title: Are neutrophil-, eosinophil-, and basophil-to-lymphocyte ratios useful markers for pinpointing patients at higher risk of recurrent sinonasal polyps?
abstract: OBJECTIVE
  Despite advances in the diagnosis and treatment of chronic rhinosinusitis with nasal polyps (CRSwNP), their recurrence rate remains significant. There is a need for promptly-obtainable, inexpensive, minimally-invasive prognostic parameters to enable rhinologists to identify patients at higher risk of recurrent CRSwNP. The prognostic role of the neutrophil-to-lymphocyte ratio (NLR) and eosinophil-to-lymphocyte ratio (ELR), previously discussed as potential markers of inflammation, has already been investigated in CRSwNP. The aim of the present study was to test the prognostic value of the NLR and ELR, and also of the basophil-to-lymphocyte ratio (BLR) (given the emerging role of basophils in CRSwNP) in a large series of CRSwNP.
  
  
  METHODS
  The study concerned 240 patients who underwent FESS for CRSwNP from 2009 to 2014 and had a postoperative follow-up longer than 12months. We considered patients with recurrences as those with endoscopic evidence of at least grade I polyposis.
  
  
  RESULTS
  In our series, the mean NLR, ELR and BLR were significantly higher in patients whose disease recurred than in those remaining recurrence-free (p=0.03, p=0.0001, and p=0.0002, respectively), but the discriminatory power of the NLR, ELR, or BLR in terms of disease recurrence was unacceptable (AUCs=0.600, 0.678, and 0.662, respectively).
  
  
  CONCLUSIONS
  The heterogeneous prognostic role of NLR, ELR and BLR identified in the clinically and pathologically different sub-cohorts of CRSwNP considered supports the hypothesis that CRSwNPs with a similar clinical picture may differ considerably in terms of the biological and pathogenic mechanisms of polyp formation and growth.
authors.affiliation: Department of Neurosciences DNS, Otolaryngology Section, Padova University, Padova, Italy. Electronic address: giuseppe.brescia@sanita.padova.it.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Brescia
authors.affiliation: Department of Neurosciences DNS, Otolaryngology Section, Padova University, Padova, Italy.
authors.forename: Barbara
authors.initials: B
authors.lastname: Pedruzzi
authors.affiliation: Department of Neurosciences DNS, Otolaryngology Section, Padova University, Padova, Italy.
authors.forename: Umberto
authors.initials: U
authors.lastname: Barion
authors.affiliation: Department of Medicine DIMED, Clinical Immunology and Hematology Unit, Padova University, Padova, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Cinetto
authors.affiliation: Department of Medicine DIMED, Padova University, Padova, Italy.
authors.forename: Luciano
authors.initials: L
authors.lastname: Giacomelli
authors.affiliation: Department of Neurosciences DNS, Otolaryngology Section, Padova University, Padova, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Martini
authors.affiliation: Department of Neurosciences DNS, Otolaryngology Section, Padova University, Padova, Italy.
authors.forename: Gino
authors.initials: G
authors.lastname: Marioni
mesh_terms: D000328:Adult; D001491:Basophils; D015415:Biomarkers; D015331:Cohort Studies; D004804:Eosinophils; D005260:Female; D006801:Humans; D018655:Lymphocyte Count; D008214:Lymphocytes; D008297:Male; D008875:Middle Aged; D009298:Nasal Polyps / Q000097:blood* / Q000209:etiology*; D009504:Neutrophils; D012008:Recurrence; D012307:Risk Factors
chemical_list: D015415:Biomarkers