1 Introduction
Chronic rhinosinusitis (CRS) is a heterogenous disease accompanied with
persistent mucosal inflammation, which makes an impact on 3% to 6.4%
of the whole population(1). CRS could be grouped into two phenotype
based on the presence or absense of nasal polyps(2). Although the
relative prevalence of CRSwNP phenotype is about 20%, CRSwNP shows more
serious condition and a greater degree of impairment for quality of
life(3, 4). Meanwhile, a few reports have shown that over thirty
percentage of patients suffered from CRSwNP continue to be clinically
uncontrolled after standard therapy(5, 6). Therefore, several biomarkers
have been applied for predicting the prognosis and guiding the therapy
and follow-up.
Recently, the clinical parameters such as blood eosinophil count and
paranasal sinus compute tomography (CT) score have been proposed as
markers for identifying phenotypes of CRSwNP and predicting disease
severity(7-9). For example, the parameter about CT scores like the ES/MS
ratio could be an predictor in diagnosis of eosinophilic CRS and
prediction of CRSwNP recurrence(10). Ho, et al reported that blood
eosinophil number can be used as a systemic predictor of eosinophilic
CRS(11). In addition, paranasal sinus CT findings combined with
eosinophilia in peripheral blood can be used for predicting the
treatment outcome and the degree of disease severity of CRSwNP(12).
Furthermore, our recent study showed that blood eosinophilia is an
independent risk factor related to poor disease control in patients with
CRSwNP(5). Together, these studies suggest that paranasal sinus CT and
blood eosinophilia as useful markers may play important roles in
prediction of phenotype and prognosis of CRS. However, few studies focus
on the relationship between paranasal sinus CT and blood eosinophilia,
and whether the imaging features of paranasal sinus CT could be closely
related to the phenotype of nasal polyps with blood eosinophilia remains
unknown.
Here, we hypothesized that the specific findings in paranasal sinus CT
of CRSwNP patients may be associated with systemic eosinophilia. For the
sake of confirming the hypothesis, we performed the retrospective study
to determine the relationship between paranasal sinus CT features and
blood eosinophilia in CRSwNP.