The Expression And The Predictive Value Of Short-term Prognosis Of TGF-?1?HIF-1? And TSLP In Nasal Polyps

ObjectiveThe purpose of this study was to investigate the expression of TGF-?1,HIF-1?,TSLP in nasal polyps.The immunohistochemical method was used to analyze the relationship between the expression and the correlation analysis of them,to investigate the predictive value of TGF-?1,HIF-1? and TSLP in the short-term prognosis of nasal polyps,aiming to provide a new direction for the treatment of nasal polyps.Materials and Methods1.30 nasal polyps tissues,which were from the patient with double nasal polys were used as an experimental group,and 30 cases of uncinate process mucosa,which were from the patient with sinus mucocele were selected as a control group.All preoperative patients were with no history of allergic rhinitis,aspirin intolerance,asthma,fungal sinusitis,antrochoanal polyp and recurrent nasal polyps.All the cases were recorded completely.Preoperative visual analogue scales(VAS)and the sino-nosal outcome test-22(snot-22)were performed on the clinical symptoms of nasal congestion,runny nose,hyposmia/loss,head/facial pain in all patients,and thepreoperative sinus CT score was performed on the patients according to the Lund-Mackay sinus evaluation criteria,and the internal nasal conditions were graded according to the Lund-Kennedy endoscopic score.All patients were followed up for more than 3 months postoperatively,and the short-term efficacy of the patients was evaluated by the endoscopic score at 3 months postoperatively.2.All of the tissues were performed by HE staining,The immunohistochemical method(SP)was used to test the expression and distribution of TGF-?1,HIF-1? and TSLP in the two groups.Nasal polys was define as Eos CRSwNP when the proportion of eosinophilic infiltration was more than 10% of all inflammatory cells.3.All the expermental results using SPSS20.0 software for statistical analysis.qualitative data were analyzed using the rank sum test of two independent samples,two groups of ranked data using Mann-Whitney rank test,the relationship among the three factors using Spearman rank correlation analysis.P<0.05 was statistical significance.Results1.VAS score of patients in nasal polyp group(6.2±1.5)was significantly higher than that in control group(5.2±1.4),and the difference was statistically significant(P< 0.05).Snot-22 score in nasal polyp group(39.0±11.4)was significantly higher than that in control group(26.3±9.3),and the difference was statistically significant(P < 0.05).2.HE staining showed that the polyp tissue was formed by loose connective tissue with high edema,and a large number of goblet cells were observed,with obvious glandular hyperplasia but irregular shape,thickened basement membrane,highly edema interstitium and a large number of inflammatory cell infiltrations,such as eosinophils,neutrophils and lymphocytes.Eosinophil cytoplasm with 2-3 lobulated nuclei is seen under light microscope.Eos CRSwNP 12 cases,non-Eos CRSwNP 18 cases,The preoperative Lund-Kennedy endoscopic score of Eos CRSwNP patients was higher than that of non-Eos CRSwNP patients,and the difference was statistically significant(Z=-2.4,P=0.019 < 0.5).3.The expression of TGF-?1 TGF-?1 is mainly located in the cytoplasm,with a positive expression rate of 86.7% in nasal polyps,while with a positive expression rate of 40.0% in the control group;the expression strength of the nasal polyps group is higher than that in the control group,the difference was statistically significant(P<0.05).There was no significant difference in the expression of TGF-?1 between different staging groups(P> 0.05).4.The expression of HIF-1? HIF-1? is mainly located in the cytoplasm and the nucleus,with a positive expression rate of 90.0% in the nasal polyps,while with a positive expression rate of 36.7% in the control group;the expression strength of the nasal polyps group is higher than the inferior turbinate group,the difference was statistically significant(P<0.05).There was no significant difference in the expression of HIF-1? between different staging groups(P> 0.05).5.The expression of TSLP TSLP is mainly located in the cytoplasm and the nucleus,with a positive expression rate of 83.3% in the nasal polyps,while with a positive expression rate of 33.3% in the control group;the expression strength of the nasal polyps group is higher than the inferior turbinate group,the difference was statistically significant(P<0.05).There was no significant difference in the expression of TSLP between different staging groups(P> 0.05).6.The expression correlation of TGF-?1,HIF-1? and TSLP in nasal polyps group The expression of TGF-?1 and HIF-1? was positively correlated(r=0.447,P<0.05),The expression of TGF-?1 and TSLP was positively correlated(r=0.403,P<0.05),The expression of HIF-1? and TSLP was positively correlated(r=0.456,P<0.05).7.The predictive value of TGF-?1,HIF-1?,TSLP and eosinophilic infiltration in the short-term prognosis of patients with nasal polyps TGF-?1,HIF-1? and TSLP have no effect on the short-term prognosis of patients with nasal polyps,The postoperative Lund-Kennedy endoscopic score of Eos CRSwNP patients(3.08±0.79)was significantly higher than that of non-Eos CRSwNP patients(1.89±1.32),and the difference was statistically significant(P < 0.05).Conclusion1.Increased expression of TGF-?1,HIF-1? and TSLP May be involved in the occurrence and development of nasal polyps,the expressions of TGF-?1,HIF-1? and TSLP in nasal polyps have a synergistic effect,which jointly promote the formation of nasal polyps.2.The expression of TGF-?1,HIF-1? and TSLP in nasal polyps was independent of disease stage and short-term prognosis.3.The short-term prognosis in Eos CRSwNP patients was worse than that of non-Eos CRSwNP patients.4.The involvement of TGF-?1,HIF-1? and TSLP in the occurrence of nasal polyps may provide a new dirction for the pathogenesis of nasal polyps.