Can EPOS2020 criteria of type 2 inflammation be applied to Asian patients with chronic rhinosinusitis?

AbstractBackground There is a large diversity of mucosal immunologic chronic rhinosinusitis with nasal polyps (CRSwNP) endotypes across Western and Asian patient populations.Objectives The objective of the study was whether the European Position Paper on Rhinosinusitis and Nasal Polyps (EPOS) 2020 criteria for type 2 inflammation are appropriate for biological use in CRSwNP patients.Methods A total of 207 participants are enrolled for the study. Retrospective evaluations of the tissues taken during surgery and the patients' clinical features were performed. We investigated whether the criteria described in the EPOS2020 guideline were appropriate based on the criteria for type 2 inflammation identified based on prior studies using receiver-operating characteristic (ROC) analyses.Results The EPOS 2020 criteria are also shown to be an insufficient evaluation approach with low specificity (area under curve [AUC] = 0.645, specificity 8.4%). The authors created a novel scoring method using the total serum IgE level, blood eosinophil percentage, and tissue eosinophil percentage. This novel scoring system (AUC = 0.862, p < .001) fared better in ROC analyses than the EPOS 2020 criteria (AUC = 0.645) and Japanese Epidemiological Survey of Refractory Eosinophilic Chronic Rhinosinusitis scoring system (AUC = 0.647).Conclusions and Significance A novel standard for type 2 inflammation in Asian CRSwNP patients must be established, as the EPOS 2020 criteria do not appear to be sufficient.Chinese Abstract背景: 西方和亚洲患者群体中, 伴有鼻息肉(CRSwNP)的内型的粘膜免疫性慢性鼻窦炎具有很大的多样性。目的: 该研究的目的是, 关于鼻窦炎和鼻息肉 (EPOS)的欧洲立场书2020 2 型炎症标准是否适合CRSwNP 患者的生物使用。方法: 共有 207 名参与者参加了该研究。 回顾性评估了手术中取得的组织及患者的临床特征。 我们使用接受者操作特征(ROC)分析, 根据先前研究而鉴定出的2型炎症标准, 调查了 EPOS2020 指南中描述的标准是否适当。结果: EPOS 2020 标准还被证明是一种不充分的评估方法, 其特异性较低(曲线下面积[AUC] = 0.645, 特异性8.4%)。 作者创造了一种新颖的评分方法, 使用总血清 IgE 水平、血液嗜酸性粒细胞百分比和组织嗜酸性粒细胞百分比。 这一新颖的评分系统(AUC = 0.862, p<.001)在 ROC 分析中表现优于 EPOS 2020 标准(AUC = 0.645)和日本难治性嗜酸性慢性鼻鼻窦炎流行病学调查评分系统(AUC = 0.647)。结论和意义: 亚洲 CRSwNP 患者 2 型炎症的新标准必须建立, 因为 EPOS 2020 标准似乎有欠缺。Keywords: guidelineinflammationmonoclonal antibodiesnasal polypsinusitis AcknowledgementsThe present research was supported by the research fund of Dankook University in 2022.Disclosure statementNo potential conflict of interest relevant to this article was reported.Conflict of interestsNoneAuthor contributionsConceptualization, data curation, formal analysis, and methodology: all authors. Funding acquisition: S.H.Y. Project administration, visualization, and writing–original draft: S.H.Y. Writing–review and editing: J.H.M.Data availability statementAvailable.