Langley Blake O, Guedry Sara E, Goldenberg Joshua Z, Hanes Douglas A, Beardsley Jennifer A, Ryan Jennifer Joan
Helfgott Research Institute, National University of Natural Medicine, Portland, OR 97201, USA.
Independent Researcher, Seattle, WA 98115, USA.
J Clin Med. 2021 Sep 17;10(18):4219. doi: 10.3390/jcm10184219.
Neutrophil-lymphocyte ratio (NLR) is a biomarker of the systemic inflammatory response. The objective of this systematic scoping review was to examine the literature on NLR and inflammatory bowel disease (IBD). PubMed, Embase, Cochrane CENTRAL, CINAHL, ClinicalTrials.gov, Cochrane Specialized Register, DOAJ, PDQT, Biosis Citation Index, Scopus, and Web of Science were systematically searched. A total of 2621 citations yielding 62 primary studies were synthesized under four categories: distinguishing patients with IBD from controls, disease activity differentiation, clinical outcome prediction, and association of NLR with other IBD biomarkers. Thirty-eight studies employed receiver operating characteristic (ROC) curve analysis to generate optimal NLR cutpoints for applications including disease activity differentiation and prediction of response to treatment. Among the most promising findings, NLR may have utility for clinical and endoscopic disease activity differentiation and prediction of loss of response to infliximab (IFX). Overall findings suggest NLR may be a promising IBD biomarker. Assessment of NLR is non-invasive, low cost, and widely accessible given NLR is easily calculated from blood count data routinely and serially monitored in patients with IBD. Further research is justified to elucidate how evaluation of NLR in research and clinical practice would directly impact the quality and cost of care for patients living with IBD.
中性粒细胞与淋巴细胞比值（NLR）是全身炎症反应的生物标志物。本系统综述的目的是研究关于NLR与炎症性肠病（IBD）的文献。我们系统检索了PubMed、Embase、Cochrane CENTRAL、CINAHL、ClinicalTrials.gov、Cochrane专业注册库、DOAJ、PDQT、生物科学引文索引、Scopus和科学网。共有2621条引文，从中筛选出62项主要研究，并归纳为四类：区分IBD患者与对照、疾病活动度区分、临床结局预测以及NLR与其他IBD生物标志物的关联。38项研究采用受试者工作特征（ROC）曲线分析来生成最佳NLR切点，用于疾病活动度区分和治疗反应预测等应用。在最有前景的研究结果中，NLR可能有助于临床和内镜下疾病活动度的区分，以及预测英夫利昔单抗（IFX）治疗反应的丧失。总体研究结果表明，NLR可能是一种有前景的IBD生物标志物。鉴于NLR可根据IBD患者常规和连续监测的血常规数据轻松计算得出，对其进行评估具有非侵入性、低成本且广泛可及的特点。进一步的研究很有必要，以阐明在研究和临床实践中对NLR的评估将如何直接影响IBD患者的护理质量和成本。
