Revisiting the Clinical Scoring System for the Prognosis of Chronic Rhinosinusitis with Nasal Polyps
10.3349/ymj.2019.60.6.578
- Author:
Jin Youp KIM
1
;
Young Eun HAN
;
Yuju SEO
;
Goun CHOE
;
Min Kyung KIM
;
Gene HUH
;
Deuktae CHO
;
Seung Koo YANG
;
Seung Heon KANG
;
Dae Woo KIM
Author Information
1. Department of Otorhinolaryngology-Head and Neck Surgery, Boramae Medical Center, Seoul Metropolitan Government-Seoul National University, Seoul, Korea. kicubi@daum.net
- Publication Type:Original Article
- Keywords:
Sinusitis;
eosinophils;
neutrophils;
prognosis
- MeSH:
Asian Continental Ancestry Group;
Classification;
Eosinophilia;
Eosinophils;
Humans;
Nasal Polyps;
Neutrophils;
Osteitis;
Prognosis;
Sinusitis
- From:Yonsei Medical Journal
2019;60(6):578-584
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: To evaluate the Japanese Epidemiological Survey of Refractory Eosinophilic Chronic Rhinosinusitis (JESREC) classification, a clinical scoring system, for predicting disease control status in chronic rhinosinusitis with nasal polyps (CRSwNP) and to investigate prognostic factors. MATERIALS AND METHODS: In total, 134 CRSwNP patients who underwent functional endoscopic sinus surgery after maximal medical treatment were enrolled. These patients were categorized into four groups according to JESREC classification: 1) non-eosinophilic CRSwNP (non-ECRSwNP), 2) mild eosinophilic CRSwNP (ECRSwNP), 3) moderate ECRSwNP, and 4) severe ECRSwNP. Disease control status among the patients was evaluated at 1 year after surgery, and the patients were divided into two groups (disease-controlled and disease-uncontrolled groups) for the investigation of prognostic factors. RESULTS: There was no significant difference in disease control status between non-ECRSwNP and ECRSwNP groups (p=0.970). Age, Lund-Mackay CT scores, global osteitis scores, tissue neutrophil count, and tissue eosinophil count were associated with disease control status. In subgroup analysis of the non-ECRSwNP group, only high tissue neutrophil count was related with disease control status, whereas for the ECRSwNP group, young age, high Lund-Mackay CT scores, high global osteitis scores, and high tissue and blood eosinophil counts were associated with disease control status. CONCLUSION: No difference in disease control status was identified between non-ECRSwNP and ECRSwNP cases. Tissue neutrophilia, however, appeared to be associated with disease control status in non-ECRSwNP cases, whereas tissue and blood eosinophilia was associated with ECRSwNP cases.
