Skip to main content
SpringerLink
Log in

Can the systemic immune inflammation index preoperatively predict nasal polyp subtypes?

  • Rhinology
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Purpose

Chronic rhinosinusitis with nasal polyps can be classified as eosinophilic or neutrophilic based on the major inflammatory cell type in the tissue. There is a need for predictive parameters to enable rhinologists to identify the type of nasal polyp in a patient without surgery. The aim of the present study was to test the predictive value of the markers of inflammation to estimate eosinophilic nasal polyps.

Methods

The study analyzed 299 patients who underwent sinus surgery for nasal polyps from 2012 to 2019. Patients were divided into two groups according to pathology results (eosinophilic polyps = group 1, neutrophilic polyps = group 2). The values of preoperative complete blood count, systemic immune inflammation index, neutrophil-to-lymphocyte ratio, and platelet-to-lymphocyte ratio were compared.

Results

In our series, results of ROC analyses for both mean eosinophil count and systemic immune inflammation index were statistically significant. For the eosinophil count (AUC = 0.681, p < 0.001) and systemic immune inflammation index (AUC = 0.621, p = 0.001). Patients with an eosinophil cut-off value of 0.25 cells × 109/L had ORs of 49.27 (95% CI 11.68–207.81) and sensitivity: 0.69, specificity: 0.64. Patients with a systemic immune inflammation index cut-off value of 332.39 had ORs of 1.003 (95% CI 1.002–1.004) and sensitivity: 0.84, specificity: 0.39.

Conclusion

The systemic immune inflammation index and absolute blood eosinophil count could be used to predict nasal polyp subtypes before surgery. We believe that systemic immune inflammation index should also be studied to estimate postoperative recurrence.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Pleis JR, Coles R (2002) Summary health statistics for U.S. adults: National Health Interview Survey,1998. Vital Health Stat 10(209):1–113

    Google Scholar 

  2. Pleis JR, Lucas JW, Ward BW (2009) Summary health statistics for U.S. adults: National Health Interview Survey, 2008. Vital Health Stat 10(242):1–157

    Google Scholar 

  3. Adams PF, Hendershot GE, Marano MA (1999) Current estimates from the National Health Interview Survey, 1996. Vital Health Stat 10(200):1–203

    Google Scholar 

  4. Shi JB, Fu QL, Zhang H, Cheng L, Wang YJ, Zhu D, Lv W, Liu SX, Li PZ, Ou CQ, Xu G (2015) Epidemiology of chronic rhinosinusitis: results from a cross-sectional survey in seven Chinese cities. Allergy 70(5):533–539. https://doi.org/10.1111/all.12577

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  5. Hastan D, Fokkens WJ, Bachert C, Newson RB, Bislimovska J, Bockelbrink A, Bousquet PJ, Brozek G, Bruno A, Dahlén SE, Forsberg B, Gunnbjörnsdóttir M, Kasper L, Krämer U, Kowalski ML, Lange B, Lundbäck B, Salagean E, Todo-Bom A, Tomassen P, Toskala E, van Drunen CM, Bousquet J, Zuberbier T, Jarvis D, Burney P (2011) Chronic rhinosinusitis in European underestimated disease A GA2LEN study. Allergy 66(9):1216–1223. https://doi.org/10.1111/j.1398-9995.2011.02646.x

    Article  PubMed  CAS  Google Scholar 

  6. Yenigun A (2015) Assessment of patients with nasal polyposis by the neutrophil-to-lymphocyte ratio and eosinophil-to-lymphocyte ratio. Kulak Burun Bogaz Ihtis Derg 25(4):193–199. https://doi.org/10.5606/kbbihtisas.2015.10734

    Article  PubMed  Google Scholar 

  7. Hu Y, Cao PP, Liang GT, Cui Y, Liu Z (2012) Diagnostic significance of blood eosinophil count in eosinophilic chronic rhinosinusitis with nasal polyps in Chinese adults. Laryngoscope 122(3):498–503. https://doi.org/10.1002/lary.22507

    Article  PubMed  Google Scholar 

  8. Meltzer EO, Hamilos DL, Hadley JA, Lanza DC, Marple BF, Nicklas RA, Adinoff AD, Bachert C, Borish L, Chinchilli VM, Danzig MR, Ferguson BJ, Fokkens WJ, Jenkins SG, Lund VJ, Mafee MF, Naclerio RM, Pawankar R, Ponikau JU, Schubert MS, Slavin RG, Stewart MG, Togias A, Wald ER, Winther B, Initiative R (2006) Rhinosinusitis: developing guidance for clinical trials. Otolaryngol Head Neck Surg 135(5):31–80. https://doi.org/10.1016/j.otohns.2006.09.014

    Article  Google Scholar 

  9. Fokkens WJ, Lund VJ, Mullol J, Bachert C, Alobid I, Baroody F, Cohen N, Cervin S, Douglas R, Gevaert P, Georgalas C, Goossens H, Harvey R, Hellings P, Hopkins C, Jones N, Joos G, Kalogjera L, Kern B, Kowalski M, Price D, Riechelmann H, Schlosser R, Senior B, Thomas M, Toskala E, Voegels R, Wang DY, Wormald PJ (2012) EPOS 2012: European position paper on rhinosinusitis and nasal polyps 2012. A summary for otorhinolaryngologists. Rhinology 50(1):1–12. https://doi.org/10.4193/rhino50e2

    Article  PubMed  Google Scholar 

  10. Tecimer SH, Kasapoglu F, Demir UL, Ozmen OA, Coskun H, Basut O (2015) Correlation between clinical findings and eosinophil/neutrophil ratio in patients with nasal polyps. Eur Arch Otorhinolaryngol 272(4):915–921. https://doi.org/10.1007/s00405-0143174-4

    Article  PubMed  Google Scholar 

  11. Ishitoya J, Sakuma Y, Tsukuda M (2010) Eosinophilic chronic rhinosinusitis in Japan. Allergol Int 59(3):239–245. https://doi.org/10.2332/allergolint.10-RAI-0231

    Article  PubMed  Google Scholar 

  12. Brescia G, Zanotti C, Parrino D, Barion U, Marioni G (2018) Nasal polyposis pathophysiology: endotype and phenotype open issues. Am J Otolaryngol 39(4):441–444. https://doi.org/10.1016/j.amjoto.2018.03.020

    Article  PubMed  Google Scholar 

  13. Lou H, Zhang N, Bachert C, Zhang L (2018) Highlights of eosinophilic chronic rhinosinusitis with nasal polyps in definition, prognosis, and advancement. Int Forum Allergy Rhinol 8(11):1218–1225. https://doi.org/10.1002/alr.22214

    Article  PubMed  PubMed Central  Google Scholar 

  14. Wang X, Zhang N, Bo M, Holtappels G, Zheng M, Lou H, Wang H, Zhang L, Bachert C (2016) Diversity of TH cytokine profiles in patients with chronic rhinosinusitis: a multicenter study in Europe, Asia, and Oceania. J Allergy Clin Immunol 138(5):1344–1353. https://doi.org/10.1016/j.jaci.2016.05.041

    Article  PubMed  CAS  Google Scholar 

  15. Eltohami YI, Kao HK, Lao WW, Huang Y, Abdelrahman M, Liao CT, Yen TC, Chang KP (2018) The prediction value of the systemic inflammation score for oral cavity squamous cell carcinoma. Otolaryngol Head Neck Surg 158(6):1042–1050. https://doi.org/10.1177/0194599817751678

    Article  PubMed  Google Scholar 

  16. Jiang W, Chen Y, Huang J, Xi D, Chen J, Shao Y, Xu G, Ying W, Wei J, Chen J, Ning Z, Gu W, Pei H (2017) Systemic immune-inflammation index predicts the clinical outcome in patients with nasopharyngeal carcinoma: a propensity score-matched analysis. Oncotarget 8(39):66075–66086. https://doi.org/10.18632/oncotarget.19796

    Article  PubMed  PubMed Central  Google Scholar 

  17. Boztepe OF, Gun T, Demir M, Gur OE, Ozel D, Dogru H (2016) A novel predictive marker for the recurrence of nasal polyposis following endoscopic sinus surgery. Eur Arch Otorhinolaryngol 273(6):1439–1444. https://doi.org/10.1007/s00405-015-3753-z

    Article  PubMed  Google Scholar 

  18. Atan D, Özcan KM, Köseoğlu S, Ikinciogullari A, Cetin MA, Ensari S, Dere H (2015) New predictive parameters of nasal polyposis: neutrophil to lymphocyte ratio and platelet to lymphocyte ratio. Kulak Burun Bogaz Ihtis Derg 25(2):97–101. https://doi.org/10.5606/kbbihtisas.2015.01947

    Article  PubMed  Google Scholar 

  19. Brescia G, Pedruzzi B, Barion U, Cinetto F, Giacomelli L, Martini A, Marioni G (2016) Are neutrophil-, eosinophil-, and basophil-to-lymphocyte ratios useful markers for pinpointing patients at higher risk of recurrent sinonasal polyps? Am J Otolaryngol 37(4):339–345. https://doi.org/10.1016/j.amjoto.2016.02.002

    Article  PubMed  Google Scholar 

  20. Wang H, Pan L, Liu Z (2019) Neutrophils as a protagonist and target in chronic rhinosinusitis. Clin Exp Otorhinolaryngol 12(4):337–347. https://doi.org/10.21053/ceo.2019.00654

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  21. Wen W, Liu W, Zhang L, Bai J, Fan Y, Xia W, Luo Q, Zheng J, Wang H, Li Z, Xia J, Jiang H, Liu Z, Shi J, Li H, Xu G, Nasal Health Group China (2012) Increased neutrophilia in nasal polyps reduces the response to oral corticosteroid therapy. J Allergy Clin Immunol 129(6):1522–1528. https://doi.org/10.1016/j.jaci.2012.01.079

    Article  PubMed  CAS  Google Scholar 

  22. Liao B, Liu JX, Li ZY, Zhen Z, Cao PP, Yao Y, Long XB, Wang H, Wang Y, Schleimer R, Liu Z (2018) Multidimensional endotypes of chronic rhinosinusitis and their association with treatment outcomes. Allergy 73(7):1459–1469. https://doi.org/10.1111/all.13411

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  23. Cervin A, Wallwork B (2007) Macrolide therapy of chronic rhinosinusitis. Rhinology 45(4):259–267

    PubMed  Google Scholar 

  24. Kim DK, Jin HR, Eun KM, Mo JH, Cho SH, Oh S, Cho D, Kim W (2017) The role of interleukin-33 in chronic rhinosinusitis. Thorax 72(7):635–645. https://doi.org/10.1136/thoraxjnl-2016-208772

    Article  PubMed  Google Scholar 

Download references

Funding

None.

Author information

Authors and Affiliations

  1. Department of Oto-Rhino-Laryngology and Head and Neck Surgery, Faculty of Medicine, S.Demirel University, Isparta, Turkey

    Mehmet Emre Sivrice, Erdoğan Okur, Hasan Yasan, Mustafa Tüz, Yusuf Çağdaş Kumbul & Vural Akın

Authors
  1. Mehmet Emre Sivrice
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Erdoğan Okur
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Hasan Yasan
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Mustafa Tüz
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Yusuf Çağdaş Kumbul
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Vural Akın
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Erdoğan Okur.

Ethics declarations

Conflict of interest

The authors have no conflict of interest to disclose.

Ethical approval

Ethical approval was approved by the ethical committee of Suleyman Demirel University (date: 16.04.2020, number: 116).

Informed consent

Informed consent was obtained from the parents of all participants.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Sivrice, M.E., Okur, E., Yasan, H. et al. Can the systemic immune inflammation index preoperatively predict nasal polyp subtypes?. Eur Arch Otorhinolaryngol 277, 3045–3050 (2020). https://doi.org/10.1007/s00405-020-06174-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00405-020-06174-6

Keywords

Search

Navigation