Eur Arch Otorhinolaryngol:鼻腔细胞学方法诊断非过敏性鼻炎的表现如何?

2021-09-07 AlexYang MedSci原创

鼻部病理可以通过症状学来表征,但难以区分过敏性鼻炎(AR)、非过敏性鼻炎(NAR)和慢性鼻窦炎(CRS)。鼻腔细胞学(NC)能够帮助临床医生区分鼻炎的各种亚型,其重要性日益增加。

鼻部病理可以通过症状学来表征,但难以区分过敏性鼻炎(AR)、非过敏性鼻炎(NAR)和慢性鼻窦炎(CRS)。鼻腔细胞学(NC)能够帮助临床医生区分鼻炎的各种亚型,其重要性日益增加。

近期,来自意大利的研究人员在《Eur Arch Otorhinolaryngol》发表文章,他们评估了NC的敏感性、特异性和预测价值,进而分析了其诊断性能

研究招募了387名鼻炎患者,进行了鼻腔细胞学检查,并获得了鼻细胞图和细胞计数数据。

在387名患者中,有215名患者根据鼻症状进行了分类(占比55.5%;38名为急性鼻炎,24名为急性鼻窦炎,153名为慢性鼻炎)。根据所有参与者的细胞学样本,纤毛细胞平均占比94±4%,粘液细胞平均占比29±0.2%,中性粒细胞平均占比16±0.1%,嗜酸性细胞平均占比11±0.08%,淋巴细胞平均占比4±0.03,肥大细胞平均占比4±0.03%,其他细胞平均占比4±0.01%。有271例(70%)NC为阳性。修正病史后,153名患者(39%)认为是NAR阳性。NC测试的敏感性为100%(95% CI 97-100),特异性为49.6%(95% CI 43-56%)。阳性预测值(PPV)为56%(95% CI 50-62%),阴性预测值(NPV)为100%(95% CI 96-100%)。阳性似然比为1.98(95% CI 1.75-2.25)。测试的准确性为69.5%(95% CI 64.6-74.0%)。

鼻腔细胞学方法的测试结果

综上所述,NC有能力识别真阳性NAR患者,但识别真阴性患者的能力较低,总体准确率为69.5%

原始出处:

Andrea Ciofalo , Carlo Cavaliere , Cristoforo Incorvaia et al. Diagnostic performance of nasal cytology. Eur Arch Otorhinolaryngol. Aug 2021

 

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