Eosinophilic chronic rhinosinusitis with nasal polyps (ECRSwNP) exhibits a poorer outcome compared with non-eosinophilic chronic rhinosinusitis with nasal polyps (nonECRSwNP), so it is significant to identify effective markers to differentiate ECRSwNP in guiding the treatment strategies of these patients. Although arachidonate 15-lipoxygenase (ALOX15) is positioned as a marker of eosinophilic inflammation, its study in differentiating ECRSwNP has not been reported. The aim of this study is to assess the potential of ALOX15 in distinguishing and predicting ECRSwNP. Forty-eight patients with chronic rhinosinusitis with nasal polyps (CRSwNP), including 30 ECRSwNP and 18 nonECRSwNP patients, were enrolled. ALOX15 mRNA level was determined in polyps by real-time polymerase chain reaction (RT-PCR). The patients’ baseline characteristics were evaluated and analyzed for correlations with ALOX15. Receiver operating characteristic (ROC) curve was used to assess the predictive significance of the potential predictors for ECRSwNP. ALOX15 mRNA level was significantly higher in ECRSwNP patients than in nonECRSwNP patients (P < 0.001). ALOX15 mRNA was significantly correlated with tissue and blood eosinophil percentages (r = 0.565, P < 0.001 and r = 0.395, P = 0.006), olfaction scores (r = 0.400, P = 0.005), total visual analogue scale (VAS) symptom scores (r = 0.383, P = 0.007), ethmoid/maxillary sinus (E/M) ratio (r = 0.463, P = 0.001), and endoscopy scores (r = 0.409, P = 0.004). Logistic regression analysis showed ALOX15 mRNA level and percentage of blood eosinophils to be predictive factors for ECRSwNP (P = 0.004 and P = 0.036, respectively). ROC curve indicated ALOX15 to have high predictive accuracy for ECRSwNP (area under the curve (AUC) = 0.909), which was further improved by combination of ALOX15 with percentage of blood eosinophils (AUC = 0.933). The relative ALOX15 mRNA level alone or in combination with blood eosinophils might be a reliable biomarker for predicting a diagnosis of ECRSwNP.

中文翻译：

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花生四烯酸15-脂氧合酶对嗜酸性慢性鼻窦炎伴鼻息肉的预测意义

嗜酸性慢性鼻窦炎伴鼻息肉（ECRSwNP）与非嗜酸性慢性鼻窦炎伴鼻息肉（nonECRSwNP）相比，预后较差，因此寻找有效的标志物区分ECRSwNP对指导这些患者的治疗策略具有重要意义。尽管花生四烯酸 15-脂氧合酶 (ALOX15) 被定位为嗜酸性粒细胞炎症的标志物，但其在鉴别 ECRSwNP 方面的研究尚未见报道。本研究的目的是评估 ALOX15 在区分和预测 ECRSwNP 方面的潜力。入组 48 例慢性鼻窦炎伴鼻息肉 (CRSwNP) 患者，包括 30 例 ECRSwNP 和 18 例非 ECRSwNP 患者。通过实时聚合酶链反应 (RT-PCR) 在息肉中测定 ALOX15 mRNA 水平。评估和分析患者的基线特征与 ALOX15 的相关性。接受者操作特征 (ROC) 曲线用于评估 ECRSwNP 潜在预测因子的预测意义。ECRSwNP 患者的 ALOX15 mRNA 水平显着高于非 ECRSwNP 患者（P < 0.001）。ALOX15 mRNA 与组织和血液嗜酸性粒细胞百分比（r = 0.565，P < 0.001 和 r = 0.395，P = 0.006）、嗅觉评分（r = 0.400，P = 0.005）、总视觉模拟评分（VAS）症状评分显着相关(r = 0.383, P = 0.007)、筛窦/上颌窦 (E/M) 比值 (r = 0.463, P = 0.001) 和内窥镜评分 (r = 0.409, P = 0.004)。Logistic 回归分析显示 ALOX15 mRNA 水平和血嗜酸性粒细胞百分比是 ECRSwNP 的预测因素（P = 0.004 和 P = 0.036，分别）。ROC 曲线表明 ALOX15 对 ECRSwNP 具有较高的预测准确性（曲线下面积 (AUC) = 0.909），通过将 ALOX15 与血嗜酸性粒细胞百分比（AUC = 0.933）相结合，进一步提高了预测准确性。单独或与血液嗜酸性粒细胞结合的相对 ALOX15 mRNA 水平可能是预测 ECRSwNP 诊断的可靠生物标志物。