PMID- 22419386
OWN - NLM
STAT- MEDLINE
DCOM- 20130405
LR  - 20220410
IS  - 2042-6984 (Electronic)
IS  - 2042-6976 (Linking)
VI  - 2
IP  - 5
DP  - 2012 Sep-Oct
TI  - Structured histopathology profiling of chronic rhinosinusitis in routine 
      practice.
PG  - 376-85
LID - 10.1002/alr.21032 [doi]
AB  - BACKGROUND: Tissue eosinophilia in chronic rhinosinusitis (CRS) is a marker of 
      inflammatory disorders recalcitrant to surgical intervention. Eosinophilic 
      chronic rhinosinusitis (ECRS) is traditionally associated with asthma, polyps, 
      aspirin sensitivity, high serum eosinophilia, and elevated immunoglobulin E 
      (IgE). However, patients with ECRS may not present with these associations and 
      there is a need to establish other surrogate markers. The objective of the study 
      was to determine the associations between the histopathology, serology, and 
      clinical characteristics in CRS patients. METHODS: A cross-sectional study was 
      undertaken of CRS patients undergoing surgery. Tissue eosinophilia and other 
      pathological features were compared to traditional surrogate features of ECRS, as 
      well as to symptoms, and to radiologic and endoscopic scores. RESULTS: A total of 
      51 patients were assessed (47% female, mean age 46.6 +/- 4.1 years). High tissue 
      eosinophilia (>10 per high-power field [HPF]) was more prominent in polyps (84%) 
      (chi(2) = 25.76; p < 0.01) but was also seen in nonpolyp patients (19%). Asthma was 
      not associated with high tissue eosinophilia (p = 0.60), with 43% of 
      nonasthmatics demonstrating high tissue eosinophilia. Serum eosinophilia 
      predicted high tissue eosinophilia at >0.30 x 10(9)/L or 4.4% of leukocytes 
      (sensitivity 52%, specificity 87%, receiver operating characteristic [ROC] p = 
      0.001), with low negative predictive value. Serum IgE was nonpredictive (p = 
      0.08). CONCLUSION: The diagnosis of ECRS has unique prognostic implications. 
      Traditional features of the ECRS phenotype are not necessarily reliable markers 
      for the presence of tissue eosinophilia. Serum eosinophilia may be a good 
      surrogate marker of tissue eosinophilia but of limited use. The routine use of 
      structured histopathology reporting in CRS is suggested, to allow for the 
      diagnosis of ECRS and to identify other prognostic markers.
CI  - Copyright (c) 2012 American Rhinologic Society-American Academy of Otolaryngic 
      Allergy, LLC.
FAU - Snidvongs, Kornkiat
AU  - Snidvongs K
AD  - Australian School of Advanced Medicine, Macquarie University, Sydney, Australia. 
      drkornkiat@yahoo.com
FAU - Lam, Matthew
AU  - Lam M
FAU - Sacks, Raymond
AU  - Sacks R
FAU - Earls, Peter
AU  - Earls P
FAU - Kalish, Larry
AU  - Kalish L
FAU - Phillips, P Seamus
AU  - Phillips PS
FAU - Pratt, Eleanor
AU  - Pratt E
FAU - Harvey, Richard J
AU  - Harvey RJ
LA  - eng
PT  - Journal Article
DEP - 20120314
PL  - United States
TA  - Int Forum Allergy Rhinol
JT  - International forum of allergy & rhinology
JID - 101550261
SB  - IM
MH  - Adult
MH  - Chronic Disease
MH  - Cross-Sectional Studies
MH  - Diagnostic Tests, Routine
MH  - Eosinophilia/complications/*pathology
MH  - Eosinophils/*pathology
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Nasal Polyps/complications/*pathology
MH  - Paranasal Sinuses/*pathology
MH  - Prognosis
MH  - Rhinitis/complications/*pathology
MH  - Sinusitis/complications/*pathology
EDAT- 2012/03/16 06:00
MHDA- 2013/04/06 06:00
CRDT- 2012/03/16 06:00
PHST- 2011/08/14 00:00 [received]
PHST- 2011/10/06 00:00 [revised]
PHST- 2012/01/05 00:00 [accepted]
PHST- 2012/03/16 06:00 [entrez]
PHST- 2012/03/16 06:00 [pubmed]
PHST- 2013/04/06 06:00 [medline]
AID - 10.1002/alr.21032 [doi]
PST - ppublish
SO  - Int Forum Allergy Rhinol. 2012 Sep-Oct;2(5):376-85. doi: 10.1002/alr.21032. Epub 
      2012 Mar 14.