Li Shengjie, Cao Wenjun, Han Jianping, Tang Binghua, Sun Xinghuai
Department of Clinical Laboratory, Eye & ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, China.
Department of Ophthalmology & Visual Science, Eye & ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, China.
Oncotarget. 2017 Mar 25;8(40):68984-68995. doi: 10.18632/oncotarget.16571. eCollection 2017 Sep 15.
Inflammatory mechanisms may have a role in the pathogenesis of primary angle closure glaucoma (PACG). The objective of this study was to investigate the diagnostic value of white blood cell (WBC), neutrophil, neutrophil to lymphocyte ratio (NLR), and lymphocyte to monocyte ratio (LMR) in patients with PACG and its association with glaucoma severity.
The study was retrospectively assessed in 771 consecutive PACG patients and 770 control subjects, laboratory parameters and clinical parameters were obtained from a medical data platform. Patients were divided into three groups with different severity based on perimetry, i.e. mild (mean deviation (MD) ≤6.00 dB), moderate (12 dB≥ MD>6 dB) and severe (MD>12 dB). We developed a nomogram to specifically identify individual patient's risk.
The mean levels of neutrophil, NLR and WBC was higher in PACG than control group, and lowest in the mild PACG group, followed by moderate PACG and severe PACG (<0.05). The AUROC value of NLR and LMR was found to be 0.719, 0.699, respectively. Multiple linear regressions showed that there was a significant correlation between WBC and MD (B=0.151, <0.001), neutrophil and MD (B=0.143, =0.003), NLR and MD (B=0.144, =0.001), LMR and MD (B=-0.100, =0.034). Logistic regression analyses revealed that WBC (OR=1.208, 95%CI=1.179-1.238), neutrophil (OR=1.598, 95%CI=1.541-1.656), NLR (OR=2.313, 95%CI=2.200-2.431), and LMR (OR=0.682, 95%CI=0.666-0.699) were associated with PACG.
Our study suggested that WBC, neutrophil, NLR, and LMR was related with PACG, and NLR and LMR may be useful as biomarkers.
炎症机制可能在原发性闭角型青光眼（PACG）的发病机制中起作用。本研究的目的是探讨白细胞（WBC）、中性粒细胞、中性粒细胞与淋巴细胞比值（NLR）以及淋巴细胞与单核细胞比值（LMR）在PACG患者中的诊断价值及其与青光眼严重程度的关系。
对771例连续的PACG患者和770例对照者进行回顾性评估，从医学数据平台获取实验室参数和临床参数。根据视野检查将患者分为三组不同严重程度，即轻度（平均偏差（MD）≤6.00 dB）、中度（12 dB≥MD>6 dB）和重度（MD>12 dB）。我们绘制了列线图以具体识别个体患者的风险。
PACG组中性粒细胞、NLR和WBC的平均水平高于对照组，在轻度PACG组中最低，其次是中度PACG组和重度PACG组（<0.05）。发现NLR和LMR的曲线下面积（AUROC）值分别为0.719、0.699。多元线性回归显示WBC与MD之间存在显著相关性（B = 0.151，<0.001），中性粒细胞与MD之间（B = 0.143，= 0.003），NLR与MD之间（B = 0.144，= 0.001），LMR与MD之间（B = -0.100，= 0.034）。逻辑回归分析显示WBC（比值比（OR）= 1.208，95%置信区间（CI）= 1.179 - 1.238）、中性粒细胞（OR = 1.598，95%CI = 1.541 - 1.656）、NLR（OR = 2.313，95%CI = 2.200 - 2.431）和LMR（OR = 0.682，95%CI = 0.666 - 0.699）与PACG相关。
我们的研究表明WBC、中性粒细胞、NLR和LMR与PACG相关，且NLR和LMR可能作为生物标志物有用。
