Predictive Value of Blood Eosinophil Ratio for Risk Stratification in Patients With Eosinophilic Chronic Rhinosinusitis With Nasal Polyps

作者：Ting Zuo, Jianwei Wang, Ying Chen, Hongfei Zhao, Yan Hao, Hang Yu, Yu Zhang, Xicheng Song · 发表于：Laryngoscope Investigative Otolaryngology · 年份：2025 · DOI：10.1002/lio2.70300 · 被引用次数：3 · 研究领域：Sinusitis and nasal conditions、Asthma and respiratory diseases、Allergic Rhinitis and Sensitization

ABSTRACT Background Eosinophilic chronic rhinosinusitis with nasal polyps (ECRSwNP) is associated with severe symptoms and poor outcomes, but the diagnostic criteria remain elusive. The objective of this study is to identify preoperative predictors of ECRSwNP using multiple diagnostic thresholds and to propose a clinically actionable risk stratification model. Methods A retrospective analysis was conducted on 1081 CRSwNP patients who underwent endoscopic sinus surgery. Receiver operating characteristic (ROC) curves were generated to predict ECRSwNP based on clinical features and identify reliable predictors. Results Both the blood eosinophil count and ratio were identified as indicators for predicting ECRSwNP. The ratio exhibited the strongest correlation with that of tissue ( r = 0.401, p < 0.001). The optimal blood eosinophil ratio cutoffs exhibited variability according to tissue‐based criteria, ranging from 2.65% to 4.65%. For blood eosinophil ratios, thresholds of 2.65% (for > 10% tissue ratio) and 3.85% (for > 27% tissue ratio) exhibited divergent predictive profiles: the former yielded high positive predictive value (PPV = 79.87%), while the latter yielded high negative predictive value (NPV = 84.39%). To reconcile conflicting PPV/NPV profiles between thresholds, we defined a threshold of 3.25% (median between 2.65% and 3.85%). Patients could be divided into a group with a low risk(LR‐ECRSwNP) for being defined as ECRSwNP and another group with a high risk(HR‐...