侵袭性真菌性鼻窦炎:越南首次组织病理学研究

IF 3.2 Q2 PATHOLOGY Head & Neck Pathology Pub Date : 2024-10-16 DOI:10.1007/s12105-024-01711-9
Giang Huong Tran, Khoa Anh Luong, Thinh Phuc Ngo, Tri Minh Bui, Bac An Luong, Hoang Anh Vu
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摘要

背景:侵袭性真菌性鼻炎(IRFS)是一种罕见但高度致命的疾病。目的:本研究旨在分析侵袭性真菌性鼻炎的组织病理学特征:我们对 57 例 IFRS 病例进行了回顾性研究。人口统计学特征和合并症特征来自临床病历。两名病理学家使用 H&E、PAS 和 GMS 染色切片独立检查组织病理学特征。在组织病理学的指导下,用 PCR 鉴定真菌群:结果:IFRS患者的平均年龄为(58.9 ± 13.4)岁。男女比例为 1.4:1。100%的病例合并糖尿病。在61.4%、33.3%和5.3%的病例中分别发现了粘菌、曲霉和其他真菌。没有发现曲霉菌和粘菌的合并感染。组织病理学和 PCR 结果在病原体分类方面非常一致(Cohen's kappa = 84.2%,95% CI 60.1% - 100%,P 结论):IFRS 主要影响老年人和男性。组织病理学是区分粘菌和曲霉的可靠方法。当发现大面积坏死时,仔细检查血管侵犯情况至关重要。血管侵犯、坏死程度、色素和孢子是区分 IFRS 真菌病原体的重要因素。
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Invasive Fungal Rhinosinusitis: The First Histopathological Study in Vietnam.

Background: Invasive fungal rhinosinusitis (IRFS) is a rare but highly fatal disease. The two primary groups of pathogens, Mucorales and Aspergillus, require different treatments and have distinct prognoses.

Purpose: This study aimed to analyze the histopathological features of IFRS.

Methods: We conducted a retrospective study involving 57 IFRS cases. Demographic and comorbid characteristics were obtained from clinical records. Two pathologists independently examined the histopathological features using H&E, PAS, and GMS-stained slides. Fungal groups were identified with PCR under the guidance of histopathology.

Results: The mean age of IFRS was 58.9 ± 13.4. The male-to-female ratio was 1.4:1. 100% of cases had diabetes comorbidity. Mucorales, Aspergillus, and other fungi were found in 61.4%, 33.3%, and 5.3% of cases, respectively. No Aspergillus and Mucorales co-infections were detected. Histopathology and PCR results were strongly concordant in classifying pathogens (Cohen's kappa = 84.2%, 95% CI 60.1% - 100%, p < 0.001). Mucormycosis exhibited higher rates of extensive necrosis and vascular invasion, and lower rates of pigment and spore presence than the non-Mucormycosis group (p < 0.001, p = 0.01, p = 0.02, p = 0.03, respectively). Extensive necrosis and vascular invasion were statistically significantly correlative (OR = 13.03, 95% CI 2.62-64.75, p = 0.002).

Conclusions: IFRS predominantly affects older adults and males. Histopathology is a reliable method for differentiating between Mucorales and Aspergillus. When extensive necrosis is detected, it is critical to investigate for vascular invasion carefully. The vascular invasion, degree of necrosis, pigments, and spores are valuable factors for distinguishing fungal agents of IFRS.

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来源期刊
CiteScore
5.70
自引率
9.50%
发文量
99
期刊介绍: Head & Neck Pathology presents scholarly papers, reviews and symposia that cover the spectrum of human surgical pathology within the anatomic zones of the oral cavity, sinonasal tract, larynx, hypopharynx, salivary gland, ear and temporal bone, and neck. The journal publishes rapid developments in new diagnostic criteria, intraoperative consultation, immunohistochemical studies, molecular techniques, genetic analyses, diagnostic aids, experimental pathology, cytology, radiographic imaging, and application of uniform terminology to allow practitioners to continue to maintain and expand their knowledge in the subspecialty of head and neck pathology. Coverage of practical application to daily clinical practice is supported with proceedings and symposia from international societies and academies devoted to this field. Single-blind peer review The journal follows a single-blind review procedure, where the reviewers are aware of the names and affiliations of the authors, but the reviewer reports provided to authors are anonymous. Single-blind peer review is the traditional model of peer review that many reviewers are comfortable with, and it facilitates a dispassionate critique of a manuscript.
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