The Characteristics Of Pathogens Infection And The Expression Of NF-κB、IL-2 And CD^8α In Patients With Fungal Sinusitis

Objective:The characteristics of fungal infection in patients with fungal sinusitis and its correlation with the expression of NF-κB,IL-2 and CD^8αwere analyzed systematically.The risk factors affecting fungal sinusitis and their correlation with NF-κB,IL-2 and CD^8αwere obtained,which can provide practical experience for the clinical diagnosis and treatment of fungal sinusitis in the future.Methods:1. All the specimens collected in this study were from the patients with sinusitis who were operated by nasal endoscopy from October Two thousand and sixteenyear to September Two thousand and nineteen year in the Department of Otorhinolaryngology of our hospital,and the patients with sinusitis were excluded because of the deviation of nasal septum.According to the results of pathogen culture,45 cases of fungal sinusitis,45 cases of chronic sinusitis and 45 cases of normal nasal mucosa were randomly selected.45patients with fungal sinusitis were in group A,25-60 years old,median age 38years old,average age 38.8±11.6 years old,male:female ratio 24:21;45patients with chronic sinusitis were in group B,age 26-60 years old,median age 39 years old,average age 38.1±11.4 years old,male:female ratio 23:22;45 patients with normal nasal mucosa were in group C,age 24-60 years old,median age 38 years old,average age 38 years old The ratio of male to female was 22:23.The subjects in the three groups were excluded from allergic rhinitis,bronchial asthma,autoimmune diseases and aspirin triad.The subjects of group C were patients who needed to be operated in our department due to the deviation of nasal septum.Before the operation,the patients had been excluded from the history of turbinate mucosa disease or chronic sinusitis.In group A,group B and group C,mucosa samples were taken from the medial wall of the superior collar sinus near the uncinate process.After the mucosal samples of all the subjects were taken out,they were washed with 0.9%normal saline to remove the blood stains and mucus on the surface of the samples,and then the surface water of the samples was dried by filter paper.Each specimen was divided into two pieces with a diameter of about 0.4cm,one of which was quickly placed in a cryopreservation tube,and then put into a liquid nitrogen tank for preservation.Another specimen was immersed in formalin solution for 24 hours,then was dehydrated and embedded in paraffin.The expression of NF-κB,IL-2 and CD^8αin the nasal mucosa of three groups of patients was detected by immunohistochemistry.2.Spss20.0 statistical software was used to analyze the data.Descriptive statistical analysis,chi square test,variance analysis and logistic stepwise regression analysis were used to analyze the content expression of NF-κB,IL-2 and CD^8αin nasal mucosa samples of three groups.Setting P<0.05 has statistical significance.Results:1. The number of positive cells in fungal sinusitis group was significantly higher than that in chronic sinusitis group and normal control group（F=10.863,P<0.001）;2. In chronic sinusitis group,48 pathogens were cultured,including 34Gram-negative bacteria（70.83%）,12 Gram-positive bacteria（29.17%）;in fungal sinusitis group,47 pathogens were cultured,including 28Gram-negative bacteria（59.57%）,19 Gram-positive bacteria（40.43%）.The infection rate of Gram-positive bacteria in fungal sinusitis group was significantly higher than that in chronic sinusitis group（c²=11.683,P<0.001）;3. In the fungal sinusitis group,72 strains of fungi were cultured,most of which were Candida albicans,accounting for 38.89%;4. Nine factors,age>40 years old,runny blood,course>1 year,operation history in nasal cavity,calcification spot in sinuses on CT,NF-κB,IL-2,CD^8αand Gram-positive bacteria infection,had the most significant effect on fungal sinusitis（P<0.05）.Among them,OR=10.182 for NF-κB,OR=9.673 for CD^8αOR=9.463 for IL-2,OR=8.697 for Gram-positive bacterial infection,OR=6.532 for calcified spots in the paranasal sinuses on CT,OR=4.861 for more than one year,OR=3.974 for slurries;5. NF-κB was expressed in the nasal mucosa of the three groups.The expression of NF-κB in the fungal sinusitis group was significantly higher than that in the chronic sinusitis group and the normal control group（P<0.05）.The expression of NF-κB in fungal sinusitis group was significantly higher than that in chronic sinusitis group and normal control group（F=8.367,P<0.001）;6. IL-2 was expressed in the nasal mucosa of the three groups.The expression of IL-2 in fungal sinusitis group was significantly higher than that in chronic sinusitis group and normal control group（P<0.05）.The expression of IL-2 in fungal sinusitis group was significantly higher than that in chronic sinusitis group and normal control group（F=7.639,P<0.001）;7. CD^8αwas expressed in the nasal mucosa of the three groups.The expression of CD^8αin the fungal sinusitis group was significantly higher than that in the chronic sinusitis group and the normal control group（P<0.05）.The expression of NF-κB in fungal sinusitis group was significantly higher than that in chronic sinusitis group and normal control group（F=6.893,P=0.002）.Conclusions:1.Fungal sinusitis is mainly caused by Candida albicans,the most common of which is Candida albicans.Among the pathogens associated with fungal sinusitis,the proportion of Gram-positive bacteria infection is significantly higher than that of patients with chronic sinusitis.Nine factors are fungal sinusitis,including age>40 years old,runny blood,course>1 year,history of operation in the nasal cavity,CT showing calcified spots in the sinuses,NF-κB,IL-2,CD^8α,and Gram-positive bacteria infection Risk factors.2.The expression of NF-κB,IL-2 and CD^8αin the nasal mucosa of patients with fungal sinusitis is significantly higher than that of patients with chronic sinusitis and normal people.NF-κB,IL-2 and CD^8αcan be used as the reference indexes for the diagnosis of fungal sinusitis and the clinical evaluation of the therapeutic effect of fungal sinusitis.