Abstract：
OBJECTIVE: Structured histopathology (SHP) is a method of analyzing sinonasal tissue to characterize endotypes of chronic rhinosinusitis with nasal polyps (CRSwNP). Allergic fungal rhinosinusitis (AFRS) shares several features with certain endotypes of CRSwNP. Our objective was to compare the histopathology of AFRS and eosinophilic CRSwNP to further understand whether they are separate endotypes or disease entities altogether.
METHODS: A retrospective review of AFRS and CRSwNP patients undergoing endoscopic sinus surgery was performed. Data were collected on demographics, comorbidities, subjective and objective severity scores, and 13-variable SHP reports. CRSwNP patients with >10 eosinophils per high-power field (eCRSwNP) were included. Chi-squared and t-tests were used for statistical analysis.
RESULTS: A total of 29 AFRS and 108 eCRSwNP patients were identified. AFRS patients were younger and more often Black. Symptom severity scores (SNOT-22, Lund-MacKay, and Lund-Kennedy) were uniform between groups. AFRS patients had a higher rate of Charcot-Leyden crystals (41.4% vs. 10.2%; p < 0.001). Severe degree of inflammation, eosinophilic inflammatory predominance, eosinophil aggregates, subepithelial edema, and basement membrane thickening were common in both groups, and their rates were not statistically significantly different between groups. Metaplasia, ulceration, fibrosis, and hyperplastic/papillary change rates were low (<30%) and similar between groups.
CONCLUSIONS: The SHP of eCRSwNP and AFRS are highly consistent, which suggests AFRS is a severe subtype of CRSwNP overall rather than a separate disease entity. This also lends credence to AFRS belonging on the endotypic spectrum of CRSwNP.
METHODS: 3 Laryngoscope, 134:2617-2621, 2024.
METHODS: A retrospective review of AFRS and CRSwNP patients undergoing endoscopic sinus surgery was performed. Data were collected on demographics, comorbidities, subjective and objective severity scores, and 13-variable SHP reports. CRSwNP patients with >10 eosinophils per high-power field (eCRSwNP) were included. Chi-squared and t-tests were used for statistical analysis.
RESULTS: A total of 29 AFRS and 108 eCRSwNP patients were identified. AFRS patients were younger and more often Black. Symptom severity scores (SNOT-22, Lund-MacKay, and Lund-Kennedy) were uniform between groups. AFRS patients had a higher rate of Charcot-Leyden crystals (41.4% vs. 10.2%; p < 0.001). Severe degree of inflammation, eosinophilic inflammatory predominance, eosinophil aggregates, subepithelial edema, and basement membrane thickening were common in both groups, and their rates were not statistically significantly different between groups. Metaplasia, ulceration, fibrosis, and hyperplastic/papillary change rates were low (<30%) and similar between groups.
CONCLUSIONS: The SHP of eCRSwNP and AFRS are highly consistent, which suggests AFRS is a severe subtype of CRSwNP overall rather than a separate disease entity. This also lends credence to AFRS belonging on the endotypic spectrum of CRSwNP.
METHODS: 3 Laryngoscope, 134:2617-2621, 2024.
摘要：
目的：结构化组织病理学（SHP）是一种分析鼻窦组织以表征慢性鼻-鼻窦炎伴鼻息肉（CRSwNP）的内型的方法。过敏性真菌性鼻-鼻窦炎(AFRS)与CRSwNP的某些内型共有几个特征。我们的目的是比较AFRS和嗜酸性粒细胞CRSwNP的组织病理学，以进一步了解它们是否完全是单独的内生型或疾病实体。
方法：对接受内窥镜鼻窦手术的AFRS和CRSwNP患者进行回顾性回顾。收集了人口统计数据，合并症,主观和客观严重程度评分，和13个变量SHP报告。包括每个高倍视野（eCRSwNP）>10个嗜酸性粒细胞的CRSwNP患者。采用卡方检验和t检验进行统计分析。
结果：共确定了29例AFRS和108例eCRSwNP患者。AFRS患者更年轻，更常见的是黑人。症状严重程度评分（SNOT-22，Lund-MacKay，和Lund-Kennedy）在小组之间是统一的。AFRS患者的Charcot-Leyden晶体发生率较高（41.4%vs.10.2%；p<0.001)。严重程度的炎症，嗜酸性粒细胞炎症占优势，嗜酸性粒细胞聚集体，上皮下水肿，基底膜增厚在两组中都很常见，两组之间的比率无统计学差异。化生,溃疡,纤维化，增生/乳头状改变率低（<30%），组间相似。
结论：eCRSwNP和AFRS的SHP高度一致，这表明AFRS总体上是CRSwNP的严重亚型，而不是单独的疾病实体。这也为AFRS属于CRSwNP的内生谱提供了依据。
方法：3喉镜，2023年。
方法：对接受内窥镜鼻窦手术的AFRS和CRSwNP患者进行回顾性回顾。收集了人口统计数据，合并症,主观和客观严重程度评分，和13个变量SHP报告。包括每个高倍视野（eCRSwNP）>10个嗜酸性粒细胞的CRSwNP患者。采用卡方检验和t检验进行统计分析。
结果：共确定了29例AFRS和108例eCRSwNP患者。AFRS患者更年轻，更常见的是黑人。症状严重程度评分（SNOT-22，Lund-MacKay，和Lund-Kennedy）在小组之间是统一的。AFRS患者的Charcot-Leyden晶体发生率较高（41.4%vs.10.2%；p<0.001)。严重程度的炎症，嗜酸性粒细胞炎症占优势，嗜酸性粒细胞聚集体，上皮下水肿，基底膜增厚在两组中都很常见，两组之间的比率无统计学差异。化生,溃疡,纤维化，增生/乳头状改变率低（<30%），组间相似。
结论：eCRSwNP和AFRS的SHP高度一致，这表明AFRS总体上是CRSwNP的严重亚型，而不是单独的疾病实体。这也为AFRS属于CRSwNP的内生谱提供了依据。
方法：3喉镜，2023年。
