Inflammatory cell relationship between nasal polyps and paranasal sinus mucosa in chronic paranasal sinusitis.
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概要
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Several theories concern the pathogenesis of nasal polyps and chronic paranasal sinusitis, but the correlation of inflammatory cells between nasal polyps and chronic paranasal sinusitis mucosae has not been investigated. We studied inflammatory cells in 82 nasal polyps and ethmoid sinus mucosa and in 28 maxillary sinus mucosa in 53 patients with chronic paranasal sinusitis, grading the tissue density of eosinophils, lymphocytes/plasma cells, and neutrophils from 3+to-. Many neutrophils infiltrated only a few tissues, so we first studied predominant inflammatory cells by combining the positivity of eosinophils or lymphocytes/plasma cells. A statistically significant correlation was seen between nasal polyps and ethmoid sinuses and between ethmoid and maxillary sinuses. We then studied the correlation of positivity of eosinophils and lymphocytes/plasma cells. Eosinophils showed a high positive correlation among nasal polyps, ethmoid sinuses, and maxillary sinuses, as did that of lymphocytes/plasma cells, but not between nasal polyps and maxillary sinuses. Nasal polyps and ethmoid sinus mucosa in patients with asthma showed a higher positivity of eosinophils than in those without asthma. The positivity of lymphocytes/plasma cells showed no such difference. The positivity of eosinophils differed significantly between small and large nasal polyps. Our results thus suggest that (1) the same mechanism of inflammatory cell infiltration operates in nasal polyps and paranasal sinuses, (2) the presence of eosinophils may be related to the growth of nasal polyps and, (3) histologic nasal polyp biopsy may indicate the type of inflammatory cells predominant in chronic paranasal sinusitis, clarifying the course of medical management before and after surgery.
- 日本鼻科学会の論文
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