Correlation between peripheral blood EOS,IL-21,CCL4 and postoperative recurrence in patients with chronic rhinosinusitis and nasal polyps
Objective To investigate the correlation between peripheral blood eosinophile count(EOS),interleukin-21(IL-21),chemokine 4(CCL4)and postoperative recurrence in patients with chronic rhi-nosinusitis with nasal polyps(CRSwNP).Methods A total of 86 patients with chronic rhinosinusitis who un-derwent nasal polypectomy were admitted to the Eighth People's Hospital of Qingdao from January 2020 to June 2022.General data for all patients were collected,and levels of peripheral blood EOS,IL-21 and CCL4 were measured.The patients were followed up for one year to track recurrence.Based on recurrence status,patients were divided into a recurrence group(n=34)and a normal group(n=52).Clinical data and peripheral blood lev-els of EOS,IL-21 and CCL4 were compared between the two groups.Pearson correlation analysis was used to explore the relationship between peripheral blood EOS,IL-21,CCL4 and sinus CT Lund-Mackay scores in pa-tients with CRSwNP.The predictive value of postoperative recurrence in patients with CRSwNP was assessed using receiver operating characteristic(ROC)curves.Results During the follow-up period,34 patients with recurrence were recorded,accounting for 39.53%,and 52 patients without recurrence,accounting for 60.47%.Patients were divided into two groups:the relapse group(n=34)and the normal group(n=52)based on their postoperative recurrence.The number of eosinophilic nasal polyps,sinus CT Lund-Mackay score,EOS,IL-21 and CCL4 levels in peripheral blood were compared between the two groups,and the differences were statistical-ly significant(t=4.250,5.300,3.890,3.089,3.499,P<0.05).Multivariate logistic regression analysis showed that EOS,IL-21 and CCL4 levels in peripheral blood were independent risk factors for postoperative recurrence in patients with CRSwNP(P<0.05).Pearson correlation analysis indicated that peripheral blood EOS,IL-21 and CCL4 levels were correlated with sinus CT Lund-Mackay scores in patients with CRSwNP(r=0.433,0.681,0.547,P<0.05).ROC curve results showed that the AUC area of peripheral blood EOS,IL-21,CCL4 and their combination in predicting postoperative recurrence in patients with CRSwNP was 0.725,0.686,0.709 and 0.834,respectively,with the combined prediction showing the highest sensitivity and specificity and the best effect(P<0.05).Conclusion Peripheral blood EOS,IL-21 and CCL4 levels are correlated with the sever-ity of disease in patients with CRSwNP.These markers also have predictive value in anticipating postoperative recurrence in patients with chronic rhinosinusitis with nasal polyps.
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