Abstract
PURPOSE: To investigate the relationship between the expression levels of Chemokine C-C Motif Ligand 13 (CCL13) in nasal mucosal tissue and the likelihood of postoperative recurrence in patients with chronic rhinosinusitis (CRS). PATIENTS AND METHODS: In this retrospective study, we collected clinical data from 230 CRS patients who underwent functional endoscopic sinus surgery at our hospital from January 2022 and December 2023. Based on follow-up results, patients were divided into a recurrence group (66 cases) and a non-recurrence group (164 cases). The concentration of CCL13 in nasal mucosal tissue was measured using ELISA. Statistical analyses were performed using Spearman correlation analysis, multivariate logistic regression analysis, receiver operating characteristic (ROC) curve analysis, and a nomogram model. RESULTS: After a one-year follow-up period, the recurrence rate was 28.70%. The concentration of CCL13 was significantly higher in the recurrence group compared to the non-recurrence group (P<0.05). A negative correlation was observed between CCL13 levels and the Lund-Mackay score (r=-0.425, P<0.001). Multivariate analyses indicated that the presence of nasal polyps, the Lund-Mackay score, and CCL13 concentration were independent risk factors for postoperative recurrence (P<0.05). ROC curve analysis showed that the area under the curve (AUC) for CCL13 in predicting recurrence was 0.727 (P<0.05), with a sensitivity of 51.22% and a specificity of 89.39% at a threshold of 422.3 pg/mL. The nomogram model demonstrated strong predictive capabilities, with AUC values of 0.80 in the training set and 0.85 in the validation set. CONCLUSION: The expression level of CCL13 is an independent predictor of postoperative recurrence in CRS and holds significant assessment value. However, this study has some limitations, including its retrospective design and potential selection bias. Future prospective studies are needed to further validate these findings.