Prognostic value of preoperative CCL26 serum levels in the surgical treatment of chronic rhinosinusitis.

Eosinophilic chronic rhinosinusitis (CRS), characterized by prominent eosinophil infiltration, has the highest postoperative recurrence rate among CRS subtypes. Given the critical role of eotaxins in CRS pathogenesis, this study aimed to identify eotaxins associated with eosinophilic CRS and evaluate their correlation with surgical outcomes. Transcriptomic data from GSE36830 revealed 125 differentially expressed genes (49 up-regulated, 76 down-regulated) in CRSwNP compared to CRSsNP, with significant enrichment of eosinophil and dendritic cell infiltration pathways. Functional analysis identified chemotaxis and cell migration as key dysregulated processes in CRSwNP. Among eotaxins, CCL26 and CCL13 emerged as hub molecules from the intersection of these dysregulated pathways. In a clinical cohort of 115 CRS patients, preoperative serum CCL26 and CCL13 levels were significantly elevated in CRSwNP compared to CRSsNP (P<0.001). ROC analysis demonstrated strong diagnostic power for nasal polyps (CCL26: AUC=0.895; CCL13: AUC=0.830). Higher preoperative CCL26 levels predicted poorer symptom improvement post-surgery (standardized β=-0.564, P<0.001). In conclusion, preoperative serum CCL26 serves as both a diagnostic biomarker for CRSwNP and a prognostic indicator for surgical outcomes, with elevated levels associated with reduced symptom improvement.