CRSwNP患者中IL-8、IFN-γ表达与全身炎症指数的关联及临床意义

摘要/Abstract

摘要： 目的探究张家口地区慢性鼻窦炎伴鼻息肉(chronic rhinosinusitis with nasal polyps, CRSwNP)组织的形态学构造和炎症因子表达;分析白细胞介素8(interleukin-8, IL-8)、干扰素γ(interferon-γ, IFN-γ)在CRSwNP组织中的表达及其与全身炎症指数的关联和临床意义。方法采集2021年1月8日至2024年12月8日于河北北方学院第一附属医院耳鼻咽喉头颈外科行鼻内镜手术治疗的135例CRSwNP患者的鼻息肉组织与血浆(CRSwNP组),另取同期确诊为上颌窦囊肿患者的正常钩突组织与血浆(57例)作为对照(对照组),采用苏木精-伊红染色(hematoxylin-eosin staining, HE)、免疫组织化学染色(immunohistochemistry, IHC)观察鼻窦黏膜形态和炎细胞分布、Western blot和ELISA检测炎细胞标志物、IL-8与IFN-γ的表达。采用ROC曲线分析全身炎症指数、IL-8与IFN-γ单独及联合诊断CRSwNP的价值。结果 HE显示CRSwNP组织上皮增生、肥厚,部分可见鳞状上皮化生,间质中嗜酸性粒细胞、中性粒细胞、淋巴细胞及浆细胞浸润,结缔组织高度水肿;IHC显示CRSwNP组IL-8、IFN-γ与CD138、CD3、CD79a、CD68的AOD值较对照组均明显升高(P<0.05);Western blot显示 CRSwNP组织IL-8和IFN-γ表达明显高于对照组(P<0.001);ELISA测得IL-8和IFN-γ在CRSwNP组含量显著高于对照组(P<0.001)。ROC曲线分析显示,LMR、血浆IL-8和IFN-γ诊断CRSwNP的曲线下面积分别为0.656(95%CI:0.509~0.802),0.894(95%CI:0.809~0.978),0.731(95%CI:0.570~0.893),三者联合诊断CRSwNP的曲线下面积为0.981(95%CI:0.955~0.999)。结论张家口地区CRSwNP以混合型炎症(尤其中性粒细胞型)居多,IL-8与IFN-γ高表达;LMR、IFN-γ和IL-8联合诊断显著提高了CRSwNP诊断效能。

关键词: 慢性鼻窦炎伴鼻息肉, 白细胞介素8, 干扰素-γ, 全身炎症指数

Abstract: Objective The present study aims to explore the morphological configuration and inflammatory factor expression of CRSwNP in the Zhangjiakou area. In particular, it will analyze the expression of IL-8 and IFN-γ in CRSwNP, as well as its relationship and significance with systemic inflammatory index. Methods A total of 135 patients dignosed with CRSwNP who underwent rhinoscopic surgery at the Department of Otorhinolaryngology Head and Neck Surgery of the First Affiliated Hospital of Hebei North University from 8 January 2021 to 8 December 2024 were included in the study(CRSwNP group). Nasal polyp tissues and plasma from these patients were collected for analysis. In order to establish a basis for comparison, normal uncinate process tissues and plasma from patients diagnosed with maxillary sinus cysts during the same period(57 cases)were taken as a control group(control group).The control group was stained with hematoxylin and eosin(HE)and immunohistochemistry(IHC)to observe the morphology of sinus mucosa and the distribution of inflammatory cells. Furthermore,Western blot and enzyme-linked immunosorbent assay(ELISA)were used to detect the expression and semi-quantitative analysis of inflammatory cell markers, interleukin(IL)-8 and interferon(IFN)-γ. ROC analysis was employed to evaluate the diagnostic value of systemic inflammation index, IL-8 and IFN-γ, both individually and in combination, for the diagnosis of CRSwNP. Results The study revealed that CRSwNP tissues exhibited epithelial hyperplasia and hypertrophy, accompanied by squamous epithelial hyperplasia, eosinophil, neutrophil, lymphocyte and plasma cell infiltration in the mesenchyme, and markedly edematous connective tissues. The results of the IHC analysis demonstrated that the AOD values of IL-8, IFN-γ, CD138, CD3, CD79a, and CD68 in the CRSwNP group were significantly higher compared with those in the control group(P<0.05). The results of IL-8 and IFN-γ in CRSwNP tissues were significantly higher than those in the control group by Western blot (P<0.001); In addition, the ELISA assay results showed that the plasma levels of IL-8 and IFN-γ in the CRSwNP group were significantly higher than those in the control group(P<0.001). ROC curve analysis showed that the area under the curve of LMR, plasma IL-8 and IFN-γ in the diagnosis of CRSwNP was 0.656(95%CI:0.509-0.802), 0.894(95%CI:0.809-0.978)and 0.731(95%CI:0.570-0.893), respectively. The area under the curve of the combined diagnosis of CRSwNP was 0.981(95%CI:0.955-0.999 ). Conclusion CRSwNP was predominantly of mixed inflammation(especially neutrophilic type), with high expression of IL-8 and IFN-γ; the combined diagnosis of LMR, IFN-γ and IL-8 significantly improved the diagnostic efficacy of CRSwNP in the Zhangjiakou area.

Key words: Chronic rhinosinusitis with nasal polyps, Interleukin-8, Interferon-γ, Systemic inflammation index

中图分类号:

R765.4

王予诺,李政霖,赵佳娴,李文凯,卢慧,吴靖芳,薛刚. CRSwNP患者中IL-8、IFN-γ表达与全身炎症指数的关联及临床意义[J]. 山东大学耳鼻喉眼学报, 2026, 40(6): 46-53.

WANG Yunuo, LI Zhenglin, ZHAO Jiaxian, LI Wenkai, LU Hui, WU Jingfang, XUE Gang. The correlation between the expression of IL-8, IFN-γ and systemic inflammatory index in CRSwNP patients and its clinical significance[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2026, 40(6): 46-53.

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