Gulturk Emine, Kapucu Korhan
Department of Hematology, Bakirkoy Sadi Konuk Training and Research Hospital, 34147 Istanbul, Turkey.
J Pers Med. 2024 Apr 29;14(5):471. doi: 10.3390/jpm14050471.
To investigate inflammation indices and erythropoietin levels for their potential role in distinguishing polycythemia vera from secondary polycythemia and to compare different parameter combinations in terms of the diagnostic accuracy.
This retrospective cohort was created from patients assessed for polycythemia from January 2020 to December 2023. Polycythemia vera diagnosis was made according to the 2016 World Health Organization criteria ( = 145). Those who did not fulfill the criteria were defined as having secondary polycythemia ( = 84).
The neutrophil lymphocyte ratio, platelet lymphocyte ratio and systemic immune-inflammation index were significantly higher in the polycythemia vera group ( < 0.001 for all). Erythropoietin had the highest area under the curve in the analysis to distinguish groups, followed by the systemic immune-inflammation index. The platelet lymphocyte ratio (≥135) had the highest specificity to detect polycythemia vera, followed closely by the systemic immune-inflammation index. The sensitivity for polycythemia vera detection was highest with the erythropoietin and systemic immune-inflammation index combination, followed by erythropoietin and the neutrophil lymphocyte ratio. All the single and combinatory variables exhibited significant performance in predicting polycythemia vera after adjusting for age and sex. However, the erythropoietin and systemic immune-inflammation index combination had the highest odds ratio, followed by erythropoietin alone.
These are promising findings supporting the usability of these biomarkers, especially the systemic immune-inflammation index, as minor criteria in the diagnosis of polycythemia vera. It is especially crucial to note that using erythropoietin in combination with these markers may improve diagnostic accuracy.
研究炎症指标和促红细胞生成素水平在区分真性红细胞增多症与继发性红细胞增多症方面的潜在作用，并比较不同参数组合的诊断准确性。
本回顾性队列研究选取了2020年1月至2023年12月期间接受红细胞增多症评估的患者。真性红细胞增多症的诊断依据2016年世界卫生组织标准（n = 145）。未符合该标准的患者被定义为继发性红细胞增多症（n = 84）。
真性红细胞增多症组的中性粒细胞淋巴细胞比值、血小板淋巴细胞比值和全身免疫炎症指数显著更高（均P < 0.001）。在区分组别的分析中，促红细胞生成素的曲线下面积最高，其次是全身免疫炎症指数。血小板淋巴细胞比值（≥135）检测真性红细胞增多症的特异性最高，其次是全身免疫炎症指数。促红细胞生成素和全身免疫炎症指数组合检测真性红细胞增多症的敏感性最高，其次是促红细胞生成素和中性粒细胞淋巴细胞比值。在调整年龄和性别后，所有单一和组合变量在预测真性红细胞增多症方面均表现出显著性能。然而，促红细胞生成素和全身免疫炎症指数组合的比值比最高，其次是单独的促红细胞生成素。
这些有前景的发现支持了这些生物标志物，尤其是全身免疫炎症指数，作为真性红细胞增多症诊断次要标准的可用性。特别需要注意的是，将促红细胞生成素与这些标志物联合使用可能会提高诊断准确性。
