Nasal polyposis: A semiquantitative morphometric histopathological study
2018
Background / Aim. Nasal polyps are inflammatory hypertrophic proliferations
of the sinonasal mucosa composed of both epithelial and stromal elements.
The aim of this study was to determine histopathological hallmarks of nasal
polyposis via semiquantitative morphometric study. Methods. Study was
designed as prospective study with semiquantitative morphometric analysis
and it comprised 77 patients with chronic rhinosinusitis and nasal polyposis
that underwent functional endoscopic sinonasal surgery performed by the same
surgeon. Morphometric analysis included gradation of tissue edema within
polyps, thickening of epithelial basal membrane, degree of inflammation,
presence/absence of metaplasia within epithelium, degree of fibrosis within
polyps, and percentage of inflammatory cells within inflammatory infiltrate
(lymphocytes, macrophages, plasma cells, neutrophils and eosinophils).
Results. As expected, samples from study group showed significantly higher
degree of inflammation than samples from control group (χ2 =35.89 with p
value less than 0.01). Degree of fibrosis in nasal polyposis is in positive
correlation with duration of symptoms (r = 0.25, p < 0,05) and with
percentage of macrophages in inflammatory infiltrate (r = 0.26, p < 0.05)..
Patients with NP had significantly lower number of lymphocytes (r=-7.66, p <
0.01), but significantly higher number of eosinophils (r=3.84, p < 0.01),
macrophages (r=3.34, p < 0.01) and plasma cells (r=3.14, p < 0.01) than
controls, with p value less than 0.01. Conclusion. Tissue samples from
patients with nasal polyposis show significant changes that reflect in
various degrees of inflammation, fibrosis and basement membrane thickening
which may contribute to more difficult surgical management and perioperative
complications such as bleeding.
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