血清IL-5、IL-17对慢性鼻-鼻窦炎伴鼻息肉患者术后复发的预测价值

Predictive Analysis of Serum IL-5 and IL-17 on Postoperative Recurrence of Chronic Rhinosinusitis with Nasal Polyp

目的探究血清白细胞介素-5(IL-5)、白细胞介素-17(IL-17)对慢性鼻-鼻窦炎伴鼻息肉(CRSwNP)患者术后复发的预测价值。方法回顾性分析,采集2020年3月至2022年3月在医院完成鼻内镜鼻窦开放术治疗与术后12个月随访的84例CRSwNP患者的资料,患者手术治疗资料、人口学资料、治疗结果相关资料、实验室主要指标资料、随访资料等均保存完整。记录患者术前血清和组织中的IL-5、IL-17表达情况,记录其复发情况,将复发患者纳入复发组,未复发患者纳入未复发组,比较两组人口学资料、手术相关资料及术前血清学指标水平,分析术前血清IL-5、IL-17对术后复发的预测价值。结果84例患者术后有16例复发,复发率为19.05%(16/84);两组患者的年龄、性别、病程比较差异无统计学意义(P>0.05);疾病分型、病变程度比较差异有统计学意义(P<0.05);复发组术前血清IL-5、IL-17水平和组织中IL-5、IL-17 mRNA表达量均高于未复发组(P<0.05);绘制受试者工作特征(ROC)曲线,结果显示,血清和组织中IL-5与IL-17单独和联合预测CRSwNP患者术后复发的曲线下面积(AUC)均>0.7,预测价值较高;血清和组织中IL-5、IL-17联合预测的AUC差异无统计学意义(Z=0.178,P=0.858)。结论CRSwNP患者术前血清IL-5、IL-17异常过表达可能提示术后复发风险,二者可用于术后复发风险预测,且联合预测价值最高。

Objective To explore the predictive value of serum interleukin-5(IL-5)and interleukin-17(IL-17)for postoperative recurrence of chronic rhinosinusitis with nasal polyp(CRSwNP).Methods Retrospective analysis was carried out to collect the data of 84 patients with CRSwNP who completed endoscopic sinus surgery in the hospital from March 2020 to March 2022 and were followed up 12 months after surgery.The data of surgical treatment,demography,treatment results,main laboratory indicators and follow-up were kept intact.The preoperative serum and tissue IL-5,IL-17 expression were recorded,the follow-up data of the patients were reviewed,and the recurrence was recorded.The patients with recurrence were included in the recurrence group and the patients without recurrence were included in the non-recurrence group.The demography data,operation related data and preoperative serological indicators of patients with and without recurrence were compared,and the predictive value of preoperative serum IL-5 and IL-17 on postoperative recurrence was analyzed.Results According to data review,16 out of 84 patients experienced postoperative recurrence,with a recurrence rate of 19.05%(16/84).There was no statistical difference in age,gender and course of disease between the two groups(P>0.05).There was a statistical difference in disease classification and severity(P<0.05).The preoperative serum IL-5 and IL-17 levels and tissue IL-5 and IL-17 mRNA expression levels in the recurrence group were higher than those in the non-recurrence group(P<0.05).The results of the receiver operating characteristic(ROC)curve showed that IL-5 and IL-17 in serum and tissue,both alone and in combination,had certain predictive power in predicting the risk of postoperative recurrence in CRSwNP patients,with area under the curve(AUC)>0.7,indicating high predictive value.There was no statistically difference in the combined prediction of AUC between IL-5 and IL-17 in serum and tissue(Z=0.178,P=0.858).Conclusion The abnormal overexpression of IL-5 and IL-17 in preoperative serum of CRSwNP patients may indicate the risk of postoperative recurrence,and the two can be used for predicting postoperative recurrence risk,with the highest combined predictive value.