| Research background and objective:Chronic rhinosinusitis（CRS）is a common disease to the otorhinolaryngology department.The symptoms include nasal congestion,runny nose,facial pain,headache and loss of the sense of smell.Patients affected by CRS usually report impaired quality of life,and this is persistent,even relapsing after surgery.The pathogenesis of CRS is complex and The economic burden is heavy and has a great impact on the lives of patients,Therefore,this study will investigate the expression level of periostin in CRS tissues and its significance in different types of CRS,and to investigate the relationship between the expression of periostin and the severity of chronic rhinosinusitis,and whether high expression of periostin is an influential factor for disease recurrence after endoscopic surgery in patients with chronic rhinosinusitis.Method:Patients admitted to Department of Otorhinolaryngology head and Neck Surgery,Yangzhou University Affiliated Hospital from September 2019 to September 2020 who were diagnosed with CRS after functional endoscopic sinus surgery were selected and Fifty-two cases were selected as the observation group;During this period,patients hospitalized for nasal septum correction surgery were diagnosed as simple nasal septum deviation,and 30 cases were selected as the control group.Pathological mucosal tissues of chronic rhinosinusitis patients and inferior turbinate mucosal tissues of nasal septum deviation patients were collected and Immunohistochemical method was used to determine the expression level of periostin in the collected tissues.The expression level of periostin in the nasal mucosa tissues of patients with chronic rhinosinusitis was compared with that of normal nasal mucosa tissues.They were divided into the high expression group and the low expression group according to the median expression level of periostin.Analysis the difference and its clinical significance of different age,sex and course of disease;Smoking,drinking,diabetes,hypertension,nasal polyps,allergic rhinitis;And the difference of tissue periostin expression in patients with fungal or eosinophilic chronic rhinosinusitis;Result:（1）The expression level of periostin in chronic rhinosinusitis:the periostin is mainly distributed in the basement membrane of the nasal mucosa epithelium and the extracellular matrix region below the epithelium,and the yellow staining degree and yellow staining area of patients with chronic rhinosinusitis are significantly higher than those with non-chronic rhinosinusitis.Immunohistochemical score of periostin in 52 patients with chronic rhinosinusitis（pathological nasal mucosa）was significantly higher than that in 30 patients with simple nasal septum deviation（inferior turbinate mucosa）,the difference was statistically significant（P<0.05）.（2）Expression and significance of periostn in different types of CRS:The high expression rate of periostin in CRSwNP lesion nasal mucosa（72.0%）was significantly higher than that in CRSsNP lesion nasal mucosa（25.9%）,P=0.001,P<0.05,The difference was statistically significant;The high expression rate of periostin in eCRS lesion nasal mucosa（78.9%）was significantly higher than that in non-eCRS lesion nasal mucosa（30.3%）,P<0.05,The difference was statistically significant;The high expression rate of periostin in recurrent CRS lesions nasal mucosa（70.0%）was significantly higher than that in non-recurrent CRS esions nasal mucosa（34.4%）,P<0.05,The difference was statistically significant;However,there was no significant difference in the ratio of high and low expression of periostin in CRS patients with different gender,age,disease course and whether accompanied by fungi,P>0.05,The difference was not statistically significant.（3）Relationship between the expression of periosteal protein and severity of CRS patients:there was a significant positive correlation between the expression of periostin and the Lund-Kennedy score,rs=0.614,P<0.05,the difference was statistically;There was a significant positive correlation between the expression of periostin and lund-Mackay CT scan score,rs=0.6 78,P<0.05,the difference was statistically;There was no significant correlation between the expression of periostin and VAS score（P>0.05）,The difference was not statistically significant.（4）High expression of periosteum protein in nasal mucosa,history of smoking and history of allergic rhinitis are risk factors for recurrence after NASAL endoscopy of CRS,P<0.05,The difference was statistically significant.Conclusion:（1）The expression of periostin is involved in the inflammatory process of CRS,especially eCRS;（2）Periostin may serve as molecular biomarkers of CRS intra type;（3）Periostin is an independent risk factor for recurrence after nasal endoscopy in CRS patients. |
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