生物制剂治疗的克罗恩病患者的基于血液的预后生物标志物：预测内镜结局的有前途的工具。

Blood-based prognostic biomarkers in Crohn's Disease patients on biologics: a promising tool to predict endoscopic outcomes.

机构信息

Department of Health Promotion Sciences Maternal and Infant Care, Section of Gastroenterology & Hepatology, Internal Medicine and Medical Specialties, PROMISE, University of Palermo, Italy.

Inflammatory Bowel Disease Unit, A.O.O.R. Villa Sofia-Cervello Hospital, Palermo, Italy.

出版信息

Expert Opin Biol Ther. 2021 Aug;21(8):1133-1141. doi: 10.1080/14712598.2021.1935857. Epub 2021 Jun 13.

DOI:10.1080/14712598.2021.1935857

PMID:34042009

Abstract

OBJECTIVE

There is a growing need for biomarkers to predict therapeutic outcome in Crohn's disease (CD).

MAIN OUTCOME MEASURES

The aim was to evaluate whether NLR (neutrophil-to-lymphocyte ratio), PLR (platelet-to-lymphocyte ratio), ELR (eosinophil-to-lymphocyte ratio), and ENLR (eosinophil*neutrophil-to-lymphocyte ratio), could be prognostic biomarkers of endoscopic response (ER) when starting biologics.

RESEARCH DESIGN AND METHODS

Patients with CD who started biologics were enrolled. Multivariate analysis was used to evaluate whether NLR, PLR, ELR and ENLR at baseline and at w12 could predict ER (Simple Endoscopic Score for Crohn's disease [SES-CD] ≤2 or SES-CD≤2 and Rutgeerts i0-i1) after 52 weeks of treatment. Area under the curve (AUC) was calculated to find the cutoffs.

RESULTS

107 patients were included. Patients who achieved ER had significantly lower baseline NLR (p = 0.025), ELR (p = 0.013), and ENLR (p = 0.020) compared with those without ER; results after 12 weeks of treatment for ELR (p = 0.006) and ENLR (p = 0.003). AUC was 0.64 (p = 0.003), 0.67 (p = 0.006) and 0.65 (p = 0.014) for NLR, ELR and ENLR.

CONCLUSIONS

Low NLR, ELR and ENLR can predict ER and could be used in clinical practice for a better management of CD patients.

摘要

目的

目前需要生物标志物来预测克罗恩病（CD）的治疗效果。

主要观察指标

本研究旨在评估中性粒细胞与淋巴细胞比值（NLR）、血小板与淋巴细胞比值（PLR）、嗜酸性粒细胞与淋巴细胞比值（ELR）和嗜酸性粒细胞*中性粒细胞与淋巴细胞比值（ENLR）在开始使用生物制剂时是否可作为内镜缓解（ER）的预后生物标志物。

研究设计与方法

纳入开始使用生物制剂的 CD 患者。采用多变量分析评估基线和治疗 12 周时 NLR、PLR、ELR 和 ENLR 是否可预测治疗 52 周后（SES-CD≤2 或 SES-CD≤2 且 Rutgeerts i0-i1）的 ER。计算曲线下面积（AUC）以找到截断值。

结果

共纳入 107 例患者。与未达到 ER 的患者相比，达到 ER 的患者基线 NLR（p=0.025）、ELR（p=0.013）和 ENLR（p=0.020）显著降低；治疗 12 周后 ELR（p=0.006）和 ENLR（p=0.003）结果也降低。NLR、ELR 和 ENLR 的 AUC 分别为 0.64（p=0.003）、0.67（p=0.006）和 0.65（p=0.014）。