Giuseppe Brescia1, Barbara Pedruzzi2, Umberto Barion2, Francesco Cinetto3, Luciano Giacomelli4, Alessandro Martini2, Gino Marioni2. 1. Department of Neurosciences DNS, Otolaryngology Section, Padova University, Padova, Italy. Electronic address: giuseppe.brescia@sanita.padova.it. 2. Department of Neurosciences DNS, Otolaryngology Section, Padova University, Padova, Italy. 3. Department of Medicine DIMED, Clinical Immunology and Hematology Unit, Padova University, Padova, Italy. 4. Department of Medicine DIMED, Padova University, Padova, Italy.
Abstract
PURPOSE: Despite advances in the diagnosis and treatment of chronic rhinosinusitis with nasal polyps (CRSwNP), their recurrence rate remains significant. There is a need for promptly-obtainable, inexpensive, minimally-invasive prognostic parameters to enable rhinologists to identify patients at higher risk of recurrent CRSwNP. The prognostic role of the neutrophil-to-lymphocyte ratio (NLR) and eosinophil-to-lymphocyte ratio (ELR), previously discussed as potential markers of inflammation, has already been investigated in CRSwNP. The aim of the present study was to test the prognostic value of the NLR and ELR, and also of the basophil-to-lymphocyte ratio (BLR) (given the emerging role of basophils in CRSwNP) in a large series of CRSwNP. MATERIALS AND METHODS: The study concerned 240 patients who underwent FESS for CRSwNP from 2009 to 2014 and had a postoperative follow-up longer than 12months. We considered patients with recurrences as those with endoscopic evidence of at least grade I polyposis. RESULTS: In our series, the mean NLR, ELR and BLR were significantly higher in patients whose disease recurred than in those remaining recurrence-free (p=0.03, p=0.0001, and p=0.0002, respectively), but the discriminatory power of the NLR, ELR, or BLR in terms of disease recurrence was unacceptable (AUCs=0.600, 0.678, and 0.662, respectively). CONCLUSIONS: The heterogeneous prognostic role of NLR, ELR and BLR identified in the clinically and pathologically different sub-cohorts of CRSwNP considered supports the hypothesis that CRSwNPs with a similar clinical picture may differ considerably in terms of the biological and pathogenic mechanisms of polyp formation and growth.
PURPOSE: Despite advances in the diagnosis and treatment of chronic rhinosinusitis with nasal polyps (CRSwNP), their recurrence rate remains significant. There is a need for promptly-obtainable, inexpensive, minimally-invasive prognostic parameters to enable rhinologists to identify patients at higher risk of recurrent CRSwNP. The prognostic role of the neutrophil-to-lymphocyte ratio (NLR) and eosinophil-to-lymphocyte ratio (ELR), previously discussed as potential markers of inflammation, has already been investigated in CRSwNP. The aim of the present study was to test the prognostic value of the NLR and ELR, and also of the basophil-to-lymphocyte ratio (BLR) (given the emerging role of basophils in CRSwNP) in a large series of CRSwNP. MATERIALS AND METHODS: The study concerned 240 patients who underwent FESS for CRSwNP from 2009 to 2014 and had a postoperative follow-up longer than 12months. We considered patients with recurrences as those with endoscopic evidence of at least grade I polyposis. RESULTS: In our series, the mean NLR, ELR and BLR were significantly higher in patients whose disease recurred than in those remaining recurrence-free (p=0.03, p=0.0001, and p=0.0002, respectively), but the discriminatory power of the NLR, ELR, or BLR in terms of disease recurrence was unacceptable (AUCs=0.600, 0.678, and 0.662, respectively). CONCLUSIONS: The heterogeneous prognostic role of NLR, ELR and BLR identified in the clinically and pathologically different sub-cohorts of CRSwNP considered supports the hypothesis that CRSwNPs with a similar clinical picture may differ considerably in terms of the biological and pathogenic mechanisms of polyp formation and growth.
Authors: Karina Bayer; Selmir Hamidovic; Faris F Brkic; Gerold Besser; Christian A Mueller; David T Liu Journal: Eur Arch Otorhinolaryngol Date: 2022-06-23 Impact factor: 2.503
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Authors: Markus Jukka Lilja; Anni Koskinen; Paula Virkkula; Seija Inkeri Vento; Jyri Myller; Sari Hammarén-Malmi; Anu Laulajainen-Hongisto; Maija Hytönen; Antti Mäkitie; Jura Numminen; Saara Sillanpää; Hannu Raitiola; Markus Rautiainen; Sanna Katriina Toppila-Salmi Journal: Allergy Rhinol (Providence) Date: 2021-04-26