The Significance Of Blood Eosinophils Cutoff Value In Diagnosis Of Eos CRSwNP

Objective: To Look for a simple method to diagnose eosinophilic nasal polyp,we have done some analysis of the blood eosinophils absolute value and blood eosinophils percentage.We intend to determin one and(or) two cutoff value.From this(these) cutoff value ,we can classify the chronic rhinosinusitis with nasal polyps into eosinophilic nasal polyps and non-eosinophilic nasal polyps.Method: 133 Patients with bilateral chronic rhinosinusitis with nasal polyp(CRSwNP) in 2004-2009 were included.Nasal polyps obtained in the surgery were differentiated into eosinophilic nasal polyp(Eos CRSwNP) and non-eosinophilic nasal polyp(non-Eos CRSwNP) by HE staining. 52 eosinophilic nasal polyp and 81 non-eosinophilic nasal polyps.Clinical characteristics including sex,age,with or without asthma,allergic rhinitis (AR),drinking,smoking,course of disease ,visual analogue scal score,nasalpolyp score, CT score, blood immunoglobulin E, atopy, blood eosinophils absolute and blood eosinophils percentage were evaluated by monofactorial logistic regression analysis in SPSS13.0. p value and odd ratios (ORs) were calculated to filter one and (or) two predicting index(s) to distinguish Eos CRSwNP and non-Eos CRSwNP,and judged for their predicting abilitiy. Then valuable predicting indicatrixs were chosen to do the reciever operator characteristive curve(ROC curve),the area under the curve(AUC) reflected the relationship of the sensitivity and specificity at every cutoff value, a suitable dividing line was determined to divid Eos CRSwNP and non-Eos CRSwNP. At last, the cutoff value was used to make a forecast for another independent sample, positive predictive value and negative predictive value were calculated, the value of the chosen cutoff value was estimated again.Results: Gender,blood eosinophils absolute value and blood eosinophils percentage,blood immunoglobulin E showed significant differences in Eos CRSwNP and non-Eos CRSwNP by monofactorial logistic regression analysis, blood eosinophils absolute value and blood eosinophils percentage p<0.001,and OR was very large ,when blood eosinophils is 0.215×109/L,sensitivity and specificity is 69.2% and 76.5%,respectively. Blood eosinophils percentage is 2.65%, sensitivity and specificity is 76.9% and 64.2%.If blood eosinophils is 0.145×109/L and blood IgE is 12.1ku/l, sensitivity and specificity is 80% and 85.2%.If blood eosinophils percentage is 2.65% and blood IgE is 12.1ku/l,sensitivity and specificity of the diagnose is 80%和81.5%。Conclution: Aggregate analysis of gender,smoking and blood eosinophils,blood eosinophils percentage and blood IgE could be considered to be a primary screening method to predict Eos CRSwNP.