, Saudi Arabia.；Security Forces Hospitals Program, General Directorate of Medical Services, Ministry of Interior, Riyadh, Saudi Arabia.
期刊	The Laryngoscope
SCI 分区	Q2
IF	2.3
研究类型	临床研究 · 临床
所属专科	鼻科

中文摘要

背景： 变应性真菌性鼻窦炎（AFRS）与嗜酸性慢性鼻窦炎伴鼻息肉（eCRSwNP）在临床上存在重叠。二者究竟代表不同疾病实体还是同一疾病谱中的不同位点仍存争议，且来自中东地区的结构化组织病理学数据有限。本研究旨在比较沙特三级医疗队列中AFRS与eCRSwNP的临床、影像学、实验室及13变量结构化组织病理学（SHP）特征。
方法： 我们回顾性分析了2017年1月至2024年1月期间在沙特一家三级转诊中心接受功能性内镜鼻窦手术（FESS）的415例成人患者。AFRS依据Bent和Kuhn标准定义，eCRSwNP依据EPOS 2020标准并满足每高倍视野组织嗜酸性粒细胞≥10个。我们比较了13变量结构化组织病理学、临床、影像学及实验室特征。
结果： 50例患者（12.0%）符合AFRS标准。AFRS患者更年轻（中位年龄27岁 vs. 38岁；p < 0.001），总血清IgE更高（869 vs. 191 IU/mL；p < 0.001），并且CT上更常表现为单侧病变（58.0% vs. 19.6%；OR 5.66，95% CI 3.05-10.51）。AFRS显示中性粒细胞浸润较少、上皮下水肿较少、增生性或乳头状改变较少以及鳞状化生较少。两组复发率相似（40.9% vs. 42.6%；p = 0.872）。
结论： 在该沙特队列中，AFRS与eCRSwNP在临床、影像学、实验室及SHP领域均存在差异，支持AFRS是CRSwNP疾病谱中一个独特的表型。

英文摘要

BACKGROUND: Allergic fungal rhinosinusitis (AFRS) and eosinophilic chronic rhinosinusitis with nasal polyps (eCRSwNP) overlap clinically. Whether they represent distinct entities or points on the same spectrum is debated, and structured histopathology data from the Middle East are limited. The aim of this study was to compare clinical, radiographic, laboratory, and 13-variable structured histopathological (SHP) profiles between AFRS and eCRSwNP in a Saudi tertiary-care cohort.
METHODS: We retrospectively reviewed 415 adults who underwent functional endoscopic sinus surgery (FESS) at a Saudi tertiary referral center between January 2017 and January 2024. AFRS was defined by Bent and Kuhn criteria, and eCRSwNP by EPOS 2020 criteria plus 10 or more tissue eosinophils per high-power field. We compared 13-variable structured histopathology, clinical, radiographic, and laboratory features.
RESULTS: Fifty patients (12.0%) met AFRS criteria. AFRS patients were younger (median 27 vs. 38 years; p < 0.001), had higher total serum IgE (869 vs. 191 IU/mL; p < 0.001), and more often had unilateral disease on CT (58.0% vs. 19.6%; OR 5.66, 95% CI 3.05-10.51). AFRS showed less neutrophilic infiltration, less subepithelial oedema, less hyperplastic or papillary change, and less squamous metaplasia. Recurrence was similar between groups (40.9% vs. 42.6%; p = 0.872).
CONCLUSION: AFRS and eCRSwNP differ across clinical, radiographic, laboratory, and SHP domains in this Saudi cohort, supporting AFRS as a distinct phenotype within the CRSwNP spectrum.