Korkmaz Celalettin, Demircioglu Sinan
Department of Chest Diseases, Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey.
Department of Internal Medicine, Division of Hematology, Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey.
Can Respir J. 2020 Sep 24;2020:1696450. doi: 10.1155/2020/1696450. eCollection 2020.
Sarcoidosis is a rare disease characterized by granulomatous inflammation in affected organs, primarily in lungs. Neutrophil/lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR) are easy and practical methods providing valuable information in diagnosis, severity, and prognosis of various diseases. Here, we aimed to investigate the association between NLR, PLR, and hematological parameters in sarcoidosis. The study was performed with 75 sarcoidosis patients and 92 controls. Patients' NLR, PLR, and hematological parameters were compared with those of controls. Additionally, while differences between NLR and PLR were investigated in sarcoidosis patients, differences of extrapulmonary involvement, pulmonary hypertension (PH), and spontaneous remission between those with and without responses to treatment concerning stages were also assessed. NLR and PLR were significantly higher in sarcoidosis patients than controls. For NLR, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were found as 68, 61, 58, and 70% respectively, while sensitivity, specificity, PPV, and NPV for PLR were found as 72, 67, 63, and 74%, respectively. In sarcoidosis patients, NLR and PLR were significantly higher at stage-2 and -3 than at stage -1 and -4. There was a significant weak positive correlation between C-reactive protein (CRP) and NLR and PLR. Mean platelet volume (MPV), hemoglobin (Hgb), and mean corpuscular volume (MCV) were lower among patients than controls. A positive moderate correlation was detected between NLR and CD4/CD8 in blood, while there was a strong positive correlation between CD4/CD8 in bronchoalveolar lavage (BAL) and positive moderate correlation between PLR and CD4/CD8 in BAL. High NLR and PLR values were not significantly associated with pulmonary PH, spontaneous remission, response to treatment, and prognosis. The increase in PLR and NLR may be a guide for diagnoses of both sarcoidosis and lung parenchymal involvement. To use these entities as markers, our findings should be supported with prospective studies with larger samples.
结节病是一种罕见疾病，其特征为受累器官（主要是肺部）出现肉芽肿性炎症。中性粒细胞/淋巴细胞比值（NLR）和血小板/淋巴细胞比值（PLR）是简便实用的方法，可为各种疾病的诊断、严重程度及预后提供有价值的信息。在此，我们旨在研究结节病中NLR、PLR与血液学参数之间的关联。该研究纳入了75例结节病患者和92例对照。将患者的NLR、PLR及血液学参数与对照进行比较。此外，在结节病患者中研究了NLR和PLR之间的差异，同时还评估了肺外受累、肺动脉高压（PH）以及不同分期中治疗有反应者与无反应者之间的自发缓解差异。结节病患者的NLR和PLR显著高于对照。对于NLR，其敏感性、特异性、阳性预测值（PPV）和阴性预测值（NPV）分别为68%、61%、58%和70%，而PLR的敏感性、特异性、PPV和NPV分别为72%、67%、63%和74%。在结节病患者中，2期和3期的NLR和PLR显著高于1期和4期。C反应蛋白（CRP）与NLR和PLR之间存在显著的弱正相关。患者的平均血小板体积（MPV）、血红蛋白（Hgb）和平均红细胞体积（MCV）低于对照。血液中NLR与CD4/CD8之间存在中度正相关，而支气管肺泡灌洗（BAL）中的CD4/CD8与PLR之间存在强正相关，BAL中的PLR与CD4/CD8之间存在中度正相关。高NLR和PLR值与肺部PH、自发缓解、治疗反应及预后无显著关联。PLR和NLR的升高可能对结节病及肺实质受累的诊断具有指导意义。要将这些指标用作标志物，我们的研究结果应得到更大样本量的前瞻性研究的支持。
