Which is Best for Predicting Uveitis in Behc¸et’s Syndrome: Systemic Immune Inflammatory Index, Mean Platelet Volume, Platelet/Lymphocyte Ratio, or Neutrophil/Lymphocyte Ratio?
Which is Best for Predicting Uveitis in Behc¸et’s Syndrome: Systemic Immune Inflammatory Index, Mean Platelet Volume, Platelet/Lymphocyte Ratio, or Neutrophil/Lymphocyte Ratio?
Objective: Behc¸et’s Syndrome (BS) is a multisystemic disease characterized by oral and genital ulcers, which can cause vasculitis that can affect all size of the vessels. We aimed to investigate the power of predicting uveitis of neutrophil/lymphocyte ratio (NLR), platelet/ lymphocyte ratio (PLR), mean platelet volume (MPV) and a new parameter, the systemic inflammatory immune index (SII). Methods: Two hundred four patients with BS were enrolled at Kayseri City Education and Research Hospital, whose follow-up continued from July 2018-September 2020. Thirty-three patients were excluded because of history of cancer, colchicine use, arthritis at the time of diagnosis and complete blood count parameters being excessively higher or lower than the limit values. Of the remaining 171 patients, 35 uveitis patients’ NLR, PLR, MPV and SII at the time of uveitis were compared with the results of patients without uveitis. Results: The sensitivity of NLR in predicting uveitis was calculated as 74.3% and specificity was 64.7%. The sensitivity and specificity of SII, in predicting uveitis, were 62.9% and 65.4%, respectively. The area under the ROC curve for NLR was 0.684 and (P = 0.001). In addition, the area under the curve for SII was 0.662 (P = 0.003). Again for PLR and MPV, the area under the ROC curve was found as 0.566 and 0.428, respectively (P = 0.188 and 0.230, respectively). Conclusion: There is no specific test that can precisely predict BS and its complications. . These findings suggest that NLR is a better marker than SII, MPV and PLR in predicting anterior uveitis in patients with BS.
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- 1. Yazici H, Seyahi E, Hatemi G, Yazici Y. Behc¸et syndrome: A contemporary view. Nat Rev Rheumatol. 2018;14(2):107-119. [CrossRef]
- 2. Hatemi G, Seyahi E, Fresko I, Talarico R, Hamuryudan V. One year in review 2018: Behc¸et’s syndrome. Clin Exp Rheumatol. 2018;36 (6 Suppl. 115):13-27.
- 3. Ozguler Y, Hatemi G, Cetinkaya F, et al. Clinical course of acute deep vein thrombosis of the legs in Behc¸et’s syndrome. Rheumatology (Oxford). 2020;59(4):799-806. [CrossRef]
- 4. Seng JJB, Kwan YH, Low LL, Thumboo J, Fong WSW. Role of neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR) and mean platelet volume (MPV) in assessing disease control in Asian patients with axial spondyloarthritis. Biomarkers Biochem Indic Expo Response Suscep Chem. 2018;23(4):335-338. [CrossRef]
- 5. Mannaerts D, Heyvaert S, De Cordt C, Macken C, Loos C, Jacquemyn Y. Are neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), and/or mean platelet volume (MPV) clinically useful as predictive parameters for preeclampsia? J Matern Neonatal Med. 2019;32(9):1412-1419. [CrossRef]
- 6. Temur I, Kucukgoz Gulec U, Paydas S, Guzel AB, Sucu M, Vardar MA. Prognostic value of pre-operative neutrophil/lymphocyte ratio, monocyte count, mean platelet volume, and platelet/ lymphocyte ratio in endometrial cancer. Eur J Obstet Gynecol Reprod Biol. 2018;226:25-29. [CrossRef]
- 7. Shi H, Jiang Y, Cao H, Zhu H, Chen B, Ji W. Nomogram based on systemic immune-inflammation index to predict overall survival in gastric cancer patients. Dis Markers. 2018;2018:1-11. [CrossRef]
- 8. Huang J, Zhang Q, Wang R, et al. Systemic immune-inflammatory index predicts clinical outcomes for elderly patients with acute myocardial infarction receiving percutaneous coronary intervention. Med Sci Monit. 2019;25:9690-9701. [CrossRef]
- 9. Fang H, Zhang H, Wang Z, Zhou Z, Li Y, Lu L. Systemic immuneinflammation index acts as a novel diagnostic biomarker for postmenopausal osteoporosis and could predict the risk of osteoporotic fracture. J Clin Lab Anal. 2020;34(1):e23016. [Cross- Ref]
- 10. Arevalo JF, Lasave AF, Al Jindan MY, et al. Uveitis in Behc¸et disease in a tertiary center over 25 years: The KKESH uveitis survey study group. Am J Ophthalmol. 2015;159(1):172-177.
- 11. Tugal-Tutkun I, Onal S, Altan-Yaycioglu R, Huseyin Altunbas H, Urgancioglu M. Uveitis in Behc¸et disease: An analysis of 880 patients. Am J Ophthalmol. 2004;138(3):373-380. [CrossRef]
- 12. Miyamoto R, Inagawa S, Sano N, Tadano S, Adachi S, Yamamoto M. The neutrophil-to-lymphocyte ratio (NLR) predicts short-term and long-term outcomes in gastric cancer patients. Eur J Surg Oncol. 2018;44(5):607-612. [CrossRef]
- 13. Asaoka T, Miyamoto A, Maeda S, et al. Prognostic impact of preoperative NLR and CA19-9 in pancreatic cancer. Pancreatology. 2016;16(3):434-440. [CrossRef]
- 14. Diem S, Schmid S, Krapf M, et al. Neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) as prognostic markers in patients with non-small cell lung cancer (NSCLC) treated with nivolumab. Lung Cancer. 2017;111:176-181. [CrossRef]
- 15. Soylu K, Gedikli O¨ , Dagasan G, et al. Neutrophil-to-lymphocyte ratio predicts coronary artery lesion complexity and mortality after non-ST-segment elevation acute coronary syndrome. Rev Port Cardiol. 2015;34(7–8):465-471. [CrossRef]
- 16. Atas H, Canpolat F, Eskioglu F. Evaluation of mean platelet volume in patients with Behcet’s disease as an indicator of vascular thrombosis. Arch Iran Med. 2018;21(6):234-239.
- 17. Balkarli A, Kucuk A, Babur H, Erbasan F. Neutrophil/lymphocyte ratio and mean platelet volume in Behc¸et’s disease. Eur Rev Med Pharmacol Sci. 2016;20(14):3045-3050.
- 18. Kobayashi M, Ito M, Nakagawa A, et al. Neutrophil and endothelial cell activation in the vasa vasorum in vasculo-Behc¸et disease. Histopathology. 2000;36(4):362-371. [CrossRef]
- 19. Emmi G, Becatti M, Bettiol A, Hatemi G, Prisco D, Fiorillo C. Behc¸et’s syndrome as a model of thrombo-inflammation: The role of neutrophils. Front Immunol. 2019;10:1085. [CrossRef]
- 20. Perazzio SF, Soeiro-Pereira PV, Dos Santos VC, et al. Soluble CD40L is associated with increased oxidative burst and neutrophil extracellular trap release in Behc¸et’s disease. Arthritis Res Ther. 2017;19(1):235. [CrossRef]
- 21. Morales JF, Chuguransky S, Alberca LN, et al. Positive predictive value surfaces as a complementary tool to assess the performance of virtual screening methods. Mini Rev Med Chem. 2020;20(14):1447-1460. [CrossRef]
- 22. Lolli C, Caffo O, Scarpi E, et al. Systemic immune-inflammation index predicts the clinical outcome in patients with mCRPC treated with abiraterone. Front Pharmacol. 2016;7:376.
- 23. Ulu S , Kınar A, Bucak A, et al. Systemic immune inflammatory index of patients with idiopathic sudden sensorineural hearing loss: Comparison of NLR and PRL values. Ear Nose Throat J. 2020;145561320924312.