Mao Ting, Zhang Bin, Yang Ti, Qian Yinyan, Zhou Chenchen, He Chunyan
Department of Clinical Laboratory, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China.
Department of Clinical Laboratory, Kunshan Hospital of Chinese Medicine, Affiliated Hospital of Yangzhou University, Kunshan, Jiangsu, China.
Heliyon. 2023 Jul 21;9(8):e18556. doi: 10.1016/j.heliyon.2023.e18556. eCollection 2023 Aug.
Lymphocytes are generally accepted to be a key component of the immune response, and an inadequate immune response is closely associated with disease severity and adverse outcomes in hepatitis B virus (HBV)-infected patients. The present study aimed to determine and compare the prognostic values of five lymphocyte-based scores (monocyte-to-lymphocyte ratio [MLR], mean platelet volume-to-lymphocyte ratio [MPVLR], neutrophil-to-lymphocyte ratio [NLR], red cell distribution width-to-lymphocyte ratio [RLR], and C-reactive protein-to-lymphocyte ratio [CLR]) for HBV-associated decompensated cirrhosis (HBV-DC).
Data were extracted from an institutional database. The outcome was 30-day mortality. Receiver operating characteristic curve analyses were conducted, and the resulting area under the curve (AUC) values were used to evaluate the predictive capabilities of the five lymphocyte-based scores for mortality in HBC-DC relative to Model for End-Stage Liver Disease (MELD) score.
The study included 273 patients, and the 30-day mortality was 20.9%. Lymphocyte counts were slightly lower in non-survivors than in survivors. The prognostic values of CLR, NLR, MLR, MPVLR, and RLR for mortality in HBV-DC were different. The predictive powers of NLR and MLR were superior to those of the other three scores and similar to that of MELD score. Multivariate analyses identified NLR, MLR, and MELD score as independent prognostic predictors.
High NLR and MLR are easily accessible and reliable indicators for predicting 30-day mortality in HBV-DC and have superior prognostic ability compared with other lymphocyte-based scores.
淋巴细胞通常被认为是免疫反应的关键组成部分，免疫反应不足与乙型肝炎病毒（HBV）感染患者的疾病严重程度和不良结局密切相关。本研究旨在确定并比较五种基于淋巴细胞的评分（单核细胞与淋巴细胞比值[MLR]、平均血小板体积与淋巴细胞比值[MPVLR]、中性粒细胞与淋巴细胞比值[NLR]、红细胞分布宽度与淋巴细胞比值[RLR]以及C反应蛋白与淋巴细胞比值[CLR]）对HBV相关失代偿性肝硬化（HBV-DC）的预后价值。
从机构数据库中提取数据。结局指标为30天死亡率。进行了受试者工作特征曲线分析，所得曲线下面积（AUC）值用于评估这五种基于淋巴细胞的评分相对于终末期肝病模型（MELD）评分对HBC-DC患者死亡率的预测能力。
该研究纳入了273例患者，30天死亡率为20.9%。非幸存者的淋巴细胞计数略低于幸存者。CLR、NLR、MLR、MPVLR和RLR对HBV-DC患者死亡率的预后价值各不相同。NLR和MLR的预测能力优于其他三个评分，且与MELD评分相似。多因素分析确定NLR、MLR和MELD评分是独立的预后预测因素。
高NLR和MLR是预测HBV-DC患者30天死亡率的易于获取且可靠的指标，与其他基于淋巴细胞的评分相比，具有更好的预后能力。
