Division of Hematology & Medical Oncology, Department of Internal Medicine, Soonchunhyang University Seoul Hospital, Seoul, South Korea.
Division of Cardiology, Department of Internal Medicine, Soonchunhyang University Seoul Hospital, Seoul, South Korea.
Int J Lab Hematol. 2023 Dec;45(6):853-859. doi: 10.1111/ijlh.14138. Epub 2023 Jul 27.
The role of inflammation in the pathophysiology of polycythemia vera (PV) is important. The presence of JAK2 mutations is important in the diagnosis of PV, and serum levels of erythropoietin (EPO) also play a supporting role. However, serum EPO levels show some limitations. The neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) are a readily available marker of inflammation. Thus, we examined whether NLR & PLR might diagnose PV in erythrocytosis patients. We compared NLR & PLR and EPO diagnostic values.
We retrospectively reviewed clinical and laboratory data from two referral hospitals. Two hundred and eighty-five patients with erythrocytosis who underwent a test for the JAK2 mutation were included. It wac classified as the PV group and the secondary polycythemia (SP) group.
The median NLR & PLR in the PV group (n = 70) was significantly higher than that in the SP group (n = 170) (NLR: 6.04 vs. 1.77, PLR: 283.18 vs. 101.56, respectively, p < 0.001). In the receiver operating characteristic analysis, the area under the curve of NLR & PLR was significantly higher than that of serum EPO (NLR vs EPO: 0.921 vs. 0.827, p = 0.003; PLR vs EPO: 0.917 vs 0.827, p = 0.003).
In conclusion, NLR & PLR were higher in PV than in SP and showed better diagnostic value than serum EPO level, highlighting their potential as minor diagnostic criteria in patients with PV.
炎症在真性红细胞增多症 (PV) 的病理生理学中起着重要作用。JAK2 突变的存在对 PV 的诊断很重要，而血清促红细胞生成素 (EPO) 水平也起支持作用。然而，血清 EPO 水平存在一些局限性。中性粒细胞与淋巴细胞比值 (NLR) 和血小板与淋巴细胞比值 (PLR) 是炎症的一个易于获得的标志物。因此，我们研究了 NLR 和 PLR 是否可以在红细胞增多症患者中诊断 PV。我们比较了 NLR 和 PLR 与 EPO 的诊断价值。
我们回顾性分析了来自两家转诊医院的临床和实验室数据。共纳入 285 例接受 JAK2 突变检测的红细胞增多症患者。根据 JAK2 突变检测结果分为 PV 组和继发性红细胞增多症 (SP) 组。
PV 组 (n=70) 的 NLR 和 PLR 中位数明显高于 SP 组 (n=170) (NLR：6.04 比 1.77，PLR：283.18 比 101.56，p<0.001)。在受试者工作特征曲线分析中，NLR 和 PLR 的曲线下面积明显高于血清 EPO (NLR 比 EPO：0.921 比 0.827，p=0.003；PLR 比 EPO：0.917 比 0.827，p=0.003)。
总之，PV 组的 NLR 和 PLR 高于 SP 组，且诊断价值优于血清 EPO 水平，提示它们可能成为 PV 患者的次要诊断标准。
