Clinical-Cytological-Grading and phenotyping in patients with chronic rhinosinusitis with nasal polyps: the relevance in clinical practice
Chronic rhinosinusitis (CRS) includes two main phenotypes: without nasal polyps (CRSsNP) and with nasal polyps (CRSwNP). CRSwNP may be associated with comorbidity, mainly concerning asthma, aspirin intolerance, and allergy. CRSwNP patients may also be evaluated by clinical-cytological grading (CCG)....
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| Format: | Article |
| Language: | English |
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PAGEPress Publications
2020-06-01
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| Series: | Monaldi Archives for Chest Disease |
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| Online Access: | https://monaldi-archives.org/index.php/macd/article/view/1277 |
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| author | Matteo Gelardi Giuseppe Porro Vitaliano Quaranta Nicola Quaranta Michele Cassano Giorgio Ciprandi *Italian Study Group on CRSwNP |
| author_facet | Matteo Gelardi Giuseppe Porro Vitaliano Quaranta Nicola Quaranta Michele Cassano Giorgio Ciprandi *Italian Study Group on CRSwNP |
| author_sort | Matteo Gelardi |
| collection | DOAJ |
| description | Chronic rhinosinusitis (CRS) includes two main phenotypes: without nasal polyps (CRSsNP) and with nasal polyps (CRSwNP). CRSwNP may be associated with comorbidity, mainly concerning asthma, aspirin intolerance, and allergy. CRSwNP patients may also be evaluated by clinical-cytological grading (CCG). The current study investigated the prevalence and characteristics of the different CCG and phenotypes in CRSwNP outpatients examined in clinical practice. This retrospective cross-sectional study enrolled 791 consecutive CRSwNP outpatients (424 males, mean age 48.8 years). In the total population, asthma was a common comorbidity (30.8%) as well as aspirin intolerance (24.8%), and allergy (50.8%). As concerns CCG-grading, 210 (26.5%) outpatients had low-grade, 366 (46.3%) medium, and 215 (27.2%) high. As regards cytological phenotypes, 87 (11%) had neutrophilic type, 371 (46.3%) eosinophilic, 112 (14.2%) mast cell, and 221 (27.9%) mixed. High-grade CCG was significantly associated with more frequent asthma, aspirin intolerance, allergy, recurrent surgery, and mixed cytological phenotype. Low-grade CCG was characterized by fewer comorbidities and operations, and neutrophilic phenotype. Therefore, the present study confirmed that CCG is a useful tool in the management of outpatients with CRSwNP. CRSwNP is frequently associated with asthma, aspirin intolerance, and allergy comorbidity. High-grade CCG is frequently characterized by a mixed cytological phenotype, thus, by more severe progress. These real-world outcomes underline that CRSwNP deserves adequate attention for careful management and optimal identification of the best-tailored therapy; CCG and cytological phenotyping could be fruitful tools in clinical practice. Asthma and aspirin intolerance should be adequately investigated in all CRS patients. |
| first_indexed | 2024-12-18T05:12:52Z |
| format | Article |
| id | doaj.art-70c0e1a08ef2456791ea0894accb7981 |
| institution | Directory Open Access Journal |
| issn | 1122-0643 2532-5264 |
| language | English |
| last_indexed | 2024-12-18T05:12:52Z |
| publishDate | 2020-06-01 |
| publisher | PAGEPress Publications |
| record_format | Article |
| series | Monaldi Archives for Chest Disease |
| spelling | doaj.art-70c0e1a08ef2456791ea0894accb79812022-12-21T21:19:50ZengPAGEPress PublicationsMonaldi Archives for Chest Disease1122-06432532-52642020-06-0190210.4081/monaldi.2020.1277Clinical-Cytological-Grading and phenotyping in patients with chronic rhinosinusitis with nasal polyps: the relevance in clinical practiceMatteo Gelardi0Giuseppe Porro1Vitaliano Quaranta2Nicola Quaranta3Michele Cassano4Giorgio Ciprandi5*Italian Study Group on CRSwNPDepartment of Otolaryngology, University of FoggiaOtolaryngology, Department of Basic Medical Science, Neuroscience and Sensory Organs, University of BariPulmonology Unit, Ospedale Di Venere, BariOtolaryngology, Department of Basic Medical Science, Neuroscience and Sensory Organs, University of BariDepartment of Otolaryngology, University of FoggiaAllergist consultant, Casa di Cura Villa Montallegro, GenoaChronic rhinosinusitis (CRS) includes two main phenotypes: without nasal polyps (CRSsNP) and with nasal polyps (CRSwNP). CRSwNP may be associated with comorbidity, mainly concerning asthma, aspirin intolerance, and allergy. CRSwNP patients may also be evaluated by clinical-cytological grading (CCG). The current study investigated the prevalence and characteristics of the different CCG and phenotypes in CRSwNP outpatients examined in clinical practice. This retrospective cross-sectional study enrolled 791 consecutive CRSwNP outpatients (424 males, mean age 48.8 years). In the total population, asthma was a common comorbidity (30.8%) as well as aspirin intolerance (24.8%), and allergy (50.8%). As concerns CCG-grading, 210 (26.5%) outpatients had low-grade, 366 (46.3%) medium, and 215 (27.2%) high. As regards cytological phenotypes, 87 (11%) had neutrophilic type, 371 (46.3%) eosinophilic, 112 (14.2%) mast cell, and 221 (27.9%) mixed. High-grade CCG was significantly associated with more frequent asthma, aspirin intolerance, allergy, recurrent surgery, and mixed cytological phenotype. Low-grade CCG was characterized by fewer comorbidities and operations, and neutrophilic phenotype. Therefore, the present study confirmed that CCG is a useful tool in the management of outpatients with CRSwNP. CRSwNP is frequently associated with asthma, aspirin intolerance, and allergy comorbidity. High-grade CCG is frequently characterized by a mixed cytological phenotype, thus, by more severe progress. These real-world outcomes underline that CRSwNP deserves adequate attention for careful management and optimal identification of the best-tailored therapy; CCG and cytological phenotyping could be fruitful tools in clinical practice. Asthma and aspirin intolerance should be adequately investigated in all CRS patients.https://monaldi-archives.org/index.php/macd/article/view/1277chronic rhinosinusitis with nasal polypsasthmaclinical-cytological-gradingcytological phenotypecomorbidityreal-world |
| spellingShingle | Matteo Gelardi Giuseppe Porro Vitaliano Quaranta Nicola Quaranta Michele Cassano Giorgio Ciprandi *Italian Study Group on CRSwNP Clinical-Cytological-Grading and phenotyping in patients with chronic rhinosinusitis with nasal polyps: the relevance in clinical practice Monaldi Archives for Chest Disease chronic rhinosinusitis with nasal polyps asthma clinical-cytological-grading cytological phenotype comorbidity real-world |
| title | Clinical-Cytological-Grading and phenotyping in patients with chronic rhinosinusitis with nasal polyps: the relevance in clinical practice |
| title_full | Clinical-Cytological-Grading and phenotyping in patients with chronic rhinosinusitis with nasal polyps: the relevance in clinical practice |
| title_fullStr | Clinical-Cytological-Grading and phenotyping in patients with chronic rhinosinusitis with nasal polyps: the relevance in clinical practice |
| title_full_unstemmed | Clinical-Cytological-Grading and phenotyping in patients with chronic rhinosinusitis with nasal polyps: the relevance in clinical practice |
| title_short | Clinical-Cytological-Grading and phenotyping in patients with chronic rhinosinusitis with nasal polyps: the relevance in clinical practice |
| title_sort | clinical cytological grading and phenotyping in patients with chronic rhinosinusitis with nasal polyps the relevance in clinical practice |
| topic | chronic rhinosinusitis with nasal polyps asthma clinical-cytological-grading cytological phenotype comorbidity real-world |
| url | https://monaldi-archives.org/index.php/macd/article/view/1277 |
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