Análise comparativa do achado de eosinofilia entre os métodos de anatomia patológica de pólipo nasal e citologia por lavado nasal em pacientes com rinossinusite crônica com pólipos nasais: um estudo transversal no estado da Bahia, Brasil

Abstract

Chronic Rhinosinusitis with Nasal Polyps (CRSwNP) results from degeneration of the sinonasal mucosa. The prevalence in the general population varies from 1 to 4%, but in Brazil there is a lack of statistics. It is a complex disease with a wide spectrum of phenotypes. Pathological anatomy (PA) of the polyp is the reference method indicated for analyzing eosinophils. Nasal lavage cytology (LN) is a less widespread and less invasive test. Objectives: The main objective is to compare eosinophilia between the AP and LN methods in CRSwNP. Secondarily, evaluate the association of tissue eosinophilia with disease control; the severity of asthma; awareness of aeroallergens; endoscopic and tomographic findings; Total IgE and peripheral eosinophilia. Methods: cross-sectional study, which compared: the degree of agreement for detecting eosinophilia between AP and LN methods; and peripheral eosinophilia with tissue, in relation to the diagnosis of the Type 2 endotype in CRSwNP. In addition to analyzing clinical and Conclusions: epidemiological factors associated with tissue eosinophilia, the following were performed: SNOT22, asthma control assessment, Prick test, laboratory tests, nasal endoscopy and tomography. Result: 30 patients were captured. The average age was 52 years. All were characterized as eosinophilic by one of three methods: peripheral eosinophilia, AP or total IgE. Eosinophils were altered by: 70% in the periphery if the cutoff point was above 250 cells/mm 3 and 83.3% when considering above 150 cells/mm 3; 86.6% in AP and 30% in LN. Total IgE was altered by 63.3%. Eosinophilic LN is statistically associated with elevated tissue eosinophilia. Peripheral eosinophilia with a cutoff point of 150 cells/mm 3 was the test that came closest to the gold standard, AP. LN is a non-invasive and easy to perform method, however it has been shown to be inferior to peripheral eosinophilia and total IgE.