The Role of KI67 in Predicting Post-ESS (Endoscopic Sinus Surgery) Outcomes in CRSwNP (Chronic Rhinosinusitis With Nasal Polyps)

Introduction Nasal and paranasal sinus inflammation, specifically chronic rhinosinusitis with nasal polyps (CRSwNP), is a prevalent condition often addressed through endoscopic sinus surgery (ESS). Despite the commonality of this surgical intervention, recurrence rates post-ESS remain significant. This study explores the relationship between the expression of KI67, a protein indicating cell proliferation, and the likelihood of recurrence in CRSwNP patients who have undergone ESS. Methods Thirty patients undergoing ESS for CRSwNP were enrolled in this prospective study conducted between January 2023 and December 2023. Nasal polyp tissue samples, obtained during the surgical procedure, were subjected to immunohistochemical analysis to determine KI67 expression levels. Post-surgical follow-up was conducted for a period of six months to monitor for recurrence, indicated by the reappearance of nasal polyps upon endoscopic examination. Results The average number of KI67-positive cells per high-powered field (HPF) was 63.7 (range, 21-82). Nasal polyp recurrence was observed in 9 patients (30%) within 6 months following ESS. A statistically significant difference in mean KI67 expression was found between patients experiencing recurrence and those who did not (74.3 ± 11.1 vs. 53.1 ± 11.6, p=0.003). Furthermore, a positive correlation emerged between KI67 expression and Sino-Nasal Outcome Test-22 (SNOT-22) scores (Pearson correlation coefficient, r=0.42, p=0.02). Conclusion The results of this study indicate that KI67 expression could potentially serve as a predictor of recurrence and disease severity in CRSwNP patients following ESS. Confirmation of these findings and determination of the clinical utility of KI67 as a prognostic marker will necessitate further investigation with an expanded sample size and extended follow-up period.