[The correlation between nasal bacterial microbiome diversity and surgical prognosis for chronic sinusitis with nasal polyp].

Objective:To compare the nasal microbiota diversity between chronic rhinosinusitis with nasal polyp（CRSwNP） patients and controls, postoperative recurrent with non-recurrent CRSwNP, in order to provide new sight in CRSwNP treatment and prognosis. Method:Forty-eight patients with CRSwNP were recruited as the experimental group, and 33 patients who underwent FESS and had no sinus inflammatory disease, including nasal septum deviation,inverted papilloma, pituitary adenomas, chronic dacryocystitis,or optical canal fractures, were recruited as control group. High-throughput sequencing of 16S rRNA was used to detect the bacterial communities in the nasal secretion which was collected from middle meatus during the operation. The difference of the microbiota diversity between CRSwNP and controls was compared. Patients with CRSwNP were followed up for 1 year after surgery to observe whether they had relapsed or not, and nasal secretions were collected again for bacterial microbiota detection. The difference between postoperative and preoperative microbiota of the non-recurrent CRSwNP were compared, and the difference between postoperative and preoperative microbiota of the recurrent CRSwNP were compared. Result:One year after surgery, 12 cases of CRSwNP recurred（recurrent rate 25%）. The clinical history of the recurrent group was longer than that of the non-recurrent group（P=0.018）, and the preoperative CT score（P=0.001）, nasal polyp size score（P=0.004） and the severity of postnasal drip symptom（P=0.032） in the recurrent group were significantly higher than non-recurrent group. Comparing the preoperative nasal microbiota of CRSwNP with control, there was no significant difference about the richness, α diversity and β diversity, but the relative abundance of Actinobacteria（FDR P=0.004） and Corynebacterium（FDR P=0.005） of CRSwNP were significantly lower than that of control. After operation, the relative abundance of Actinobacteria（FDR P＝0.012） and Corynebacterium（FDR P＝0.003） increased, while the Bacteroidetes（FDR P＝0.040） decreased in the non-recurrent CRSwNP; However, there was no change in the nasal bacterial microbiota in the recurrent group. Conclusion:CRSwNP was associated with nasal bacterial dysbiosis, and the postoperative improvement of dysbiosis was correlated with the prognosis of CRSwNP.