CXCL10在嗜酸性粒细胞型与非嗜酸性粒细胞型慢性鼻-鼻窦炎伴鼻息肉的差异表达及意义

Differential expression and significance of CXCL10 in eosinophilic and non-eosinophilic chronic rhinosinusitis with nasal polyps

目的探讨CXC趋化因子配体10(CXCL10)在嗜酸性粒细胞型及非嗜酸性粒细胞型慢性鼻-鼻窦炎伴鼻息肉的表达及意义。方法采用回顾性研究方法,依据欧洲慢性鼻窦炎及鼻息肉共识(EPOS2012),纳入诊断为慢性鼻-鼻窦炎伴鼻息肉(CRSwNP)的患者共35名,术中收集鼻息肉标本。采用Real-time PCR方法检测鼻息肉内CXCL10含量;采用HE染色法对病理活检标本染色,计算嗜酸性粒细胞、中性粒细胞、浆细胞、淋巴细胞百分比,并依据比值将CRSwNP分为嗜酸性粒细胞型(ECRSwNP)与非嗜酸性粒细胞型(nonECRSwNP);采用Spearman方法分析CXCL10水平与息肉组织中炎细胞百分比的相关性;采用受试者工作特征(ROC)曲线评估CXCL10预测nonECRSwNP的可靠性。结果nonECRSwNP中CXCL10水平显著高于ECRSwNP组(P<0.05)。鼻息肉CXCL10mRNA水平与息肉组织嗜酸性粒细胞百分比成显著负相关(P<0.05,r=-0.395),与组织浆细胞成显著正相关(P<0.05,r=0.389)。ROC曲线及约登指数表明,鼻息肉组织中CXCL10预测nonECRSwNP的最佳界值为0.026(以GAPDH为内参基因),其敏感度为58.33%,特异性为100%(曲线下面积=0.761,P<0.01)。结论非嗜酸性粒细胞型慢性鼻-鼻窦炎伴鼻息肉中CXCL10表达高于嗜酸性粒细胞型慢性鼻-鼻窦炎伴鼻息肉,提示CXCL10可能作为生物学标志物预测非嗜酸性粒细胞型慢性鼻-鼻窦炎伴鼻息肉。

Objective To evaluate the expression and significance of C-X-C motif chemokine ligand 10(CXCL10)in eosinophilic and non-eosinophilic chronic rhinosinusitis with nasal polyps(CRSwNP).Methods A retrospective analysis,with thirty-five adult CRSwNP patients enrolled in this study.Nasal biopsy was performed and tissue sample was stored at RNA later reagent.Real-time PCR assay was used to investigate the CXCL10 level in polyp tissues.HE staining was performed for histological assessment of CRSwNP.CRSwNP was divided into eosinophilic CRSwNP(ECRSwNP)and non-eosinophilic CRSwNP(non ECRSwNP)based on the percentage of infiltrated eosinophils.Spearman rank analysis was used to measure the correlation between the CXCL10 level and the percentage of inflammatory cells.The receiver operating characteristic(ROC)curve was used to assess the predictive value of the CXCL10 level.Results The CXCL10 level in nasal tissue is significantly higher in non ECRSwNP than in ECRSwNP samples(P<0.05).The CXCL10 mRNA level was negatively correlated with the percentage of tissue eosinophils(P<0.05,r=-0.395)whereas positively correlated with the percentage of tissue plasma cells(P<0.05,r=0.389).The ROC curve and Youden index indicated that the optimal cut-off value of 0.026 for CXCL10 normalized to GAPDH(the housekeeping gene)could predict non ECRSwNP with 58.33%sensitivity and 100%specificity(area under the curve=0.76,P<0.01).Conclusion The CXCL10 level in nasal tissue is significantly higher in non ECRSwNP than in ECRSwNP,indicating the CXCL10 level in nasal polyp tissue may serve as a biomarker to predict non ECRSwNP.