Yan Jing, Wu Jun, Wang Rongkun, Meng Pin, Liu Ailing, Xu Yonghong
Department of Gastroenterology, Peking University People's Hospital Qingdao Hospital, Qingdao Women's and Children's Hospital, Qingdao, Shandong, China.
Department of Gastroenterology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China.
Front Med (Lausanne). 2025 Mar 13;12:1524307. doi: 10.3389/fmed.2025.1524307. eCollection 2025.
Vedolizumab (VDZ), a novel biologic targeting α4β7 integrin, is safe and effective for the treatment of patients with ulcerative colitis (UC). The objective of this study was to compare the potential of the Platelet-to-lymphocyte ratio (PLR), neutrophil-to-lymphocyte ratio (NLR), and systemic immune-inflammation index (SII) in predicting clinical remission and treatment failure in patients with moderate-to-severe UC on VDZ therapy and to explore the risk factors for treatment failure.
Seventy-four UC patients treated with VDZ at our institution between December 1, 2020, and October 1, 2023, who had medical records were included in this study. We retrospectively collected baseline NLR, PLR, and SII values and assessed the predictive ability of the three indices for clinical remission and treatment failure using the receiver operating characteristic (ROC) curves.
Patients in the severe group ( = 47) had significantly higher baseline PLR and SII values than those in the moderate group ( = 27) ( < 0.05). Patients with MES3 had significantly higher PLR and SII values than patients with MES2 ( < 0.05). At 14 weeks after VDZ treatment, 28 patients obtained steroid-free clinical remission, whereas 46 did not. The area under the ROC curve (AUC) for SII was 0.659 for predicting clinical remission and exhibited the best predictive ability. Of the 52 patients who achieved long-term remission, 35 patients responded consistently to VDZ, whereas 17 patients experienced disease relapse. The SII, with an AUC of 0.793, showed the best predictive ability (sensitivity: 94.1%; specificity: 57.1%; cut-off value: 602.0). Cox regression analysis revealed that SII ≥602.0, was a potential predictor of relapse after VDZ treatment in UC patients ( = 0.048, hazard ratio: 8.651; 95% confidence interval: 1.017-73.593).
The SII performed better than NLR and PLR in predicting clinical remission and relapse for UC patients on VDZ therapy. Moreover, patients with high SII may relapse after VDZ treatment and should be treated with caution.
维多珠单抗（VDZ）是一种新型的靶向α4β7整合素的生物制剂，对溃疡性结肠炎（UC）患者的治疗安全有效。本研究的目的是比较血小板与淋巴细胞比值（PLR）、中性粒细胞与淋巴细胞比值（NLR）和全身免疫炎症指数（SII）在预测中度至重度UC患者接受VDZ治疗后的临床缓解和治疗失败方面的潜力，并探讨治疗失败的危险因素。
本研究纳入了2020年12月1日至2023年10月1日期间在我院接受VDZ治疗且有病历记录的74例UC患者。我们回顾性收集了基线NLR、PLR和SII值，并使用受试者工作特征（ROC）曲线评估这三个指标对临床缓解和治疗失败的预测能力。
重度组（n = 47）患者的基线PLR和SII值显著高于中度组（n = 27）（P < 0.05）。MES3患者的PLR和SII值显著高于MES2患者（P < 0.05）。VDZ治疗14周后，28例患者实现了无类固醇临床缓解，而46例患者未实现。SII预测临床缓解的ROC曲线下面积（AUC）为0.659，表现出最佳预测能力。在52例实现长期缓解的患者中，35例患者对VDZ持续有反应，而17例患者疾病复发。AUC为0.793的SII表现出最佳预测能力（敏感性：94.1%；特异性：57.1%；临界值：602.0）。Cox回归分析显示，SII≥602.0是UC患者VDZ治疗后复发的潜在预测因素（P = 0.048，危险比：8.651；95%置信区间：1.017 - 73.593）。
在预测接受VDZ治疗的UC患者的临床缓解和复发方面，SII比NLR和PLR表现更好。此外，SII高的患者在VDZ治疗后可能复发，应谨慎治疗。
