Dirican Nigar, Anar Ceyda, Kaya Sule, Bircan Haci Ahmet, Colar Huseyin Halil, Cakir Munire
Department of Chest Diseases, Medical Faculty, Suleyman Demirel University, Isparta, Turkey.
Department of Chest Diseases, Dr. Suat Seren Chest Diseases and Surgery Training and Research Hospital, Izmir, Turkey.
Clin Respir J. 2016 Jan;10(1):32-9. doi: 10.1111/crj.12178. Epub 2014 Jul 28.
Sarcoidosis is a multisystemic inflammatory granulomatous disease of unknown etiology. No suitable biomarkers are available to evaluate the prognosis of this disease, which still has an unpredictable clinical course. The aim of this study was to evaluate the potential clinical usefulness of hematologic markers.
We investigated 172 subjects: 116 patients with sarcoidosis and 56 healthy individuals at Suleyman Demirel University and Dr. Suat Seren Chest Diseases and Thoracic Surgery Training Hospital. Complete blood count, demographics and pulmonary function test data from sarcoidosis patients between 2008 and 2013 were evaluated and collated retrospectively. The cut-off values were determined by calculating the neutrophil-to-lymphocyte ratio (NLR) and mean platelet volume (MPV) of the patients.
The cut-off values were determined as 2 and 8.95 for NLR and MPV, respectively. NLRs were significantly higher in sarcoidosis patients than in healthy controls (P < 0.001) and were directly correlated with erythrocyte sedimentation rate (ESR) levels (R = 0.183, P = 0.017). Receiver operator characteristic (ROC) curve analysis revealed a 0.83 [confidence interval (CI) 68.8%-88.4%] area under the curve, 80% sensitivity and 59% specificity at the cut-off of NLR. Higher NLRs (≥2) were detected in patients with sarcoidosis than in the control group (P < 0.001). Also, high NLRs were more frequent in patients with extrapulmonary involvement (P = 0.031). MPV values were not different between control and patient groups.
NLR may be a biomarker with good sensitivity that is easily detected in serum. It can be proposed in clinical practice to identify a patient's prognosis. However, large prospective studies are required to further demonstrate the prognostic significance of these values.
结节病是一种病因不明的多系统炎症性肉芽肿疾病。目前尚无合适的生物标志物可用于评估该疾病的预后,其临床病程仍不可预测。本研究的目的是评估血液学标志物的潜在临床应用价值。
我们在苏莱曼·德米雷尔大学以及苏阿特·塞伦胸部疾病与胸外科培训医院调查了172名受试者,其中116例结节病患者和56名健康个体。对2008年至2013年间结节病患者的全血细胞计数、人口统计学数据和肺功能测试数据进行了回顾性评估和整理。通过计算患者的中性粒细胞与淋巴细胞比值(NLR)和平均血小板体积(MPV)来确定临界值。
NLR和MPV的临界值分别确定为2和8.95。结节病患者的NLR显著高于健康对照组(P < 0.001),且与红细胞沉降率(ESR)水平直接相关(R = 0.183,P = 0.017)。受试者工作特征(ROC)曲线分析显示曲线下面积为0.83[置信区间(CI)68.8%-88.4%],在NLR临界值时敏感性为80%,特异性为59%。结节病患者中检测到的NLR较高(≥2)的比例高于对照组(P < 0.001)。此外,肺外受累患者中高NLR更为常见(P = 0.031)。对照组和患者组之间的MPV值无差异。
NLR可能是一种在血清中易于检测且敏感性良好的生物标志物。在临床实践中可用于判断患者的预后。然而,需要大型前瞻性研究来进一步证明这些值的预后意义。