目的 探讨2型固有淋巴样细胞（ILC2）比例联合可溶性生长刺激表达基因2蛋白（sST2）水平对难治性慢性鼻-鼻窦炎伴鼻息肉（CRSwNP）术后复发的预测价值。 方法 回顾性选取2021年1月至2023年12月医院收治的324例难治性CRSwNP患者的临床资料，纳入训练集，所有患者内镜鼻窦手术后均随访12个月，每3个月复诊1次，根据是否复发分为复发组（n = 125）和未复发组（n = 199）。比较复发组和未复发组临床资料、ILC2细胞比例和sST2水平，单因素和多因素logistic回归分析难治性CRSwNP患者术后复发的影响因素，受试者工作曲线（ROC）分析预测价值。另按训练集同标准选取2024年1—9月医院收治的138例难治性CRSwNP患者的临床资料纳入验证集，构建列线图模型，并绘制训练集和验证集ROC曲线、校准曲线及决策曲线。 结果 复发组年龄、嗅觉功能评分、Lund-Mackay评分、Davos评分、NEUT、ILC2细胞比例、sST2蛋白水平均高于未复发组（P < 0.05）；两组过敏性鼻炎史、鼻窦炎分型、手术时长经比较，差异有统计学意义（P < 0.05）；多因素logistic回归结果显示，Ⅲ型鼻窦炎、ILC2细胞比例、sST2均为难治性CRSwNP患者术后复发的术后早期独立相关预测指标（P < 0.05）；ILC2细胞比例联合sST2预测难治性CRSwNP患者术后复发的价值高于单独预测，AUC高于单独预测（Z_ILC2~联合= 3.367、Z_sST2~联合= 4.464，P < 0.05）；列线图模型训练集和验证集ROC分别为0.88（0.84 ~ 0.93）、0.78（0.68 ~ 0.89），预测价值良好，且与实际相仿（P > 0.05）；决策曲线示阈值在40% ~ 90%间具有较高正收益。 结论 ILC2细胞比例联合sST2蛋白水平对难治性CRSwNP术后复发预测价值较高，可为临床筛选高风险人群、采取针对性干预措施提供参考。

Objective To explore the predictive value of combining type 2 innate lymphoid cell （ILC2） proportion and soluble suppression of tumorigenicity 2 （sST2） protein level for postoperative recurrence in refractory chronic rhinosinusitis with nasal polyps （CRSwNP）. Methods We retrospectively reviewed the clinical data of 324 patients with refractory CRSwNP admitted to the hospital from January 2021 to December 2023， who constituted the training set. All patients underwent endoscopic sinus surgery and were followed up for 12 months， with examinations every 3 months. Based on recurrence status， they were divided into a recurrence group （n = 125） and a non-recurrence group （n = 199）. Clinical data， ILC2 proportion， and sST2 levels were compared between the two groups. Univariate and multivariate logistic regression analyses were performed to identify factors influencing postoperative recurrence. The predictive value was assessed using receiver operating characteristic （ROC） curves. Additionally， 138 patients meeting the same criteria admitted from January to September 2024 were enrolled as the validation set. A nomogram prediction model was constructed and evaluated using ROC curves， calibration curves， and decision curve analysis in both sets. Results The recurrence group showed significantly higher age， olfactory function score， Lund-Mackay score， Davos score， neutrophil count （NEUT）， ILC2 proportion， and sST2 level compared to the non-recurrence group （all P < 0.05）. Significant differences were also observed in allergic rhinitis history， rhinosinusitis subtype， and operation duration （all P < 0.05）. Multivariate logistic regression identified type Ⅲ rhinosinusitis， ILC2 proportion and sST2 level as independent early postoperative predictive indicators for recurrence （both P < 0.05）. The combined prediction of ILC2 and sST2 demonstrated superior value for postoperative recurrence compared to either marker alone， with a higher area under the curve （AUC） （Z_{ILC2~combined} = 3.367， Z_{sST2~combined} = 4.464， P < 0.05）. The nomogram model showed good predictive performance， with AUCs of 0.88 （0.84 ~ 0.93） and 0.78 （0.68 - 0.89）， The calibration curve indicated good agreement between predicted and actual outcomes （P > 0.05）. Decision curve analysis revealed a high net benefit at threshold probabilities between 40% and 90%. Conclusion The combination of ILC2 cell proportion and sST2 protein level holds significant predictive value for postoperative recurrence in refractory CRSwNP， providing a potential reference for clinical risk stratification and targeted intervention.