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Predictive significance of tissue eosinophilia for nasal polyp recurrence in the Chinese population

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Abstract
Background: Chronic rhinosinusitis with nasal polyps (CRSwNP) remains a challenging clinical entity with its propensity for recurrence. Tissue eosinophilia is a hallmark of CRSwNP, and its role in polyp recurrence is a subject of much investigation. Objective: The aim of this study was to evaluate the association between clinical parameters, especially tissue eosinophilia and polyp recurrence, and to identify the optimal cutoff value of tissue eosinophilia as a predictor for polyp recurrence in Chinese subjects. Methods: Overall, 387 patients with CRSwNP were enrolled in this retrospective analysis and postoperative follow-up for polyp recurrence was over a period that lasted > 24 months (mean [standard deviation], 34.03 +/- 4.95 months). The baseline demographic and clinical features and the preoperative computed tomography were compared, and mucosal specimens obtained at endoscopic sinus surgery were assessed for inflammatory cells by using histocytologic staining. Predictive factors associated with polyp recurrence were analyzed by logistic regression analysis, and optimal cutoff points of the predictors were determined by receiver operating characteristic curves and the Youden index. Results: A total of 55.3% patients (214/387) experienced recurrence. Tissue eosinophilia markedly outweighed other parameters and correlated with polyp recurrence. Receiver operating characteristic curves indicated that a cutoff value of 27% tissue eosinophils predicted recurrence with 96.7% sensitivity and 92.5% specificity (area under the curve = 0.969; p < 0.001); and an absolute count of 55 eosinophils per high power field predicted recurrence with 87.4% sensitivity and 97.1% specificity (area under the curve = 0.969; p < 0.001). Conclusion: A tissue eosinophil proportion of > 27% of total cells or a tissue eosinophil absolute count of > 55 eosinophils per high power field may act as a reliable prognostic indicator for nasal polyp recurrence within 2 years after surgery.
Keywords
ENDOSCOPIC SINUS SURGERY, CHRONIC RHINOSINUSITIS, RISK-FACTORS, INFLAMMATION, SEVERITY, INFILTRATION, EXPRESSION, FEATURES, MUCOSA

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MLA
Lou, Hongfei, et al. “Predictive Significance of Tissue Eosinophilia for Nasal Polyp Recurrence in the Chinese Population.” AMERICAN JOURNAL OF RHINOLOGY & ALLERGY, vol. 29, no. 5, 2015, pp. 350–56, doi:10.2500/ajra.2015.29.4231.
APA
Lou, H., Meng, Y., Piao, Y., Wang, C., Zhang, L., & Bachert, C. (2015). Predictive significance of tissue eosinophilia for nasal polyp recurrence in the Chinese population. AMERICAN JOURNAL OF RHINOLOGY & ALLERGY, 29(5), 350–356. https://doi.org/10.2500/ajra.2015.29.4231
Chicago author-date
Lou, Hongfei, Yifan Meng, Yingshi Piao, Chengshuo Wang, Luo Zhang, and Claus Bachert. 2015. “Predictive Significance of Tissue Eosinophilia for Nasal Polyp Recurrence in the Chinese Population.” AMERICAN JOURNAL OF RHINOLOGY & ALLERGY 29 (5): 350–56. https://doi.org/10.2500/ajra.2015.29.4231.
Chicago author-date (all authors)
Lou, Hongfei, Yifan Meng, Yingshi Piao, Chengshuo Wang, Luo Zhang, and Claus Bachert. 2015. “Predictive Significance of Tissue Eosinophilia for Nasal Polyp Recurrence in the Chinese Population.” AMERICAN JOURNAL OF RHINOLOGY & ALLERGY 29 (5): 350–356. doi:10.2500/ajra.2015.29.4231.
Vancouver
1.
Lou H, Meng Y, Piao Y, Wang C, Zhang L, Bachert C. Predictive significance of tissue eosinophilia for nasal polyp recurrence in the Chinese population. AMERICAN JOURNAL OF RHINOLOGY & ALLERGY. 2015;29(5):350–6.
IEEE
[1]
H. Lou, Y. Meng, Y. Piao, C. Wang, L. Zhang, and C. Bachert, “Predictive significance of tissue eosinophilia for nasal polyp recurrence in the Chinese population,” AMERICAN JOURNAL OF RHINOLOGY & ALLERGY, vol. 29, no. 5, pp. 350–356, 2015.
@article{8506542,
  abstract     = {{Background: Chronic rhinosinusitis with nasal polyps (CRSwNP) remains a challenging clinical entity with its propensity for recurrence. Tissue eosinophilia is a hallmark of CRSwNP, and its role in polyp recurrence is a subject of much investigation. 
Objective: The aim of this study was to evaluate the association between clinical parameters, especially tissue eosinophilia and polyp recurrence, and to identify the optimal cutoff value of tissue eosinophilia as a predictor for polyp recurrence in Chinese subjects. 
Methods: Overall, 387 patients with CRSwNP were enrolled in this retrospective analysis and postoperative follow-up for polyp recurrence was over a period that lasted > 24 months (mean [standard deviation], 34.03 +/- 4.95 months). The baseline demographic and clinical features and the preoperative computed tomography were compared, and mucosal specimens obtained at endoscopic sinus surgery were assessed for inflammatory cells by using histocytologic staining. Predictive factors associated with polyp recurrence were analyzed by logistic regression analysis, and optimal cutoff points of the predictors were determined by receiver operating characteristic curves and the Youden index. 
Results: A total of 55.3% patients (214/387) experienced recurrence. Tissue eosinophilia markedly outweighed other parameters and correlated with polyp recurrence. Receiver operating characteristic curves indicated that a cutoff value of 27% tissue eosinophils predicted recurrence with 96.7% sensitivity and 92.5% specificity (area under the curve = 0.969; p < 0.001); and an absolute count of 55 eosinophils per high power field predicted recurrence with 87.4% sensitivity and 97.1% specificity (area under the curve = 0.969; p < 0.001). 
Conclusion: A tissue eosinophil proportion of > 27% of total cells or a tissue eosinophil absolute count of > 55 eosinophils per high power field may act as a reliable prognostic indicator for nasal polyp recurrence within 2 years after surgery.}},
  author       = {{Lou, Hongfei and Meng, Yifan and Piao, Yingshi and Wang, Chengshuo and Zhang, Luo and Bachert, Claus}},
  issn         = {{1945-8924}},
  journal      = {{AMERICAN JOURNAL OF RHINOLOGY & ALLERGY}},
  keywords     = {{ENDOSCOPIC SINUS SURGERY,CHRONIC RHINOSINUSITIS,RISK-FACTORS,INFLAMMATION,SEVERITY,INFILTRATION,EXPRESSION,FEATURES,MUCOSA}},
  language     = {{eng}},
  number       = {{5}},
  pages        = {{350--356}},
  title        = {{Predictive significance of tissue eosinophilia for nasal polyp recurrence in the Chinese population}},
  url          = {{http://doi.org/10.2500/ajra.2015.29.4231}},
  volume       = {{29}},
  year         = {{2015}},
}

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