Internal medicine department B, Ziv Medical Center, Safed, Israel.
Azrieli Faculty of Medicine Bar, Ilan University, Safed, Israel.
J Clin Lab Anal. 2020 Jan;34(1):e23010. doi: 10.1002/jcla.23010. Epub 2019 Sep 11.
Acute venous thromboembolism (VTE) refers to deep venous thrombosis (DVT) of the extremities or pulmonary embolism (PE), or to both. Reliable imaging is not always available making a serologic diagnosis, or biomarker, highly desirable.
This study aimed to examine the role of neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and mean platelet volume (MPV) in detection patients with acute VTE.
A total of 327 patients with initial diagnosis of acute VTE who were admitted to Ziv hospital were evaluated. Of them, 272 patients with definitive diagnosis of VTE, and 55 patients without VTE were used as control group. Complete blood count (CBC), measurements of NLR, MPV, and PLR were determined at admission.
Patients with VTE were older than controls (62 ± 18.9 vs 55.4 ± 15.1 years, respectively, P = .03). Female gender was predominant in the two groups. In the study group, 178/272 (66%) had DVT, 84/272 (31%) had pulmonary embolism (PE), and the rest had DVT and PE. NLR, MPV, and PLR were found to be significantly elevated in acute VTE compared to control (P < .001, P = .008, P = .014, respectively). A ROC curve analysis of NLR and MPV for predicting acute VTE was performed which found a cut-off value of 5.3 for NLR, an area under curve of (0.67 (0.60-0.75), P < .001, with a sensitivity of 69% and specificity of 57%. and a cut-off value of 8.6 for MPV, an area under curve of (0.61 [0.53-0.68], P = .014, with a sensitivity of 52% and specificity of 67%. Multivariate logistic regression model found that NLR (OR 1.2, 95% CI [1.01-1.4], P = .041) and MPV (OR 1.5, 95%CI [1.07-2.12], P = .5) were associated with acute VTE.
Neutrophil-lymphocyte ratio and MPV could be beneficial predictors for the early detection of potential acute VTE.
急性静脉血栓栓塞症(VTE)是指四肢深静脉血栓形成(DVT)或肺栓塞(PE),或两者兼有。可靠的影像学检查并不总是可用,因此血清学诊断或生物标志物非常理想。
本研究旨在探讨中性粒细胞/淋巴细胞比值(NLR)、血小板/淋巴细胞比值(PLR)和平均血小板体积(MPV)在检测急性 VTE 患者中的作用。
对 327 例初诊为急性 VTE 的患者进行评估,其中 272 例明确诊断为 VTE,55 例无 VTE 患者作为对照组。入院时测定全血细胞计数(CBC)、NLR、MPV 和 PLR 。
VTE 患者比对照组年龄更大(62±18.9 岁 vs 55.4±15.1 岁,P=0.03)。两组均以女性为主。在研究组中,178/272(66%)患者有 DVT,84/272(31%)患者有肺栓塞(PE),其余患者有 DVT 和 PE。与对照组相比,NLR、MPV 和 PLR 均显著升高(P<0.001,P=0.008,P=0.014,分别)。对 NLR 和 MPV 预测急性 VTE 的 ROC 曲线分析发现,NLR 的截断值为 5.3,曲线下面积为(0.67(0.60-0.75),P<0.001,敏感性为 69%,特异性为 57%。MPV 的截断值为 8.6,曲线下面积为(0.61(0.53-0.68),P=0.014,敏感性为 52%,特异性为 67%。多变量 logistic 回归模型发现,NLR(OR 1.2,95%CI [1.01-1.4],P=0.041)和 MPV(OR 1.5,95%CI [1.07-2.12],P=0.05)与急性 VTE 相关。
中性粒细胞/淋巴细胞比值和 MPV 可能是早期检测潜在急性 VTE 的有益预测因子。