Hassan Aljaf Karwan Anwar, Hama Salih Ahmed, Mohammed Mohammed Omer, Rahim Hawbash M
Biology Department, College of Science, University of Sulaimani, Sulaimaniyah, Iraq.
Department of Biology, College of Education, Garmian University, Kalar District, Sulaimaniyah, Iraq.
Ann Med Surg (Lond). 2025 Feb 7;87(5):2608-2614. doi: 10.1097/MS9.0000000000003017. eCollection 2025 May.
Investigating non-invasive laboratory biomarkers for detecting and classifying Crohn's disease (CD) activity remains challenging. Here, we aimed to evaluate the diagnostic efficacy of immunological biomarkers in identifying disease activity in newly diagnosed CD patients.
This cross-sectional study was performed from October 2022 to July 2023 and included 20 healthy participants and 46 confirmed newly diagnosed CD patients in a Teaching Hospital for Gastroenterology and Hepatology, Sulaimani, Iraq. The patients were categorized according to the disease activity assessed according to the Harvey-Bradshaw Index and divided into remission and active CD.
A statistically higher serum C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) levels were found among the remission CD group ( = 0.005 and = 0.0002, respectively) and active CD group ( < 0.0001 and < 0.0001, respectively) compared to the healthy controls. Moreover, the mean CRP and ESR levels among active CD were also considerably higher than those of remission CD ( = 0.018 and = 0.005, respectively). The lymphocyte-to-monocyte ratio (LMR) was significantly lower in patients with active disease (3.01 ± 1.36) than in remission patients (6.77 ± 2.17) (cutoff < 4.42, area under receiver-operating characteristic curve (ROC) = 0.807, 95% CI, 77.35-98.73%, 93% sensitivity, and 78% specificity). Although the neutrophil-to-lymphocyte ratio (NLR) was significantly elevated in active patients (3.64 ± 2.004) compared to healthy controls (1.91 ± 0.48; ), it is not usable for disease activity or severity as the area under the ROC curve was 0.68 (95% CI, 52.22-85.08%, sensitivity = 79%, specificity = 62%).
The LMR can be an affordable, easily accessible test that shows promise for determining disease activity in newly diagnosed CD patients.
研究用于检测和分类克罗恩病（CD）活动的非侵入性实验室生物标志物仍然具有挑战性。在此，我们旨在评估免疫生物标志物在识别新诊断的CD患者疾病活动中的诊断效力。
这项横断面研究于2022年10月至2023年7月进行，纳入了伊拉克苏莱曼尼亚胃肠病和肝病教学医院的20名健康参与者和46名确诊的新诊断CD患者。根据根据哈维-布拉德肖指数评估的疾病活动将患者分类，分为缓解期和活动期CD。
与健康对照组相比，缓解期CD组（分别为P = 0.005和P = 0.0002）和活动期CD组（分别为P < 0.0001和P < 0.0001）的血清C反应蛋白（CRP）和红细胞沉降率（ESR）水平在统计学上更高。此外，活动期CD患者的平均CRP和ESR水平也显著高于缓解期CD患者（分别为P = 0.018和P = 0.005）。活动期疾病患者的淋巴细胞与单核细胞比值（LMR）（3.01 ± 1.36）显著低于缓解期患者（6.77 ± 2.17）（临界值 < 4.42，受试者操作特征曲线（ROC）下面积 = 0.807，95% CI，77.35 - 98.73%，敏感性93%，特异性78%）。虽然活动期患者的中性粒细胞与淋巴细胞比值（NLR）（3.64 ± 2.004）与健康对照组（1.91 ± 0.48；P < 0.0001）相比显著升高，但由于ROC曲线下面积为0.68（95% CI，52.22 - 85.08%，敏感性 = 79%，特异性 = 62%），它不能用于疾病活动或严重程度的评估。
LMR可以是一种经济实惠、易于获取的检测方法，在确定新诊断的CD患者疾病活动方面显示出前景。
