上皮间质转化状态在内镜治疗慢性鼻窦炎患者预后的预测意义研究

目的 探讨不伴有鼻息肉的慢性鼻窦炎患者鼻腔或鼻窦黏膜组织中的上皮间质转化状态(EMT)与临床资料、症状评分等的相关性，分析其对患者预后的预测意义。方法 收集2012年1月~2013年5月经鼻内镜手术治疗的不伴有鼻息肉的慢性鼻窦炎患者30例及健康者15例的鼻腔或鼻窦黏膜标本，采用实时定量PCR(RT-PCR)检测黏膜组织中上皮细胞表型标志E-cadherin mRNA及间质细胞表型标志α-SMA mRNA的相对表达量，分析其与患者症状评分的关联性。结果 病例组上皮细胞标志物E-cadherin mRNA相对表达较对照组下降，间质细胞标志物α-SMA mRNA相对表达较对照组上升，提示病例组标本中存在EMT现象；α-SMA mRNA表达与吸烟史呈正相关关系，E-cadherin mRNA表达与年龄、病程、吸烟史等呈负相关关系(P＜0.05)；睡眠评分、Lund-Kennedy总评分、前筛评分与α-SMA mRNA表达呈正相关，鼻部症状评分、Lund-Kennedy体征总评分、Lund-Mackay体征总评分与E-cadherin mRNA表达呈负相关(P＜0.05)。结论 在不伴有鼻息肉的CRS患者鼻腔或鼻窦黏膜组织中确实存在EMT现象；患者的病情越重，EMT现象越明显，EMT对患者的预后和转归具有一定的预测意义。

Prognostic significance of epithelial-mesenchymal transition state in patients with chronic sinusitis treated under endoscopy

Objective To investigate the epithelial-mesenchymal transition state (EMT) of patients with chronic sinusitis and to analyze the correlation of EMT with clinical data and symptom scores and its prognostic significance for patients. Methods The nasal or sinus mucosa specimens of 30 patients with chronic sinusitis and 15 healthy people were collected. Real-time quantitative PCR (RT-PCR) was used to detect relative expressions of epithelial marker E-cadherin mRNA and mesenchymal marker α-SMA mRNA. Pearson was used to analyze its correlation with symptoms score. Results Compared with the control group, the relative expression of epithelial cell marker E-cadherin mRNA decreased and α-SMA mRNA relative expression increased suggesting the existence of EMT; α-SMA mRNA expression was positively correlated with smoking, and E-cadherin mRNA expression was negatively correlated with age, disease duration and smoking (P<0.05); The correlation of sleep score, Lund-Kennedy total score, anterior ethmoid score and α-SMA mRNA expression was positive, while the correlation of nasal symptoms score, Lund-Kennedy total score, and Lund-Mackay total score and E-cadherin mRNA expression was negative(P<0.05). Conclusion In the nasal or sinus mucosa of CRS patients without nasal polyps, EMT exists. The more severe the CRS is, the more obvious the EMT is. EMT has a certain suggestive significance for prognosis and outcome of the patients.