1.Initial exploration of non-invasive diagnosis of eosinophilic chronic rhinosinusitis with nasal polyps via nasal brush sampling.
Zhipeng CHEN ; Jian GUO ; Wenyi CHEN ; Yuan MENG ; Daxiao LI ; Junhui ZHOU ; Zhongjue WANG
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2025;39(7):617-623
Objective:To identify the key epithelial cell characteristics that can accurately diagnose eosinophilic chronic sinusitis with nasal polyps(ECRSwNP) through nasal brush sampling and comparing with the pathological results of nasal polyp tissue sections. Methods:Ninety-one patients underwent surgery in the Ophthalmology and ENT Department of the Second People's Hospital of Longgang District, Shenzhen, from January 2022 to July 2024 were selected. The cohort comprised 58 males and 33 females(mean age: 41.4 years; range: 12.0-71.0). The clinical characteristics of the patients, including gender, age, disease duration, smoking and drinking history, asthma history, subjective symptoms, sinus CT, and nasal endoscopy scores, were recorded. Nasal brush sampling of nasal polyps and inferior turbinate mucosa was performed before surgery to obtain cytological specimens, and nasal polyp tissues were collected during surgery. The demographic and clinical characteristics of patients with eosinophilic and non-eosinophilic nasal polyps were compared, as well as the relationship between nasal brush cytology of nasal polyps and inferior turbinate and nasal polyp histopathology. Statistical analysis was performed using SPSS 23.0 software. Results:Among the 91 patients, no significant differences were observed between ECRSwNP and NECRSwNP patients in terms of age, gender, smoking status, alcohol consumption, and disease duration. The nasal brush cell population in ECRSwNP patients was more likely to contain eosinophils(P<0.001) and less likely to contain lymphocytes and plasma cells(P<0.001). Additionally, the ciliated cells in ECRSwNP patients exhibited larger widths(P=0.036), shorter cilium lengths(P<0.001), and more disordered arrangements(P<0.001) compared to NECRSwNP patients. In nasal brush cells from the inferior turbinate, ECRSwNP patients also showed shorter cilium lengths(P<0.001) and shorter cilia(P=0.024) compared to NECRSwNP patients. Conclusion:There are significant differences in obtaining epithelial cytological information from nasal polyps or inferior turbinates through nasal brush sampling between ECRSwNP and NECRSwNP patients.
Humans
;
Male
;
Female
;
Middle Aged
;
Adult
;
Nasal Polyps/complications*
;
Sinusitis/complications*
;
Aged
;
Chronic Disease
;
Adolescent
;
Nasal Mucosa/pathology*
;
Young Adult
;
Rhinitis/complications*
;
Eosinophilia/pathology*
;
Child
;
Eosinophils/pathology*
;
Rhinosinusitis
2.Analysis of influencing factors on secondary olfactory dysfunction in different types of chronic sinusitis.
Lingyan HAN ; Junhao WANG ; Xiaofeng QIAO
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2025;39(8):703-716
Objective:To explore the influencing factors related to olfactory dysfunction secondary to different types of chronic rhinosinusitis(CRS). Methods:A retrospective analysis was conducted on 185 CRS patients treated at the Department of Otolaryngology-Head and Neck Surgery of Shanxi Provincial People's Hospital from July 2023 to July 2024. Based on the presence or absence of nasal polyps, CRS was divided into two groups: chronic rhinosinusitis with nasal polyps(CRSwNP) and chronic rhinosinusitis without nasal polyps(CRSsNP). Further, based on whether olfactory dysfunction was present, the CRSwNP and CRSsNP groups were divided into subgroups with olfactory dysfunction and normal olfaction. General data, laboratory tests, and modified sinus CT scores were compared between the subgroups. Logistic regression analysis was conducted to identify independent influencing factors based on the results of univariate analysis combined with clinical significance, and two nomogram models were established. The area under the curve of the receiver operating characteristic(ROC) curve, calibration curves, and decision curve analysis were used to assess the diagnostic performance, calibration, and clinical utility of the predictive model. Results:The proportion of blood eosinophils, blood urea nitrogen, and total modified CT scores of the bilateral olfactory region were identified as independent influencing factors in the CRSwNP group; the proportion of blood monocytes and modified CT scores of the bilateral posterior region were independent influencing factors in the CRSsNP group. The nomogram prediction model showed good diagnostic performance, calibration, and clinical utility in both the CRSwNP and CRSsNP groups. Conclusion:Olfactory dysfunction in CRSwNP patients is closely related to the proportion of blood eosinophils, blood urea nitrogen, and total modified CT scores of the bilateral olfactory region, while olfactory dysfunction in CRSsNP patients is closely related to the proportion of blood monocytes and modified CT scores of the bilateral posterior region. Moreover, the predictive model established in this study demonstrates good clinical performance and can be used for early identification and risk prediction of olfactory dysfunction secondary to CRS.
Humans
;
Sinusitis/complications*
;
Chronic Disease
;
Retrospective Studies
;
Olfaction Disorders/etiology*
;
Nasal Polyps/complications*
;
Rhinitis/complications*
;
Female
;
Male
;
Logistic Models
;
Middle Aged
;
Smell
;
Adult
;
ROC Curve
;
Nomograms
;
Eosinophils
;
Tomography, X-Ray Computed
3.Association between vitamin D level and blood eosinophil count in healthy population and patients with chronic obstructive pulmonary disease.
Min WANG ; Qian ZHANG ; Guiling XU ; Shuyu HUANG ; Wenqu ZHAO ; Jianpeng LIANG ; Junwen HUANG ; Shaoxi CAI ; Haijin ZHAO
Journal of Southern Medical University 2023;43(5):727-732
OBJECTIVE:
To investigate the prevalence of vitamin D deficiency and its association with blood eosinophil count in healthy population and patients with chronic obstructive pulmonary disease (COPD).
METHODS:
We analyzed the data of a total 6163 healthy individuals undergoing routine physical examination in our hospital between October, 2017 and December, 2021, who were divided according to their serum 25(OH)D level into severe vitamin D deficiency group (< 10 ng/mL), deficiency group (< 20 ng/mL), insufficient group (< 30 ng/mL) and normal group (≥30 ng/mL). We also retrospectively collected the data of 67 COPD patients admitted in our department from April and June, 2021, with 67 healthy individuals undergoing physical examination in the same period as the control group. Routine blood test results, body mass index (BMI) and other parameters were obtained from all the subjects, and logistic regression models were used to investigate the association between 25(OH)D levels and eosinophil count.
RESULTS:
The overall abnormal rate of 25(OH)D level (< 30 ng/mL) in the healthy individuals was 85.31%, and the rate was significantly higher in women (89.29%) than in men. Serum 25(OH)D levels in June, July, and August were significantly higher than those in December, January, and February. In the healthy individuals, blood eosinophil counts were the lowest in severe 25(OH)D deficiency group, followed by the deficiency group and insufficient group, and were the highest in the normal group (P < 0.05). Multivariable regression analysis showed that an older age, a higher BMI, and elevated vitamin D levels were all risk factors for elevated blood eosinophils in the healthy individuals. The patients with COPD had lower serum 25(OH)D levels than the healthy individuals (19.66±7.87 vs 26.39±9.28 ng/mL) and a significantly higher abnormal rate of serum 25(OH)D (91% vs 71%; P < 0.05). A reduced serum 25(OH)D level was a risk factor for COPD. Blood eosinophils, sex and BMI were not significantly correlated with serum 25(OH)D level in patients with COPD.
CONCLUSION
Vitamin D deficiency is common in both healthy individuals and COPD patients, and the correlations of vitamin D level with sex, BMI and blood eosinophils differ obviously between healthy individuals and COPD patients.
Male
;
Humans
;
Female
;
Eosinophils
;
Retrospective Studies
;
Leukocyte Count
;
Body Mass Index
;
Pulmonary Disease, Chronic Obstructive
4.Delineating asthma according to inflammation phenotypes with a focus on paucigranulocytic asthma.
Yinhe FENG ; Xiaoyin LIU ; Yubin WANG ; Rao DU ; Hui MAO
Chinese Medical Journal 2023;136(13):1513-1522
Asthma is characterized by chronic airway inflammation and airway hyper-responsiveness. However, the differences in pathophysiology and phenotypic symptomology make a diagnosis of "asthma" too broad hindering individualized treatment. Four asthmatic inflammatory phenotypes have been identified based on inflammatory cell profiles in sputum: eosinophilic, neutrophilic, paucigranulocytic, and mixed-granulocytic. Paucigranulocytic asthma may be one of the most common phenotypes in stable asthmatic patients, yet it remains much less studied than the other inflammatory phenotypes. Understanding of paucigranulocytic asthma in terms of phenotypic discrimination, distribution, stability, surrogate biomarkers, underlying pathophysiology, clinical characteristics, and current therapies is fragmented, which impedes clinical management of patients. This review brings together existing knowledge and ongoing research about asthma phenotypes, with a focus on paucigranulocytic asthma, in order to present a comprehensive picture that may clarify specific inflammatory phenotypes and thus improve clinical diagnoses and disease management.
Humans
;
Asthma/drug therapy*
;
Inflammation/diagnosis*
;
Respiratory System
;
Phenotype
;
Biomarkers
;
Sputum
;
Eosinophils
;
Neutrophils
5.Correlation between chronic sinusitis subtypes and basophil levels in peripheral blood.
Yuhui FAN ; Qingqing JIAO ; Aina ZHOU ; Jisheng LIU
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2023;37(4):293-301
Objective:To explore the clinical correlation between peripheral blood basophil levels and chronic sinusitis (CRS) subtypes. Methods:One hundred and twenty-six patients with CRS and 103 healthy cases from physical examination admitted to the First Affiliated Hospital of Soochow University from January 2021 to October 2022 were retrospectively analyzed. According to the histopathological classification, CRS patients were divided into eosinophilic chronic sinusitis (eCRS) group (47 cases) and non eosinophilic chronic sinusitis (non-eCRS) group (79 cases). The differences among the three groups in peripheral blood inflammation cell counts, eosinophils-to-basophils ratio(bEBR), basophils-to-neutrophils ratio(BNR), basophils-to-lymphocytes ratio(BLR), basophils-to-monocytes ratio(BMR) were compared, and study the correlation between each index and Lund-Mackay score, and the correlation between basophils in peripheral blood and other inflammatory cells. Results:The counts of basophils in the peripheral blood of the healthy control group, eCRS group and non-eCRS group were 0.03±0.01, 0.04±0.02, 0.03±0.02, respectively, the eosinophils-to-basophils ratio(bEBR) were 5.64±4.22, 8.38±5.95, 4.55±3.90, the basophils-to-neutrophils ratio(BNR) were 0.01±0, 0.01±0.01, 0.01±0.01, and the basophils-to-lymphocytes ratio(BLR) were 0.01±0.01, 0.02±0.01, and 0.02±0.01, respectively, the basophils-to-monocytes ratio(BMR) were 0.08±0.04, 0.11±0.06, and 0.08 ±0.04 respectively. There was a statistically significant difference between eCRS group and healthy control group, non-eCRS group(P<0.01), while there was no statistically significant difference between non-eCRS group and healthy control group(P>0.05). Basophil counts (r=0.185 5, P<0.05), BLR(r=0.226 9, P<0.05), BMR(r=0.228 1, P<0.01) in patients with CRS were positively correlated with Lund Makey score. In addition, basophils were also positively correlated with eosinophils(r=0.479 2, P<0.01), lymphocytes(r=0.259 4, P<0.01), and monocytes(r=0.256 4, P<0.01) in patients with CRS. Conclusion:The peripheral blood basophil count, BLR and BMR were significantly increased in eCRS, and were significantly positively correlated with Lund -Makey score. It has the potential to develop into disease biomarkers and new therapeutic targets of eCRS.
Humans
;
Basophils
;
Retrospective Studies
;
Rhinitis/surgery*
;
Eosinophils
;
Sinusitis/surgery*
;
Chronic Disease
;
Nasal Polyps/pathology*
6.Research progress on eosinophils in lung cancer.
Ya Qin WEI ; Li Hua LYU ; Ming LI
Chinese Journal of Preventive Medicine 2023;57(11):1895-1900
Eosinophils are important immune cells that contain eosinophilic particles and play a key role in allergic diseases such as asthma and helminth infections. An increasing number of studies have confirmed that eosinophils infiltrate a variety of tumor tissues, which can synthesize and secrete a large number of bioactive substances under certain circumstances, such as cytotoxic cationic proteins, cytokines, growth factors, chemokines, enzymes and so on, which may affect angiogenesis and matrix remodeling or change the tumor microenvironment, thereby affecting tumor progression. This review focused on the role of eosinophils in lung cancer and provided an outlook on the issues in clinical and basic research.
Humans
;
Eosinophils/pathology*
;
Lung Neoplasms
;
Cytokines
;
Hypersensitivity/pathology*
;
Asthma/pathology*
;
Tumor Microenvironment
7.Research progress on eosinophils in lung cancer.
Ya Qin WEI ; Li Hua LYU ; Ming LI
Chinese Journal of Preventive Medicine 2023;57(11):1895-1900
Eosinophils are important immune cells that contain eosinophilic particles and play a key role in allergic diseases such as asthma and helminth infections. An increasing number of studies have confirmed that eosinophils infiltrate a variety of tumor tissues, which can synthesize and secrete a large number of bioactive substances under certain circumstances, such as cytotoxic cationic proteins, cytokines, growth factors, chemokines, enzymes and so on, which may affect angiogenesis and matrix remodeling or change the tumor microenvironment, thereby affecting tumor progression. This review focused on the role of eosinophils in lung cancer and provided an outlook on the issues in clinical and basic research.
Humans
;
Eosinophils/pathology*
;
Lung Neoplasms
;
Cytokines
;
Hypersensitivity/pathology*
;
Asthma/pathology*
;
Tumor Microenvironment
8.Differential expression of NEDD8 in different pathological types of chronic rhinosinusitis with nasal polyps.
Chen MENG ; Bing YAN ; Yuqing HUANG ; Chengshuo WANG ; Luo ZHANG
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2023;37(11):897-901
Objective:To analyze the differential expression of neural precursor cell-expressed developmentally downregulated 8(NEDD8) protein in nasal polyp tissues of patients with different pathological types of chronic rhinorhinosinusitis with nasal polyps(CRSwNP). Methods:All specimens were obtained from the specimen library of Beijing Tongren Hospital, and were all patients who underwent nasal endoscopic surgery for chronic rhinosinusitis in Beijing Tongren Hospital. Hematoxylin-eosin staining(HE) was used to detect the number of eosinophils in nasal polyps, and CRSwNP patients were grouped according to the number of eosinophils in nasal polyps, immunohistochemistry was used to detect and analyze the expression level of NEDD8 protein in nasal polyps. Results:The expression level of NEDD8 protein in nasal polyps of patients with eosinophilic chronic rhinorhinosinusitis with nasal polyps was significantly higher than that of patients with non-eosinophilic chronic rhinosinusitis and nasal polyps(P<0.05). In addition, there was a significant positive correlation between the expression level of NEDD8 protein and the number of eosinophils in nasal polyp tissue(r=0.79, P=0.02). Conclusion:There are differences in the expression of NEDD8 protein in patients with chronic rhinosinusitis and nasal polyps of different pathological types.
Humans
;
Nasal Polyps/metabolism*
;
Rhinitis/diagnosis*
;
NEDD8 Protein/metabolism*
;
Sinusitis/diagnosis*
;
Eosinophils/metabolism*
;
Chronic Disease
10.A comparative study of artificial intelligence nasal polyp classification based on whole-slide imaging and JESREC diagnostic criteria.
Qing Wu WU ; Wei Feng KONG ; Lian Xiong YUAN ; Yong REN ; Ya Na ZHANG ; Hui Yi DENG ; Xin LUO ; Jian Ning CHEN ; Xue Kun HUANG ; Qin Tai YANG
Chinese Journal of Otorhinolaryngology Head and Neck Surgery 2022;57(2):136-141
Objective: To explore the types and clinical characteristics of chronic rhinosinusitis with nasal polyps (CRSwNP) based on artificial intelligence and whole-slide imaging (WSI), and to explore the consistency of the diagnostic criteria of the Japanese epidemiological survey of refractory eosinophilic chronic rhinosinusitis (JESREC) in Chinese CRSwNP patients. Methods: The data of 136 patients with CRSwNP (101 males and 35 females, aging 14 to 70 years) who underwent endoscopic sinus surgery from 2018 to 2019 in the Department of Otorhinolaryngology Head and Neck Surgery, the Third Affiliated Hospital of Sun Yat-sen University were analysed retrospectively. The preoperative clinical characteristics of patients were collected, such as visual analogue scale (VAS) of nasal symptoms, peripheral blood inflammatory cell count, total immunoglobulin E (IgE), Lund-Kennedy score and Lund-Mackay score. The proportion of inflammatory cells such as eosinophils, lymphocytes, plasma cells and neutrophils were calculated on the WSI of each patient through artificial intelligence chronic rhinosinusitis evaluation platform 2.0 (AICEP 2.0), and the specific type of nasal polyps was then obtained as eosinophilic CRSwNP (eCRSwNP) or non-eosinophilic CRSwNP (non-eCRSwNP). In addition, the JESREC diagnostic criteria was used to classify the nasal polyps, and the classification results were compared with the current gold standard for nasal polyps diagnosis (pathological diagnosis based on WSI). The accuracy, sensitivity and specificity of the diagnostic criteria of JESREC were evaluated. The data were expressed in M (Q1, Q3) and statistically analyzed by SPSS 17.0. Results: There was no significant difference between eCRSwNP and non-eCRSwNP in age distribution, gender, time of onset, total VAS score, Lund-Kennedy score or Lund-Mackay score. However, there was a significant difference in the ratio of nasal polyp inflammatory cells (eosinophils 40.5% (22.8%, 54.7%) vs 2.5% (1.0%, 5.3%), neutrophils 0.3% (0.1%, 0.7%) vs 1.3% (0.5%, 3.6%), lymphocytes 49.9% (39.3%, 65.9%) vs 82.0% (72.8%, 87.5%), plasma cells 5.1% (3.6%, 10.5%) vs 13.0% (7.4%, 16.3%), χ2 value was 9.91, 4.66, 8.28, 5.06, respectively, all P<0.05). In addition, eCRSwNP had a significantly higher level of proportion of allergic symptoms (nasal itching and sneezing), asthma, peripheral blood eosinophil and total IgE (all P<0.05). The overall accuracy, sensitivity and specificity of the JESREC diagnostic criteria was 74.3%, 81.3% and 64.3%, respectively. Conclusions: The eCRSwNP based on artificial intelligence and WSI has significant high level of allergic symptoms, asthma, peripheral blood eosinophils and total IgE, and the percentages of inflammatory cells in nasal polyps are different from that of non-eCRSwNP. The JESREC diagnostic criteria has good consistency in our research.
Artificial Intelligence
;
Chronic Disease
;
Eosinophils/metabolism*
;
Female
;
Humans
;
Male
;
Nasal Polyps/pathology*
;
Retrospective Studies
;
Rhinitis/pathology*
;
Sinusitis/pathology*

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