鼻窦CT及外周血细胞对鼻腔鼻窦内翻性乳头状瘤术后复发的预测分析

目的:探讨影响鼻腔鼻窦内翻性乳头状瘤(SNIP)术后复发的临床因素,并分析鼻窦CT及外周血细胞对术后复发的预测价值。方法:回顾分析2015年12月至2020年12月就诊于宁波市医疗中心李惠利医院东部院区的38例SNIP的临床资料,按Krouse分期方法进行临床分期,对比CT分期和实际手术分期的结果,研究CT诊断的准确性。同时将所有病例分为复发组和未复发组,统计患者外周血中性粒细胞计数、淋巴细胞计数、中性粒细胞计数/淋巴细胞计数比率(NLR)及鼻窦CT评分,对两组的人口统计学特征和其他临床参数进行比较,研究相关因素对复发的预测价值。结果:鼻窦CT对SNIP的侵犯范围判断的实际相符率达92.11%。淋巴细胞计数、NLR、鼻窦CT评分与SNIP术后复发有关,其中NLR和CT评分对SNIP术后复发的预测价值较高(AUC分别为0.813、0.929,P<0.01)。当NLR=2.375时,预测SNIP术后复发的敏感度为81.8%,特异度为81.5%。当CT评分=5.5时,敏感度为81.8%,特异度为96.3%。结论:鼻窦CT判断SNIP侵犯范围的准确性较高;淋巴细胞计数、NLR及鼻窦CT评...

Predictive analysis of sinus CT and peripheral blood cells for postoperative recurrence of inverted papilloma of nasal cavity and paranasal sinuses

Objective: To explore the clinical factors that affect the recurrence of sinonasal inverted papilloma, and to analyze the predictive value of sinus CT and peripheral blood cells for postoperative recurrence.Methods: A retrospective analysis was made of the clinical data of 38 SNIPs in the Ningbo Medical Center Lihuili Hospital (Eastern hospital compound) from January 2015 to December 2020, with clinical staging performed according to Krouse method. The results of CT staging and actual surgical staging were compared to study the accuracy of CT. At the same time, all cases were divided as recurrence group and non-recurrence group. Peripheral blood neutrophil count, lymphocyte count, neutrophil count/lymphocyte count and sinus CT score were counted, and demographic characteristics and other clinical parameters were compared between the two groups to study the predictive value of related factors of recurrence. Results: The actual coincidence rate of sinus CT in judging the scope of SNIP infringement was 92.11%. Lymphocyte count, NLR and sinus CT score were related to the postoperative recurrence of SNIP, of which NLR and CT score had higher predictive value.(AUC=0.813, 0.929, P<0.01). When NLR=2.375, the sensitivity was 81.8% and the specificity 81.5%; When CT score=5.5, the sensitivity was 81.8% and the specificity 96.3%. Conclusion: The accuracy of nasal sinus CT in judging the scope of SNIP violation is high, with high clinical utility. Lymphocyte count, NLR and sinus CT score are all related factors that affect the postoperative recurrence of SNIP, but NLR and CT score have higher predictive value.