Evaluation of hematological parameters as non-invasive markers in predicting the severity of the disease in ulcerative colitis

Abstract

Background: Many clinical activity indexes and non-invasive markers have been investigated for the evaluation of disease activity and regulation of treatment in ulcerative colitis (UC), but none have been as accurate as histopathological and endoscopic examinations in detecting inflammatory activity. We aimed to examine the relationship between the simple and easily achievable neutrophil/lymphocytes-platelet (N/LP) ratio in clinical disease activity in UC and the endoscopic severity of the disease.
Material and Method: According to the results of the Baron score and Clinical Colitis Activity Index (CCAI), 32 patients with active, 37 patients with remission total of 69 UK patients and 36 healthy participants were included in the study. Absolute neutrophil count, neutrophil/lymphocyte ratio (NLR), N/LP, mean platelet volume (MPV), C-reactive protein and erythrocyte sedimentation rate were measured and recorded.
Results: A significant increase in NLR was observed in the active UC group and the inactive UC group compared to the controls (2.98±1.69, 2.56±1.2, 1.59±0.43 respectively, p<0.0001). However, although there was a difference between the active UC group and the remission group, it was not statistically significant (p =0.284). A significant increase in N/LP was observed in the active UC group and the inactive UC group compared to the controls (0.96±0.4, 0.9±0.4, 0.7±0.2; p<0.0001, respectively). However, although there was a difference between the active UC group and the remission group, it was not statistically significant (p=0.588). Sedim and CRP were found to be significant independent markers to differentiate disease activity (p<0.05 and p<0.05, respectively).
Discussion: NLRs and N/LPs showed a significant difference in ulcerative colitis patients compared to the control group. However, these parameters were assessed that ulcerative colitis patients cannot be used as a biomarker to detect the activation-remission difference.

Keywords

• Ulcerative colitis,
• disease activity
• neutrophil to lymphocyte and platelet ratio
• neutrophil–lymphocyte ratio

Ülseratif kolitte hastalığın şiddetini öngörmede non-invaziv belirteçler olarak hematolojik parametrelerin değerlendirilmesi

Abstract

Amaç: Ülseratif kolitte (ÜK) hastalık aktivitesinin değerlendirilmesi ve tedavinin şekillendirilmesi için birçok klinik aktivite indeksi ve non invaziv belirteç araştırılmış fakat hiçbiri inflamatuvar aktivitenin saptanmasında histopatolojik ve endoskopik incelemeler kadar kesin bulgu vermemiştir. Basit ve kolayca elde edilebilen nötrofillerin lenfosit ve plateletlere (N/LP) oranının ÜK’deki klinik hastalık aktivitesi ve hastalığın endoskopik şiddeti arasındaki ilişkiyi incelemeyi amaçladık.
Gereç ve Yöntem: Baron skoru ve Klinik Kolit Aktivite İndeksi (CCAİ) bulgularına göre 32 si aktif, 37 si remisyonda toplam 69 ÜK hastası ve 36 sağlıklı katılımcı çalışmaya dahil edildi. Mutlak nötrofil sayısı, NLR, N/LP, MPV, C-reaktif protein ve Eritrosit sedimantasyon hızı ölçüldü ve kaydedildi.
Sonuçlar: Aktif ÜK grubunda ve aktif olmayan ÜK grubunda kontrol grubuna kıyasla önemli derecede nötrofil/lenfosit oranında (NLR) yükselme gözlendi (sırasıyla 2,98±1,69, 2,56±1,2, 1,59±0,43; p<0,0001). Fakat aktif ÜK grubu ile remisyon grubu arasında fark olmasına rağmen istatistiksel olarak anlamlı değildi (p<0,284). Aktif ÜK grubunda ve aktif olmayan ÜK grubunda kontrol grubuna kıyasla önemli derecede N/LP yükselmesi gözlendi (sırasıyla 0,96±0,4, 0,9±0,4, 0,7±0,2; p<00001). Fakat aktif ÜK grubu ile remisyon grubu arasında fark olmasına rağmen istatistiksel olarak anlımlı değildi (p=0,588). Sedim ve CRP’nin hastalık aktivitesini ayırt etmek için anlamlı bağımsız belirteçler olduğu bulundu (sırasıyla p<0,05, p<0,05).
Tartışma: NLR’ler ve N/LP’ler, kontrol grubuna kıyasla ülseratif kolit hastalarında anlamlı farklılık göstermiştir. Fakat bu parametreler ülseratif kolit hastalarının aktivasyon-remisyon farkını saptamada bir biyobelirteçleri olarak kullanılamayacağı değerlendirilmiştir.

Keywords

• ülseratif kolit
• hastalık aktivitesi
• nötrofillerin lenfosit ve plateletlere oranı
• nötrofil-lenfosit oranı

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