Study On Histological Characteristics Of Nasal Polyps In Children And The Difference Between Children And Adults On Nasal Polyps

Objective: A histopathologic study of children with CRSwNP(chronic rhinosinusitis with nasal polyps)was undertaken to compare the nasal polyps in pediatric and adult CRSwNP.Methods: 1 Clinical materials The patients were selected who received nasal endoscopic sinus surgery + nasal polypectomy at Shenzhen Children's Hospital or Shenzhen Second People's Hospital from 2018 to 2020,and were divided into 2 groups.The observation group consisted of 45 child cases and 18 adult cases as the control group.All patients' clinical symptoms,Lund-Mackay sinus score,Lund-Kennedy endoscopic score,total IgE level,allergen detection level,and blood cell count analysis of peripheral blood samples were collected before surgery.All of the tissues were performed by hematoxylin-eosin staining to test the distribution of eosinophil.2 Experimental methods Two groups of nasal polyp tissue specimens were prepared and HE stained to observe the eosinophil infiltration.SPSS 22.0 software shuld be used to analysis the results.We performed?2 tests on the general conditions and clinical characteristics of the two groups of patients,such as the patient's gender,past history,total IgE> 100U/mL ratio,total IgE level ratio,and food / inhalation allergen positive rate.For measurement data,such as age,course of disease,CT score,endoscopic score,hematology index,eosinophil count in the tissue,etc.,first perform a Kolmogorov-Smirnov normality test,and then according to the results,the The index is represented by(x±s),and the index that does not meet the normal distribution is represented by the median M(P25,P75),and the t test and Mann-Whiney test are performed respectively.P <0.05 was considered a statistical difference.Correlation studies were performed on indicators with significant differences in the studies.Spearman rank correlation analysis was used.P <0.05 was considered statistically significant.Results: 1.A total of 63 cases were included in the group,and 45 cases in the children group(34 males and 11 females)had a minimum age of 4 years,a maximum age of 14 years,and a median age of 10(7,12)years.1(0.5,2)year.There were 18 patients in the adult group(11 males and 7 females),with a median age of 38(33.5,41.5)years and a median duration of 4(1,9)years.Compared with the adult group,the children group mostly had unilateral onset(67.44% vs 33.33%,P = 0.01 <0.05),the course of disease was shorter(1 year sv 4 years,P = 0.001 <0.05),and the difference in gender No statistical significance(P > 0.05).2.The children group is divided into 2 groups according to their sources of nasal polyps.There are a total of 25 cases(20 males and 5 females)in the children's posterior nostril polyp group and 20 cases(15 males and 5 females)in the children's middle nasal polyps group..We found that both groups showed a high percentage of male gender(80% and 75%,P > 0.05).Most of the children's posterior nostril polyps are unilateral(22 cases,88%),and children's middle nasal polyps tend to be bilateral(10 cases,50%),the differences are statistically significant(P <0.05)3.In terms of clinical characteristics,we counted the manifestations of olfactory disorder,bloody nose,sneezing nasal itching,perimeter frame,frontal bloating,dizziness,and complications of adjacent organs.Among them,the differences in complications of adjacent organs were statistically significant.More complications occurred(accounting for 22.2%),and the remaining clinical symptoms were not statistically significant(P > 0.05).4.On the Lund-Mackay score of sinus CT,the score of children was significantly lower than that of adults(7 vs 11,P > 0.05).On the individual scores of LM,the adult maxillary sinus,the anterior and posterior ethmoid sinuses and frontal sinus have higher scores,and the difference is statistically significant(P <0.05),while the sphenoid sinus and sinus ostium There was no statistically significant difference in nasal complex score comparison(P > 0.05).Children's middle nasal polyps group had a higher frontal sinus score than children's posterior nostril polyp group(1.89vs0,P<0.05).There was no statistically significant difference in the scores of the other groups.In terms of endoscopic Lund-Kennedy score,the total score of the adult group is higher than that of the child group(9.1vs7.5),but the difference between the two groups in the LK score of nasal polyps is not statistically significant(P > 0.05).There was no significant difference in the Lund-Kennedy score between the posterior nostril polyp group and the children's middle nasal polyp group(7vs8,P > 0.05).5.In terms of blood testing,there were no significant differences between the two groups in the levels of white blood cells,neutrophils,lymphocytes,monocytes,eosinophils,basophils,and their percentages(P>0.05).In terms of allergen detection,the proportion of total IgE> 100 U / mL(64.52% vs 83.3)and the proportion of total IgE> 200 U / mL(25.8% vs 50%)in the children group were lower than those in the adult group,but the difference was not no statistically significant(P>0.05).There was no statistically significant difference in the positive rates of ingestion allergens and inhalation allergens among the allergen positive rates(P > 0.05);6.There was no significant difference in the proportion of eosinophil infiltration and eosinophilic nasal polyps between the posterior nostril polyp group and the children middle nasal polyp group(P >0.05).The ratio of total eosinophils,inflammatory cells and eosinophils in polyp tissues in children's posterior nostril polyp group and children's middle nasal nasal polyp group and adult CRSwNP group was lower than that in adults,except for children There was no statistically significant difference in the total number of inflammatory cells between the group and the adult group,and the differences in the remaining indicators were statistically significant.There was no significant difference in the proportion of eosinophilic nasal polyps in different stages of each group(P >0.05).7.The degree of Eos infiltration was not significantly correlated with the gender,age,disease duration,serum Eos count,serum Eos percentage,CT score(total score),LundKennedy score(total score)in children and adults(P > 0.05).Conclusion: 1.The posterior nostril polyps in children are mostly unilateral,more common in men,mainly from the maxillary sinus,the inflammation is lighter,compared with the nasal polyps of middle nasal passages in children,the degree of eosinophil infiltration in the nasal polyps of the two There is no obvious difference.2.Compared with adult patients with nasal polyps,children with nasal polyps have a shorter course of disease,mild symptoms,mostly unilateral disease,fewer adjacent organ complications,and less inflammation involving the entire group of sinuses.3.There is a difference in histology between nasal polyps in children and adults.Eosinophil infiltration is mainly in the adult group,and non-eosinophil infiltration in the children group.4.Peripheral blood eosinophil ratio and allergen test results were not statistically different between children and adults,suggesting that allergy indicators were not significantly different between children with nasal polyps and adults with nasal polyps.