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Clinical Characteristics of Patients with Non-Type 2 Chronic Rhinosinusitis with Nasal Polyps
Pei-Wen Wu1,2,3, Cheng-Hsun Chiu2,3, Cheng-Chi Lee2,4
1Division of Rhinology, Department of Otolaryngology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan.
Abstract:
BackgroundEndotype identification based on clinical characteristics is crucial for the selection and prediction of the efficacy of various therapeutic modalities in patients with chronic rhinosinusitis with nasal polyps (CRSwNP).ObjectiveThis study aimed to evaluate the clinical characteristics of patients with non-type 2 (non-T2) CRSwNP.MethodsClinical and laboratory data, as well as nasal tissues, were collected from adult patients who underwent endoscopic sinus surgery (ESS) for primary diffuse CRSwNP. Non-T2 CRSwNP was defined as a tissue eosinophil count <10/high power field. The levels of interleukin (IL)-5 and IL-13 in nasal polyps were measured using real-time polymerase chain reaction.ResultsA total of 199 patients with bilateral CRSwNP were recruited. Sixty-five (32.7%) exhibited non-T2 CRSwNP. Regression analysis revealed that male sex, absence of asthma, low ethmoid/maxillary (E/M) ratio, high blood neutrophil, low lymphocyte, and low eosinophil percentages were significantly associated with non-T2 inflammation in patients with CRSwNP. Age and nasal polyp score were significant predictors of postoperative residual sinus inflammation-defined as a modified Lund-Kennedy endoscopy score of ≥5 at 3 months after surgery-in patients with non-T2 CRSwNP.ConclusionMale sex, absence of asthma, E/M ratio, and the percentages of neutrophils, lymphocytes, and eosinophils were significantly associated with non-T2 CRSwNP. Age and polyp score were predictors of postoperative residual sinus inflammation in patients with non-T2 CRSwNP. These findings may help clinicians better evaluate patients with non-T2 CRSwNP and provide optimal therapeutic strategies.
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