Clinical and morphological predictors of recurrence of chronic rhinosinusitis with nasal polyps

The search for sensitive markers involved in remodeling of the mucous membrane of the nasal cavity and paranasal sinuses at the stages of polyp formation is important in predicting possible recurrences of nasal polyposis. Objective. To evaluate the clinical and morphological correlations on the course of chronic rhinosinusitis with nasal polyps and to determine their diagnostic significance in the prognosis of relapses. Patients and methods. A prospective randomized clinical trial, involving 32 patients aged 42—86 years with chronic rhinosinusitis with nasal polyps, was carried out. All patients underwent a planned nasal polypotomy. An analysis of the clinical manifestations of the disease, which were compared with the histological findings in the polypous tissue, was performed. Results. The clinical and morphological correlations of chronic rhinosinusitis with nasal polyps characteristic of T2 inflammation were noted. Morphometric studies have revealed a tendency towards an increase in activated fractions — macrophages and lymphocytes — when compared to other cell populations. A wide variable range of the volume fraction of macrophages from 2 to 21% and of plasma cells from 2 to 16% from the total cellular composition of infiltrates was noted. Two phenotypes of nasal polyps were identified: lymphocytic and mixed, and correlations between the cellular composition of individual phenotypes and morphological parameters of lymphocytes, macrophages, and plasma cells were evaluated. Conclusion. The obtained results confirm the existence of close correlations between the clinical manifestations and morphological characteristics of nasal polyps, which expands our understanding of the pathogenesis of different phenotypes of chronic rhinosinusitis with nasal polyps and the predictors of its recurrence.