Objective To analyse the value of osteopontin(OPN) in nasal secretions in diagnosis of eosinophilic chronic rhinosinusitis with nasal polyps(CRSwNP).Methods A total of 80 patients with CRSwNP who underwent endoscopic sinus surgery and 30 patients who underwent nasal septoplasty( control group) in Renmin Hospital of Wuhan University from January to June 2023 were recruited.The CRSwNP patients were divided into eosinophilic CRSwNP( eCRSwNP) group(eosinophils to subepithelial infiltrating immune cells ratio≥10％) and non-eosinophilic CRSwNP(neCRSwNP) group( eosinophils to subepithelial infiltrating immune cells ratio＜10％) according to eosinophilic granulocyte count in tissues,with 40 cases in each group.OPN levels in the patients' nasal polyp/turbinate tissues and nasal secretions were detected,and the clinical data of the CRSwNP patients were collected,and the correlation between the OPN level in nasal secretions and the clinical feature was investigated by using Pearson correlation analysis.Receiver operating characteristic(ROC) curve was used to analyze the diagnostic value of OPN in eCRSwNP.Results Compared to the control group,both the eCRSwNP group and the neCRSwNP group exhibited significantly elevated levels of OPN in nasal polyp tissues and nasal secretions,and the eCRSwNP group had higher OPN levels than the neCRSwNP group,and the differences were statistically significant(P＜0.05).The OPN levels in the CRSwNP patients' nasal secretions were positively correlated with peripheral blood eosinophil count(r=0.715,P＜0.001),percentage of peripheral blood eosinophils(r=0.571,P＜0.001),eosinophil count in nasal polyp tissues(r=0.521,P＜0.001),Lund-Mackay scores(r=0.421,P=0.006) and Lund-Kennedy scores(r=0.386,P=0.013).The eCRSwNP group had higher peripheral blood eosinophil count,percentage of peripheral blood eosinophils,Lund-Mackay scores and Lund-Kennedy scores than the neCRSwNP group,and the differences were statistically significant(P＜0.05).However,there were no significant differences in serum total IgE,nasal fractional exhaled nitric oxide(FnNO),and Visual Analogue Scale(VAS) scores between the two groups(P＞0.05).The results of ROC curve analysis indicated that the OPN level in nasal secretions,peripheral blood eosinophil count,percentage of peripheral blood eosinophils,Lund-Mackay scores and Lund-Kennedy scores were helpful in the diagnosis of eCRSwNP,and the diagnostic efficiency of the OPN level in nasal secretions was higher[AUC(95％CI)=0.837(0.763-0.997),P＜0.001],with a sensitivity of 95.42％ and a specificity of 65.37％.Conclusion The OPN level in nasal secretions can be used as a biomarker in the diagnosis of eCRSwNP.
Chronic rhinosinusitis with nasal polypsOsteopontinEndotypesBiomarker
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