Ülseratif kolitte hastalığın şiddetini öngörmede non-invaziv belirteçler olarak hematolojik parametrelerin değerlendirilmesi
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.
Anahtar Kelimeler:
ülseratif kolit, hastalık aktivitesi, nötrofillerin lenfosit ve plateletlere oranı, nötrofil-lenfosit oranı
Evaluation of hematological parameters as non-invasive markers in predicting the severity of the disease in ulcerative colitis
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,
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- Younis N, Zarif R, Mahfouz R. Inflammatory bowel disease: between genetics and microbiota. Mol Biol Rep 2020; 47: 3053-63.
- Beyazit Y, Sayilir A, Tanoglu A, et al. Plasma thrombin-activatable fibrinolysis inhibitor levels correlate with the disease activity of ulcerative colitis. Intern Med 2016; 55: 1831-6.
- Walsh A, Kormilitzin A, Hinds C, et al. Defining faecal calprotectin thresholds as a surrogate for endoscopic and histological disease activity in ulcerative colitis-a prospective analysis. J Crohns Colitis 2019; 13: 424-30.
- Sandborn WJ, Loftus EV Jr, Colombel JF, et al. Evaluation of serological disease markers in a population-based cohort with ulcerative colitis and Crohn’s disease. Inflamm Bowel Dis 2001; 7: 192-201.
- Lewis JD. The use of biomarkers in the diagnosis and treatment of inflammatory bowel disease. Gastroenterology. 2011; 140: 1817-26.
- Schoepfer AM, Beglinger C, Straumann A, et al. Fecal calprotectin more accurately reflects endoscopic activity of ulcerative colitis than the lichtiger index, c-reactive protein, platelets, hemoglobin, and blood leukocytes. Inflamm Bowel Dis 2013; 19: 332-41.
- Xue TC, Zhang L, Xie XY, et al. Prognostic significance of the neutrophil-to-lymphocyte ratio in primary liver cancer: a meta-analysis. PLoS One 2014; 9: e96072.
- Torun S, Tunc BD, Suvak B, et al. Assessment of neutrophil-lymphocyte ratio in ulcerative colitis: a promising marker in predicting disease severity. Clin Res Hepatol Gastroenterol 2012; 36: 491-7.
- Koo CH, Eun Jung D, Park YS, et al. Neutrophil, lymphocyte, and platelet counts and acute kidney injury after cardiovascular surgery. J Cardiothorac Vasc Anesth 2018; 32: 212-22.
- Gameiro J, Fonseca JA, Jorge S, Gouveia J, Lopes JA. Neutrophil, lymphocyte and platelet ratio as a predictor of mortality in septic-acute kidney injury patients. Nefrologia 2020: 40: 461-8. Online ahead of print.
- Ryzko J, Woynarowski M. evaluation of nonspecific inflammatory bowel disease in children using disease activity scoring systems. Pediatr Pol 1995; 70: 569-73.
- Mohammed Vashist N, Samaan M, Mosli MH, et al. Endoscopic scoring indices for evaluation of disease activity in ulcerative colitis. Cochrane Database Syst Rev 2018; 1: CD011450.
- Henderson AR. Assessing test accuracy and clinical results: a primer for receiver study characteristic curve analysis. Ann Clin Biochem 1993; 30: 521-39.
- Makkar R, Bo S. Colonoscopic perforation in inflammatory bowel disease. Gastroenterol Hepatol 2013; 9: 573-83.
- Karagoz E, Tanoglu A. Clinical importance of serum procalcitonin in ulcerative colitis patients World J Gastroenterol 2014; 20: 15941-2.
- Akpınar M, Ozin Y, Kaplan M, et al. Platelet-to-lymphocyte ratio and neutrophil-to-lymphocyte ratio predict mucosal disease severity in ulcerative colitis. J Med Biochem 2018; 37: 155-62.
- Gewirtz AT, Liu Y, Sitaraman SV, Madara JL. Intestinal epithelial pathobiology: past, present and future. Best Pract Res Clin Gastroenterol 2002; 16: 851-67.
- Qin X. Etiology of inflammatory bowel disease: A combined hypothesis. World J Gastroenterol 2012; 18: 1708-22.
- Vermeire S, Van Assche G, Rutgeerts P. Laboratory markers in IBD: useful, magic or unnecessary toys? Gut 2006; 55: 426-31.
- Demir AK, Demirtaş A, Kaya SU, et al. The relationship between the neutrophil-lymphocyte ratio and disease activity in patients with ulcerative colitis. Kaohsiung J Med Sci 2015; 31: 585-90.
- Başlangıç: 2020
- Yayıncı: MediHealth Academy Yayıncılık
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