鼻息肉临床病程与组织学和影像学表现的关系。
The clinical course of nasal polyps in relation with histological and radiological findings.
文献信息
| PMID | 42866716 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Suh-Young Lee |
| 作者单位 | Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul, Korea. |
| 期刊 | Asia Pacific allergy |
| SCI 分区 | Q2 |
| IF | 1.9 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 鼻科 |
中文摘要
背景： 鼻息肉（NPs）在组织学特征上表现出不同的炎症细胞和间质改变，但其临床意义仍知之甚少。
目的： 确定鼻息肉组织学、临床特征、骨口鼻道复合体计算机断层扫描（OMU-CT）所显示的影像学疾病负担与术后复发之间的关联。
方法： 我们回顾性分析了219例接受鼻息肉切除术的患者。鼻息肉根据主要炎症细胞（嗜酸性粒细胞性 vs. 淋巴浆细胞性）和间质特征（水肿性、腺性或致密性）进行组织学分类。分析了临床变量、术前OMU-CT评分和复发率。
结果： 总体而言，62.6%（137/219）的鼻息肉为嗜酸性粒细胞性。水肿性间质是最常见的间质亚型（72.6%，159/219），在嗜酸性粒细胞性鼻息肉中占主导（96.3%，132/137）。与淋巴浆细胞性鼻息肉患者相比，嗜酸性粒细胞性鼻息肉患者表现出更高的CT严重程度评分（18.4 ± 0.7 vs. 15.5 ± 1.1；P = 0.021）和更高的广泛病变患病率（78.3% vs. 60.0%；P = 0.010）。CT严重程度评分与血嗜酸性粒细胞计数相关（r = 0.17，P = 0.018）。与无哮喘患者相比，哮喘患者（11.9%）表现出更高的CT严重程度评分（22.4 ± 1.4 vs. 16.9 ± 0.6；P = 0.002）和广泛病变的趋势（92.0% vs. 70.3%；P = 0.052）。在99例有随访的患者中，复发率为16.2%。虽然复发率不因组织学类型而异，但复发患者的术前CT评分显著高于非复发患者（21.9 vs. 16.9；P = 0.002）。
结论： 嗜酸性粒细胞性鼻息肉与更大的CT疾病负担和范围相关。外周血嗜酸性粒细胞计数反映组织嗜酸性粒细胞增多，并与影像学严重程度相关。
英文摘要
BACKGROUND: Nasal polyps (NPs) show distinct characteristics in histologic features with different inflammatory cells and stromal changes, but their clinical implications remain poorly understood.
OBJECTIVE: To determine the associations between NP histology, clinical characteristics, radiologic disease burden on osteomeatal unit computed tomography (OMU-CT) findings, and postoperative recurrence.
METHODS: We retrospectively reviewed 219 patients who underwent nasal polypectomy. NPs were histologically classified by predominant inflammatory cells (eosinophilic vs. lymphoplasmacytic) and stromal features (edematous, glandular, or dense). Clinical variables, preoperative OMU-CT scores, and recurrence rates were analyzed.
RESULTS: Overall, 62.6% (137/219) of NPs were eosinophilic. Edematous stroma was the most common stromal subtype (72.6%, 159/219), predominating in eosinophilic NPs (96.3%, 132/137). Patients with eosinophilic NPs showed higher CT severity scores (18.4 ± 0.7 vs. 15.5 ± 1.1; P = 0.021) and a higher prevalence of extended disease (78.3% vs. 60.0%; P = 0.010) than those with lymphoplasmacytic NPs. CT severity score correlated with blood eosinophil counts (r = 0.17, P = 0.018). Patients with asthma (11.9%) showed higher CT severity scores (22.4 ± 1.4 vs. 16.9 ± 0.6; P = 0.002) and a tendency toward extended disease (92.0% vs. 70.3%; P = 0.052) compared to those without asthma. Among 99 patients with follow-up, recurrence occurred in 16.2%. While recurrence rates did not differ by histologic type, recurrent cases had significantly higher preoperative CT scores than nonrecurrent cases (21.9 vs. 16.9; P = 0.002).
CONCLUSION: Eosinophilic NPs are associated with greater CT disease burden and extent. Peripheral eosinophil counts reflect tissue eosinophilia and correlate with radiologic severity.