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Do neutrophil-lymphocyte ratio and platelet-lymphocyte ratio correlate with clinical and endoscopic activity indices in ulcerative colitis patients?

Year 2020, Volume: 28 Issue: 1, 5 - 11, 30.04.2020
https://doi.org/10.17940/endoskopi.646673

Abstract

Objective:
Classification
of ulcerative colitis (UC) according to disease activity and severity is
important in clinical practice because it determines the management of the
patient. In this study, we aimed to investigate the relationship between
neutrophil lymphocyte ratios (NLR) and platelet lymphocyte ratios (PLR) with
clinical activity index (CAI) in UC patients as well as endoscopic activity
indexes (EIA) that determine disease severity relative to mucosal disease.

Materials
and Methods:
The study was planned as a retrospective
single-center study. Active disease and remission groups were formed from 99
newly diagnosed UC patients according to their CAIs and EAIs. The control group
consisted of 56 healthy subjects.

Results:
Serum
NLR and PLR levels of clinically active patients were significantly higher than
inactive UC and control groups (p <0.01). The cut-off values for NLR and PLR
were 2.10 (90% sensitivity, 45% specificity) and 152.13 (70% sensitivity, 33%
specificity), respectively. Serum NLR and PLR of endoscopically active patients
were significantly higher than inactive UC and control group (p <0.01). The
cut-off values for NLR and PLR were 2.09 (97% sensitivity, 39% specificity) and
151.72 (73% sensitivity, 31% specificity), respectively.







Conclusion:
Our
study showed that NLR and PLR levels were significantly increased in active UC
patients and correlated with clinical, endoscopic and laboratory indices. These
inflammatory markers can predict disease activity alone or in combination.

References

  • 1- Lamb CA, Kennedy NA, Raine T, Hendy PA, Smith PJ, Limdi JK. British Society of Gastroenterology consensus guidelines on the management of inflammatory bowel disease in adults. Gut, gutjnl–2019–318484.2- Caprilli R, Viscido A, Latella G. Current management of severe ulcerative colitis. Nat Clin Pract Gastroenterol Hepatol. 2007;4(2):92–101.3- Lok KH, Ng CH, Hung HG, Li KF, Li KK, Szeto ML. (2008). Correlation of serum biomarkers with clinical severity and mucosal inflammation in Chinese ulcerative colitis patients. Journal of Digestive Diseases, 9(4), 219–224.4- Hassan EA, Ramadan HK, Ismael AA, Mohamed KF, El-Attar MM, Alhelali I. Noninvasive biomarkers as surrogate predictors of clinical and endoscopic remission after infliximab induction in patients with refractory ulcerative colitis. Saudi J Gastroenterol. 2017 Jul-Aug; 23(4):238-245.5- Vermeire S, Van Assche G, Rutgeerts P. Laboratory Markers in IBD: Useful, magic, or unnecessary toys? Gut 2006; 55: 426-431.6- Zahorec R. Ratio of neutrophil to lymphocyte counts — rapid and simple parameter of systemic inflammation and stress incritically ill. Bratisl Lek Listy 2001; 102:5—14.7- Yodying H, Matsuda A, Miyashita M, Matsumoto S, Sakurazawa N, Yamada M, et al. Prognostic Significance of Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio in Oncologic Outcomes of Esophageal Cancer: A Systematic Review and Meta-analysis. Ann Surg Oncol. 2016 Feb;23(2):646-54.8- Akpinar MY, OzinYO, Kaplan M, Ates I, Kalkan İH, Kilic ZMY et al. Platelet to Lymphocyte Ratio and Neutrophil to Lymphocyte Ratio Predict Mucosal Disease Severity in Ulcerative Colitis . J Med Biochem. 2018 Apr; 37(2): 155–162.9- Demir AK, Demirtas A, Kaya SU, Tastan I, Butun I, Sagcan M, Et al. The relationship between the neutrophilelymphocyte ratio and disease activity in patients with ulcerative colitis. Kaohsiung Journal of Medical Sciences (2015) 31, 585e590.10- Satsangi J, Silverberg MS, Vermeire S, Colombel JF. The Montreal classification of inflammatory bowel disease: controversies, consensus, and implications. Gut 2006; 55: 749-753.11- Feagan BG, Greenberg GR, Wild G, Fedorak RN, Pare P, McDonald JW, et al. Treatment of ulcerative colitis with a humanized antibody to the alpha4beta7 integrin. New England Journal of Medicine 2005;352(24):2499‐507.12- Lee JS, Kim ES,Won, Moon W Chronological Review of Endoscopic Indices in Inflammatory Bowel Disease. Clin Endosc. 2019 Mar; 52(2): 129–136.13- Rosenberg L, Lawlor GO, Zenlea T, Goldsmith JD, Gifford A, Falchuk KR, et al. Predictors of endoscopic onflammation in patients with ulcerative colitis in clinical remission. Inflamm Bowel Dis 2013; 19(4): 779–84.14- D’Haens, Sandborn WJ, Feagan BG, Geboes K, Hanauer SB, Irvine EJ, et al. A review of activity indices and efficacy end points for clinical trials of medical therapy in adults with ulcerative colitis. Gastroenterology 2007; 132: 763–86.15- Osada T, Ohkusa T, Okayasu I, Yoshida T, Hirai S, Beppu K, et al. Correlations among total colonoscopic findings, clinical symptoms, and laboratory markers in ulcerative colitis. J Gastroenterol Hepatol 2008; 23: S262e7.16- Yoon JY, Park SJ, Hong SP, Kim TI, Kim WH, Cheon JH. Correlations of C-reactive protein levels and erythrocyte sedimentation rates with endoscopic activity indices in patients with ulcerative colitis. Dig Dis Sci 2014; 59: 829e37.17- Karoui S, Laz S, Serghini M, Bibani N, Boubaker J, Filali A. Correlation of C-reactive protein with clinical and endoscopic activity in patients with ulcerative colitis. Dig Dis Sci 2011; 56: 1801—5.18- C¸elikbilek M, Dogan S, Ozbakir O, Zararsiz G, Kucuk H, Gursoy S, et al. Neutrophil-lymphocyte ratio as a predictor of disease severity in ulcerative colitis. J Clin Lab Anal 2013; 27:72e6. 19- Gewirtz AT, Liu Y, Sitaraman SV,Madara JL. Intestinal epithelial pathobiology: Past, present and future. Best Pract Res Clin Gastroenterol. 2002;16(6):851–867.20- Posul E, Yilmaz B, Aktas G, Kurt M. Does neutrophil-tolymphocyte ratio predict active ulcerative colitis? Wiev Klin Wochenschr 2015; 127: 262–5.21- Voudoukis E, Karmiris K, Koutroubakis IE. Multipotent role of platelets in inflammatory bowel diseases: a clinical approach. World J Gastroenterol. 2014;20(12):3180–3190.

Ülseratif kolit hastalarında nötrofil lenfosit oranı ve platelet lenfosit oranı, klinik ve endoskopik aktivite indeksleri ile ilişkili mi?

Year 2020, Volume: 28 Issue: 1, 5 - 11, 30.04.2020
https://doi.org/10.17940/endoskopi.646673

Abstract

Amaç:
Ülseratif
kolitin (ÜK) hastalık aktivitesine ve ciddiyetine göre sınıflandırılması klinik
uygulamada önemlidir, çünkü hastanın yönetimini belirler. Bu çalışmada,
nötrofil lenfosit oranları (NLR) ve platelet lenfosit oranlarının (PLR), ÜK
hastalarında klinik aktivite indeksinin (KAİ) yanı sıra mukozal hastalığa göre
hastalık şiddetini belirleyen endoskopik aktivite indeksleri (EAİ) ile olan
ilişkilerinin ortaya konulması amaçlanmıştır.

Materyal
ve Metot:
Çalışma retrospektif tek merkezli çalışma olarak
planlandı. Yeni tanı almış 99 ÜK’li hastadan KAİ’lerine ve EAİ’lerine göre
aktif hastalık ve remisyon grupları oluşturuldu. Kontrol grubu 56 sağlıklı
bireyden oluşturuldu.

Bulgular:
Klinik
aktif
hastaların serum NLR’ı ve PLR’ı, inaktif ÜK ve kontrol grubuna göre anlamlı
derecede yüksekti (p<0,01). NLR ve PLR için kesme değerleri sırasıyla 2,10
(%90 sensitivite, %45 spesifite) ve 152,13 (%70 sensitivite, %33 spesifite)
olarak saptandı. Endoskopik aktif hastaların serum NLR’ı ve PLR’ı, inaktif ÜK
ve kontrol grubuna göre anlamlı derecede yüksekti (p<0,01). NLR ve PLR için
kesme değerleri sırasıyla 2,09 (%97 sensitivite, %39 spesifite) ve 151,72 (%73
sensitivite, %31 spesifite) olarak saptandı.







Sonuç: Çalışmamız
aktif ÜK hastalarında NLR ve PLR seviyelerinin anlamlı şekilde arttığını ve
bunun klinik, endoskopik ve laboratuvar endeksleri ile korele olduğunu
göstermiştir. Bu inflamatuar belirteçler tek başına ya da birlikte hastalık
aktivitesini tahmin edebilir.

References

  • 1- Lamb CA, Kennedy NA, Raine T, Hendy PA, Smith PJ, Limdi JK. British Society of Gastroenterology consensus guidelines on the management of inflammatory bowel disease in adults. Gut, gutjnl–2019–318484.2- Caprilli R, Viscido A, Latella G. Current management of severe ulcerative colitis. Nat Clin Pract Gastroenterol Hepatol. 2007;4(2):92–101.3- Lok KH, Ng CH, Hung HG, Li KF, Li KK, Szeto ML. (2008). Correlation of serum biomarkers with clinical severity and mucosal inflammation in Chinese ulcerative colitis patients. Journal of Digestive Diseases, 9(4), 219–224.4- Hassan EA, Ramadan HK, Ismael AA, Mohamed KF, El-Attar MM, Alhelali I. Noninvasive biomarkers as surrogate predictors of clinical and endoscopic remission after infliximab induction in patients with refractory ulcerative colitis. Saudi J Gastroenterol. 2017 Jul-Aug; 23(4):238-245.5- Vermeire S, Van Assche G, Rutgeerts P. Laboratory Markers in IBD: Useful, magic, or unnecessary toys? Gut 2006; 55: 426-431.6- Zahorec R. Ratio of neutrophil to lymphocyte counts — rapid and simple parameter of systemic inflammation and stress incritically ill. Bratisl Lek Listy 2001; 102:5—14.7- Yodying H, Matsuda A, Miyashita M, Matsumoto S, Sakurazawa N, Yamada M, et al. Prognostic Significance of Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio in Oncologic Outcomes of Esophageal Cancer: A Systematic Review and Meta-analysis. Ann Surg Oncol. 2016 Feb;23(2):646-54.8- Akpinar MY, OzinYO, Kaplan M, Ates I, Kalkan İH, Kilic ZMY et al. Platelet to Lymphocyte Ratio and Neutrophil to Lymphocyte Ratio Predict Mucosal Disease Severity in Ulcerative Colitis . J Med Biochem. 2018 Apr; 37(2): 155–162.9- Demir AK, Demirtas A, Kaya SU, Tastan I, Butun I, Sagcan M, Et al. The relationship between the neutrophilelymphocyte ratio and disease activity in patients with ulcerative colitis. Kaohsiung Journal of Medical Sciences (2015) 31, 585e590.10- Satsangi J, Silverberg MS, Vermeire S, Colombel JF. The Montreal classification of inflammatory bowel disease: controversies, consensus, and implications. Gut 2006; 55: 749-753.11- Feagan BG, Greenberg GR, Wild G, Fedorak RN, Pare P, McDonald JW, et al. Treatment of ulcerative colitis with a humanized antibody to the alpha4beta7 integrin. New England Journal of Medicine 2005;352(24):2499‐507.12- Lee JS, Kim ES,Won, Moon W Chronological Review of Endoscopic Indices in Inflammatory Bowel Disease. Clin Endosc. 2019 Mar; 52(2): 129–136.13- Rosenberg L, Lawlor GO, Zenlea T, Goldsmith JD, Gifford A, Falchuk KR, et al. Predictors of endoscopic onflammation in patients with ulcerative colitis in clinical remission. Inflamm Bowel Dis 2013; 19(4): 779–84.14- D’Haens, Sandborn WJ, Feagan BG, Geboes K, Hanauer SB, Irvine EJ, et al. A review of activity indices and efficacy end points for clinical trials of medical therapy in adults with ulcerative colitis. Gastroenterology 2007; 132: 763–86.15- Osada T, Ohkusa T, Okayasu I, Yoshida T, Hirai S, Beppu K, et al. Correlations among total colonoscopic findings, clinical symptoms, and laboratory markers in ulcerative colitis. J Gastroenterol Hepatol 2008; 23: S262e7.16- Yoon JY, Park SJ, Hong SP, Kim TI, Kim WH, Cheon JH. Correlations of C-reactive protein levels and erythrocyte sedimentation rates with endoscopic activity indices in patients with ulcerative colitis. Dig Dis Sci 2014; 59: 829e37.17- Karoui S, Laz S, Serghini M, Bibani N, Boubaker J, Filali A. Correlation of C-reactive protein with clinical and endoscopic activity in patients with ulcerative colitis. Dig Dis Sci 2011; 56: 1801—5.18- C¸elikbilek M, Dogan S, Ozbakir O, Zararsiz G, Kucuk H, Gursoy S, et al. Neutrophil-lymphocyte ratio as a predictor of disease severity in ulcerative colitis. J Clin Lab Anal 2013; 27:72e6. 19- Gewirtz AT, Liu Y, Sitaraman SV,Madara JL. Intestinal epithelial pathobiology: Past, present and future. Best Pract Res Clin Gastroenterol. 2002;16(6):851–867.20- Posul E, Yilmaz B, Aktas G, Kurt M. Does neutrophil-tolymphocyte ratio predict active ulcerative colitis? Wiev Klin Wochenschr 2015; 127: 262–5.21- Voudoukis E, Karmiris K, Koutroubakis IE. Multipotent role of platelets in inflammatory bowel diseases: a clinical approach. World J Gastroenterol. 2014;20(12):3180–3190.
There are 1 citations in total.

Details

Primary Language Turkish
Subjects Health Care Administration
Journal Section Articles
Authors

Serkan Yalaki 0000-0001-8137-0924

Mehmet Suat Yalçın 0000-0003-1054-1882

Hüseyin Pulat This is me 0000-0003-0635-3387

Aysu İlhan This is me 0000-0002-5750-511X

Publication Date April 30, 2020
Published in Issue Year 2020 Volume: 28 Issue: 1

Cite

APA Yalaki, S., Yalçın, M. S., Pulat, H., İlhan, A. (2020). Ülseratif kolit hastalarında nötrofil lenfosit oranı ve platelet lenfosit oranı, klinik ve endoskopik aktivite indeksleri ile ilişkili mi?. Endoskopi Gastrointestinal, 28(1), 5-11. https://doi.org/10.17940/endoskopi.646673
AMA Yalaki S, Yalçın MS, Pulat H, İlhan A. Ülseratif kolit hastalarında nötrofil lenfosit oranı ve platelet lenfosit oranı, klinik ve endoskopik aktivite indeksleri ile ilişkili mi?. Endoskopi Gastrointestinal. April 2020;28(1):5-11. doi:10.17940/endoskopi.646673
Chicago Yalaki, Serkan, Mehmet Suat Yalçın, Hüseyin Pulat, and Aysu İlhan. “Ülseratif Kolit hastalarında nötrofil Lenfosit Oranı Ve Platelet Lenfosit oranı, Klinik Ve Endoskopik Aktivite Indeksleri Ile ilişkili Mi?”. Endoskopi Gastrointestinal 28, no. 1 (April 2020): 5-11. https://doi.org/10.17940/endoskopi.646673.
EndNote Yalaki S, Yalçın MS, Pulat H, İlhan A (April 1, 2020) Ülseratif kolit hastalarında nötrofil lenfosit oranı ve platelet lenfosit oranı, klinik ve endoskopik aktivite indeksleri ile ilişkili mi?. Endoskopi Gastrointestinal 28 1 5–11.
IEEE S. Yalaki, M. S. Yalçın, H. Pulat, and A. İlhan, “Ülseratif kolit hastalarında nötrofil lenfosit oranı ve platelet lenfosit oranı, klinik ve endoskopik aktivite indeksleri ile ilişkili mi?”, Endoskopi Gastrointestinal, vol. 28, no. 1, pp. 5–11, 2020, doi: 10.17940/endoskopi.646673.
ISNAD Yalaki, Serkan et al. “Ülseratif Kolit hastalarında nötrofil Lenfosit Oranı Ve Platelet Lenfosit oranı, Klinik Ve Endoskopik Aktivite Indeksleri Ile ilişkili Mi?”. Endoskopi Gastrointestinal 28/1 (April 2020), 5-11. https://doi.org/10.17940/endoskopi.646673.
JAMA Yalaki S, Yalçın MS, Pulat H, İlhan A. Ülseratif kolit hastalarında nötrofil lenfosit oranı ve platelet lenfosit oranı, klinik ve endoskopik aktivite indeksleri ile ilişkili mi?. Endoskopi Gastrointestinal. 2020;28:5–11.
MLA Yalaki, Serkan et al. “Ülseratif Kolit hastalarında nötrofil Lenfosit Oranı Ve Platelet Lenfosit oranı, Klinik Ve Endoskopik Aktivite Indeksleri Ile ilişkili Mi?”. Endoskopi Gastrointestinal, vol. 28, no. 1, 2020, pp. 5-11, doi:10.17940/endoskopi.646673.
Vancouver Yalaki S, Yalçın MS, Pulat H, İlhan A. Ülseratif kolit hastalarında nötrofil lenfosit oranı ve platelet lenfosit oranı, klinik ve endoskopik aktivite indeksleri ile ilişkili mi?. Endoskopi Gastrointestinal. 2020;28(1):5-11.