Nazalna polipoza: semikvantitativna morfometrijska patohistološka studija

  • Aleksandar Trivić Clinical Centre of Serbia, Clinic for Otorhinolaryngology and Maxillofacial Surgery, Belgrade, Serbia
  • Nada Tomanović University of Belgrade, Faculty of Medicine, Belgrade, Serbia
  • Sanja Krejović Trivic Clinical Centre of Serbia, Clinic for Otorhinolaryngology and Maxillofacial Surgery, Belgrade, Serbia
  • Jovica Milovanović Clinical Centre of Serbia, Clinic for Otorhinolaryngology and Maxillofacial Surgery, Belgrade, Serbia
  • Ivan Boričić University of Belgrade, Faculty of Medicine, Belgrade, Serbia
  • Ana Jotić Clinical Centre of Serbia, Clinic for Otorhinolaryngology and Maxillofacial Surgery, Belgrade, Serbia
  • Miljan Folić Clinical Centre of Serbia, Clinic for Otorhinolaryngology and Maxillofacial Surgery, Belgrade, Serbia
  • Ivana Ćolović Čalovski University of Belgrade, Faculty of Medicine, Belgrade, Serbia
  • Nikola Miković University of Belgrade, Faculty of Dentistry, Clinic for Maxillofacial Surgery, Belgrade, Serbia
  • Zoran Tatić Military Medical Academy, Dental Clinic, Belgrade, Serbia
DOI: https://doi.org/10.2298/VSP171228139T
Ključne reči: nos, polipi, hirurgija, otorinolaringološka, procedure, postoperativne komplikacije, histologija

Sažetak


Uvod/Cilj. Nazalni polipi predstavljaju inflamatorne izrasline hipertrofične respiratorne sluznice i sačinjeni su od epitelnih i stromalnih elemenata. Cilj ove studije bio je da odredimo patohistološka obeležja nazalnih polipa kroz semikvantitativnu morfometrijsku studiju. Metode. Izvršena je semikvantitvna morfometrijska analiza uzoraka nazalne sliznice uzetih od 77 bolesnika sa hroničnim rinosinuzitisom i nazalnim polipima. Kontrolnu grupu sačinjavali su uzorci nazalne sluznice, uzeti od 9 pacijenta bez nazalne polipoze koji su bili podvrgnuti funkcionalnoj i estetskoj hirurgiji. Kod svih bolesnika je učinjena funkcionalna endoskopska sinonazalna hirurgija od strane istog hirurga. Morfometrijska analiza je uključivala gradaciju edema tkiva sa polipima, debljinu bazalne membrane, stepen inflamacije, prisustvo/odsustvo metaplazije u epitelu, stepen fibroze, kao i procenat zapaljenskih ćelija sa zapaljenskim infiltratom (limfocite, makrofage, plazma ćelije, neutrofile i eozinofile). Rezultati. Kao što je i očekivano, uzorci iz ispitivane grupe su imali značajno veći stepen inflamacije u odnosu na kontrolnu grupu (χ2 = 35.89, p < 0.01). Stepen fibroze kod polipa nosa je bio u pozitivnoj korelaciji sa trajanjem dužine simtoma (r = 0.25, p < 0.05) i sa procentom makrofaga u zapaljenskom infiltrate (r = 0.26, p < 0.05). Bolesnici sa nazalnom polipozom imali su značajno veći broj limfocita (r = -7.66, p < 0.01), ali i značajno veći broj eozinofila (r = 3.84, p < 0.01), makrofaga (r = 3.34, p < 0.01) i plazma ćelija (r = 3.14, p < 0.01) nego kontrolna grupa (p < 0.01). Zaključak. Uzorci tkiva kod bolesnika sa nazalnom polipozom pokazuju značajne promene koje se ogledaju u različitom stepenu inflamacije, fibroze i zadebljanja bazalne membrane što može značajno otežavati hirurški zahvat, kao i uticati na veći stepen perioperativnih komplikcija kao što je krvarenje.

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Objavljeno
2021/04/08
Broj časopisa
Vol. 77 Br. 8 (2020): Vojnosanit pregl
Rubrika
Originalni članak