评估嗜酸性粒细胞、鼻息肉和隆德-麦凯评分的分界点以预测鼻息肉的手术:一项真实世界的研究。

IF 2.3 Q1 OTORHINOLARYNGOLOGY
Allergy & Rhinology Pub Date : 2020-10-19 eCollection Date: 2020-01-01 DOI:10.1177/2152656720956596
P Virkkula, E Penttilä, S I Vento, J Myller, A Koskinen, S Hammarén-Malmi, A Laulajainen-Hongisto, M Hytönen, M Lilja, J Numminen, S Sillanpää, J Sahlman, S Toppila-Salmi
{"title":"评估嗜酸性粒细胞、鼻息肉和隆德-麦凯评分的分界点以预测鼻息肉的手术:一项真实世界的研究。","authors":"P Virkkula,&nbsp;E Penttilä,&nbsp;S I Vento,&nbsp;J Myller,&nbsp;A Koskinen,&nbsp;S Hammarén-Malmi,&nbsp;A Laulajainen-Hongisto,&nbsp;M Hytönen,&nbsp;M Lilja,&nbsp;J Numminen,&nbsp;S Sillanpää,&nbsp;J Sahlman,&nbsp;S Toppila-Salmi","doi":"10.1177/2152656720956596","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Developing tools to identify chronic rhinosinusitis with nasal polyps (CRSwNP) patients requiring surgical treatment would help clinicians treat patients more effectively. The aim of this retrospective cross-sectional study was to identify cut-off values ​​for eosinophil percentage, nasal polyps (NP), and Lund-Mackay (LM) scores that may predict the need for surgical treatment in Finnish CRSwNP patients.</p><p><strong>Methods: </strong>Data of CRSwNP patients (N = 378) undergoing consultation for ESS in 2001-19 were used. Data was collected from patient records and Lund-Mackay scores were determined from sinus computed tomography scans. The percentage of eosinophils was microscopically evaluated from the polyp samples available (n = 81). Associations were analyzed by Mann Whitney U test, and cut-off values by the area under the receiver operating characteristic curve (AUROC).</p><p><strong>Results: </strong>ESS was performed to 293 (77.5%) of patients. Polyp eosinophilia was associated significantly with ESS (p = 0.001), whereas peripheral blood eosinophil count, LM- score and endoscopic NP- score were not (p > 0.05). AUROC values (95% CI) for detecting those needing ESS were for polyp eosinophilia 0.71 (0.60-0.83), p = 0.001, for LM score 0.59 (0.50-0.67), p = 0.054; for NP score 0.56 (0.48-0.64), p = 0.17, and for blood eosinophil count 0.68 (0.46-0.90), p = 0.08. With the threshold value of polyp eosinophilia (>25%), the sensitivity and specificity were optimal for detecting the group needing ESS from the group not undergoing ESS. The cut-off value of blood eosinophil count (>0.26 × 10<sup>9</sup>/L) had relatively good, yet statistically insignificant (underpowered), predictive potential. Moderate cut-off values were found for endoscopic LM score (≥14/24) and NP score (≥4/8).</p><p><strong>Conclusions: </strong>Polyp eosinophilia (>25%) predicted ESS among Finnish hospital-level CRSwNP patients. A future challenge would be to find less invasive and cost-effective clinical factors predicting uncontrolled CRSwNP.</p>","PeriodicalId":45192,"journal":{"name":"Allergy & Rhinology","volume":null,"pages":null},"PeriodicalIF":2.3000,"publicationDate":"2020-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2152656720956596","citationCount":"6","resultStr":"{\"title\":\"Assessing Cut-off Points of Eosinophils, Nasal Polyp, and Lund-Mackay Scores to Predict Surgery in Nasal Polyposis: A Real-World Study.\",\"authors\":\"P Virkkula,&nbsp;E Penttilä,&nbsp;S I Vento,&nbsp;J Myller,&nbsp;A Koskinen,&nbsp;S Hammarén-Malmi,&nbsp;A Laulajainen-Hongisto,&nbsp;M Hytönen,&nbsp;M Lilja,&nbsp;J Numminen,&nbsp;S Sillanpää,&nbsp;J Sahlman,&nbsp;S Toppila-Salmi\",\"doi\":\"10.1177/2152656720956596\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Developing tools to identify chronic rhinosinusitis with nasal polyps (CRSwNP) patients requiring surgical treatment would help clinicians treat patients more effectively. The aim of this retrospective cross-sectional study was to identify cut-off values ​​for eosinophil percentage, nasal polyps (NP), and Lund-Mackay (LM) scores that may predict the need for surgical treatment in Finnish CRSwNP patients.</p><p><strong>Methods: </strong>Data of CRSwNP patients (N = 378) undergoing consultation for ESS in 2001-19 were used. Data was collected from patient records and Lund-Mackay scores were determined from sinus computed tomography scans. The percentage of eosinophils was microscopically evaluated from the polyp samples available (n = 81). Associations were analyzed by Mann Whitney U test, and cut-off values by the area under the receiver operating characteristic curve (AUROC).</p><p><strong>Results: </strong>ESS was performed to 293 (77.5%) of patients. Polyp eosinophilia was associated significantly with ESS (p = 0.001), whereas peripheral blood eosinophil count, LM- score and endoscopic NP- score were not (p > 0.05). AUROC values (95% CI) for detecting those needing ESS were for polyp eosinophilia 0.71 (0.60-0.83), p = 0.001, for LM score 0.59 (0.50-0.67), p = 0.054; for NP score 0.56 (0.48-0.64), p = 0.17, and for blood eosinophil count 0.68 (0.46-0.90), p = 0.08. With the threshold value of polyp eosinophilia (>25%), the sensitivity and specificity were optimal for detecting the group needing ESS from the group not undergoing ESS. The cut-off value of blood eosinophil count (>0.26 × 10<sup>9</sup>/L) had relatively good, yet statistically insignificant (underpowered), predictive potential. Moderate cut-off values were found for endoscopic LM score (≥14/24) and NP score (≥4/8).</p><p><strong>Conclusions: </strong>Polyp eosinophilia (>25%) predicted ESS among Finnish hospital-level CRSwNP patients. A future challenge would be to find less invasive and cost-effective clinical factors predicting uncontrolled CRSwNP.</p>\",\"PeriodicalId\":45192,\"journal\":{\"name\":\"Allergy & Rhinology\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":2.3000,\"publicationDate\":\"2020-10-19\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://sci-hub-pdf.com/10.1177/2152656720956596\",\"citationCount\":\"6\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Allergy & Rhinology\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1177/2152656720956596\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2020/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q1\",\"JCRName\":\"OTORHINOLARYNGOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Allergy & Rhinology","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1177/2152656720956596","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2020/1/1 0:00:00","PubModel":"eCollection","JCR":"Q1","JCRName":"OTORHINOLARYNGOLOGY","Score":null,"Total":0}
引用次数: 6

摘要

背景:开发工具来识别需要手术治疗的慢性鼻窦炎伴鼻息肉(CRSwNP)患者将有助于临床医生更有效地治疗患者。本回顾性横断面研究的目的是确定嗜酸性粒细胞百分比、鼻息肉(NP)和隆德-麦凯(LM)评分的临界值,以预测芬兰CRSwNP患者是否需要手术治疗。方法:采用2001-19年间就诊的CRSwNP患者(N = 378)的资料。数据收集自患者记录,隆德-麦凯评分由鼻窦计算机断层扫描确定。在显微镜下对息肉样本中嗜酸性粒细胞的百分比进行评估(n = 81)。相关性分析采用Mann Whitney U检验,截断值采用受试者工作特征曲线下面积(AUROC)。结果:293例(77.5%)患者行ESS手术。息肉嗜酸性粒细胞增多与ESS显著相关(p = 0.001),而外周血嗜酸性粒细胞计数、LM-评分和内镜下NP-评分无显著相关性(p > 0.05)。检测需要ESS的息肉嗜酸性粒细胞的AUROC值(95% CI)为0.71 (0.60-0.83),p = 0.001, LM评分为0.59 (0.50-0.67),p = 0.054;NP评分0.56 (0.48-0.64),p = 0.17;血嗜酸性粒细胞计数0.68 (0.46-0.90),p = 0.08。当息肉嗜酸性粒细胞增多阈值>25%时,从未行ESS组中检测需要ESS组的灵敏度和特异性最佳。血嗜酸性粒细胞计数的临界值(>0.26 × 109/L)具有相对较好的预测潜力,但统计学上不显著(不足)。内镜下LM评分(≥14/24)和NP评分(≥4/8)均为中等临界值。结论:在芬兰医院级别的CRSwNP患者中,嗜酸性息肉(>25%)可预测ESS。未来的挑战将是寻找侵入性更小、成本效益更低的临床因素来预测不受控制的CRSwNP。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Assessing Cut-off Points of Eosinophils, Nasal Polyp, and Lund-Mackay Scores to Predict Surgery in Nasal Polyposis: A Real-World Study.

Assessing Cut-off Points of Eosinophils, Nasal Polyp, and Lund-Mackay Scores to Predict Surgery in Nasal Polyposis: A Real-World Study.

Assessing Cut-off Points of Eosinophils, Nasal Polyp, and Lund-Mackay Scores to Predict Surgery in Nasal Polyposis: A Real-World Study.

Assessing Cut-off Points of Eosinophils, Nasal Polyp, and Lund-Mackay Scores to Predict Surgery in Nasal Polyposis: A Real-World Study.

Background: Developing tools to identify chronic rhinosinusitis with nasal polyps (CRSwNP) patients requiring surgical treatment would help clinicians treat patients more effectively. The aim of this retrospective cross-sectional study was to identify cut-off values ​​for eosinophil percentage, nasal polyps (NP), and Lund-Mackay (LM) scores that may predict the need for surgical treatment in Finnish CRSwNP patients.

Methods: Data of CRSwNP patients (N = 378) undergoing consultation for ESS in 2001-19 were used. Data was collected from patient records and Lund-Mackay scores were determined from sinus computed tomography scans. The percentage of eosinophils was microscopically evaluated from the polyp samples available (n = 81). Associations were analyzed by Mann Whitney U test, and cut-off values by the area under the receiver operating characteristic curve (AUROC).

Results: ESS was performed to 293 (77.5%) of patients. Polyp eosinophilia was associated significantly with ESS (p = 0.001), whereas peripheral blood eosinophil count, LM- score and endoscopic NP- score were not (p > 0.05). AUROC values (95% CI) for detecting those needing ESS were for polyp eosinophilia 0.71 (0.60-0.83), p = 0.001, for LM score 0.59 (0.50-0.67), p = 0.054; for NP score 0.56 (0.48-0.64), p = 0.17, and for blood eosinophil count 0.68 (0.46-0.90), p = 0.08. With the threshold value of polyp eosinophilia (>25%), the sensitivity and specificity were optimal for detecting the group needing ESS from the group not undergoing ESS. The cut-off value of blood eosinophil count (>0.26 × 109/L) had relatively good, yet statistically insignificant (underpowered), predictive potential. Moderate cut-off values were found for endoscopic LM score (≥14/24) and NP score (≥4/8).

Conclusions: Polyp eosinophilia (>25%) predicted ESS among Finnish hospital-level CRSwNP patients. A future challenge would be to find less invasive and cost-effective clinical factors predicting uncontrolled CRSwNP.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
Allergy & Rhinology
Allergy & Rhinology OTORHINOLARYNGOLOGY-
CiteScore
3.30
自引率
4.50%
发文量
11
审稿时长
15 weeks
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信