Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran.
Ranfanjan University of Medical Science, Ranfanjan, Iran.
Mediators Inflamm. 2022 Nov 3;2022:9680591. doi: 10.1155/2022/9680591. eCollection 2022.
The goal of this systematic review and meta-analysis was to consolidate the available data on the role of the neutrophil to lymphocyte ratio (NLR) in predicting adnexal torsion (AT), to help guide clinical decision-making and outcomes.
We used Web of Science, PubMed, and Scopus to conduct a systematic search for relevant publications published before June 26, 2022. We reported standardized mean difference (SMD) with a 95% confidence interval (CI). Because a significant level of heterogeneity was found, we used the random-effects model to calculate pooled effects. We used the Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2) too for quality assessment.
Overall, 15 articles were included in the analysis. A random-effects model revealed that patients with AT had elevated levels of NLR compared to those with other adnexal masses (SMD = 1.06, 95%CI = 0.67 to 1.45, < 0.001). So, NLR had diagnostic value. In the subgroup analysis according to ethnicity, we found that Caucasian patients with AT had elevated levels of NLR compared to patients who were operated due to adnexal mass and reported as having a benign ovarian cyst, without torsion (SMD = 1.12, 95%CI = 0.71 to 1.54, < 0.001). However, in the case of East Asian patients, there was no difference between cases and controls (SMD = 0.86, 95%CI = -0.21 to 1.94, = 0.11). The pooled sensitivity of NLR was 0.79 (95%CI = 0.72-0.85), and the pooled specificity was 0.84 (95% CI, 0.74-0.91).
In conclusion, there has been an interest in the use of NLR as a diagnostic marker for AT.
本系统评价和荟萃分析的目的是整合中性粒细胞与淋巴细胞比值（NLR）在预测附件扭转（AT）中的作用的现有数据，以帮助指导临床决策和结果。
我们使用 Web of Science、PubMed 和 Scopus 对截至 2022 年 6 月 26 日之前发表的相关文献进行了系统检索。我们报告了标准化均数差（SMD）和 95%置信区间（CI）。由于存在显著的异质性，我们使用随机效应模型来计算汇总效应。我们还使用诊断准确性研究质量评估工具 2（QUADAS-2）进行质量评估。
总体而言，有 15 篇文章纳入分析。随机效应模型显示，与其他附件肿块患者相比，附件扭转患者的 NLR 水平升高（SMD=1.06，95%CI=0.67 至 1.45， < 0.001）。因此，NLR 具有诊断价值。根据种族进行的亚组分析显示，与因附件肿块而接受手术且报告为良性卵巢囊肿、无扭转的患者相比，白人附件扭转患者的 NLR 水平升高（SMD=1.12，95%CI=0.71 至 1.54， < 0.001）。然而，对于东亚患者，病例与对照组之间没有差异（SMD=0.86，95%CI=-0.21 至 1.94， = 0.11）。NLR 的汇总敏感性为 0.79（95%CI=0.72-0.85），特异性为 0.84（95%CI，0.74-0.91）。
总之，人们对 NLR 作为 AT 的诊断标志物的应用产生了兴趣。
