Statistical analyses
Statistical analysis was performed with the Statistical Package for
Social Sciences version 19.0 for Windows (IBM Corp., Armonk, NY). The
prevalence of AFRS was calculated as the percentage of patients
diagnosed and treated as AFRS among all cases of CRS treated in the same
period; the result was presented as a percentage with a 95% confidence
interval. Categorical variables are presented as frequency and
percentage, while continuous variables are presented as mean ± standard
deviation (SD). The quantitative variables were analyzed by the t-test,
and the data not normally distributed were analyzed by the Kruskal
Wallis.The ratio were tested by the chi square test. The Mann Whitney
test and chi square test were used for multiple comparisons of
quantitative and ratio. The p value was corrected by Bonferroni.
A p -value of <0.05 was considered to reject the null
hypothesis.
Results
A total of 2,874 patients underwent endoscopic sinus surgery, including
631 cases of non-invasive fungal sinusitis. 29 patients were
re-diagnosed with AFRS, with a mean age of 33.5 (range, 13-53) years,
and
the
median age was 35 years. 69 cases were re-diagnosed with suspect AFRS,
with a mean age of 35.4 (range, 12-67) years, and the median age was 34
years. In addition, 533 cases were re-diagnosed with FBS, with a mean
age of 53.9 (range, 17-85) years, and the median age was 54 years. There
was no significant difference in gender composition among the three
groups (p = 0.316). According to the
radiology of all patients, the
lesions in AFRS and suspect AFRS mostly involved bilateral sinuses and
multiple sinuses. The CT Lund Mackay score of the two groups was
significantly higher than that in FBS (p < 0.001).
Furthermore, there was more bone erosion in AFRS and suspect AFRS, and
the proportion of secondary and multiple operations were higher in these
two groups than FBS, in which the maximum number of recurrence was five
(Table 1).
Compared with AFRS and suspect AFRS, there was no significant difference
in age, eosinophils percentage, basophils percentage, galactomannan test
positive rate, serum total IgE, recurrence times, and the proportion of
allergic rhinitis, asthma and olfactory decline (p >
0.05). However, significant differences were observed in the above
indexes between group A and group C, and between group B and group C.
Besides age, we also found that there were more cases of blood
eosinophils increase in group A (9, 31.0%) and group B (28, 40.6%),
which was significantly higher than that in group C (8, 1.5%, p< 0.01). Peripheral basophilic granulocytosis was also
observed in group A (4, 13.8%) and group B (15, 21.7%). In addition,
the galactomannan test, serum total IgE, recurrence times, the
proportion of allergic rhinitis or asthma and the proportion of
hypoolfactory in group A and group B were higher than those in group C
(p < 0.01) (Table 2).