ArticleEuropean archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery2026
Comparison of two classification systems for tissue eosinophilia in patients with chronic rhinosinusitis with nasal polyps.
Article in European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundEosinophilic chronic rhinosinusitis with nasal polyps (ECRSwNP) is commonly defined by absolute tissue eosinophil count (≥ 10 per high-power field; Def1) or eosinophil percentage of total inflammatory cells (≥ 10% per high-power field; Def2). However, these two criteria sometimes yield discordant classifications, and no consensus exists on an appropriate range of total inflammatory cells for consistent diagnosis. This study compared the consistency of these two definitions and explored whether a specific range of total inflammatory cell counts could improve their diagnostic agreement.
methodsNasal polyp tissues from 104 patients with chronic rhinosinusitis with nasal polyps (CRSwNP) and inferior turbinate samples from 19 healthy controls were analyzed. Tissue eosinophil count, eosinophil percentage, and total inflammatory cell counts were assessed histologically. Receiver operating characteristic analysis, correlation analysis, positive and negative predictive values (PPVs and NPVs), peripheral blood eosinophil indices, and local type 2 cytokine expression (IL-4, IL-5, and IL-13) were used to explore and internally assess the proposed interval.
resultsDef1 and Def2 were concordant in 88 of 104 patients, with discrepancies mainly observed outside the proposed 385-1236 total inflammatory cell-count interval. Within this interval, the correlation between tissue eosinophil count and percentage was stronger (r = 0.93), and PPVs and NPVs for ECRSwNP classification were higher (PPV: 100.00%/91.89%; NPV: 89.29%/100.00%). Peripheral blood eosinophil indices and IL-4, IL-5, and IL-13 expression also showed stronger associations with eosinophil-based classification within this interval than outside it.
conclusionWe identified an exploratory total inflammatory cell-count interval of 385-1236, within which Def1 and Def2 showed more consistent classification of ECRSwNP in the present cohort.
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