Agustos 2023
Ülseratif kolit aktivitesi ve siddetinin invaziv olmayan biyobelirteçler ile degerlendirilmesi
Evaluation of ulcerative colitis activity and severity with non-invasive biomarkers
- Ana Sayfa
- Sayılar
- Agustos 2023
- Ülseratif kolit aktivitesi ve siddetinin invaziv olmayan biyobelirteçler ile degerlendirilmesi...
Amasya Üniversitesi Sabuncuoglu Serefeddin Egitim ve Arastirma Hastanesi 2Iç Hastaliklari Bölümü, Amasya
Özet
Giris ve Amaç: Bu çalismamizda, ülseratif kolit hastalik aktivitesinin belirlenmesinde nötrofil/lenfosit orani, platelet/lenfosit orani, monosit/lenfosit orani ve C-reaktif protein/albümin oraninin rolünü degerlendirdik. Gereç ve Yöntem: Ülseratif kolit tanisi ile takip ettigimiz 18 yas üstü hastalar retrospektif olarak tarandi. Yas, cinsiyet, komorbid hastaliklar açisindan farkliligi ortadan kaldirmak için ayni hastalarin endoskopik remisyon ve aktivasyon dönemlerindeki laboratuvar ve tedavi verileri karsilastirildi. Bulgular: Çalisma kriterlerine uygun olan 87 hasta çalismaya alindi. Hastalarin %69’u erkek, %31’i kadindi. En sik sol tip (%48.3) tutulum saptandi ve aktif dönemde median endoskopik aktivite indeksi 8’di (6-12). Endoskopik olarak aktif hastalik döneminde istatistiksel açidan lökosit, nötrofil, monosit, trombosit, sedimentasyon, C-reaktif protein düzeyi anlamli olarak yüksekken, hemoglobin ve albümin düzeyleri anlamli olarak düsüktü (p < 0.05). Median platelet/lenfosit orani [152.4 (70.1 - 422.7) ve 137.5 (36 - 1212), p = 0.009)], monosit/lenfosit orani [(0.06 (0.01 - 1.54) ve 0.04 (0.01 – 0.9), p = 0.03], nötrofil/lenfosit orani [2.47 (0.73 - 9.92) ve 2.08 (0.55 - 6.54), p = 0.007] ve C-reaktif protein/albümin oraninin [2.3 (0.1-80) ve 0.51 (0.04 - 8.48), p < 0.001] degerleri aktif hastalik döneminde hastaligin inaktif oldugu döneme göre anlamli olarak daha yüksek saptandi. Yapilan ROC analizde nötrofil/lenfosit orani ve C-reaktif protein/albümin oraninin endoskopik aktif hastaligi tahmin etmede yararli oldugu, platelet/lenfosit orani ve monosit/lenfosit oraninin ise aktif hastaligi göstermede faydali olmadigi tespit edildi. Nötrofil/lenfosit orani için esik deger 2.35 alindiginda aktif hastalik için sensitivite %59.8, spesifite %66.7, egri altinda kalan alan 0.619 saptandi (p = 0.007). C-reaktif protein/albümin orani için esik deger 0.87 alindiginda aktif hastalik için sensitivite %74.7, spesifite %72.4, egri altinda kalan alan 0.806 saptandi (p < 0.001). Sonuç: Ülseratif kolit hastalarinda nötrofil/lenfosit orani, platelet/lenfosit orani, monosit/lenfosit orani, C-reaktif protein/albümin orani degerleri aktif hastalikta anlamli olarak yükselmekle birlikte, endoskopik aktif hastaligin tahmininde sadece nötrofil/lenfosit orani ve C-reaktif protein/albümin orani yeterli sensitivite ve spesifiteye sahiptir.
Abstract
Background and Aims: In this study, we evaluated the role of neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, monocyte/lymphocyte ratio and C-reactive protein/albumin ratio in determining ulcerative colitis endoscopic activity. Materials and Methods: Patients over the age of 18 who were followed up with the diagnosis of ulcerative colitis were retrospectively screened. In order to eliminate the difference in terms of age, gender, and comorbid diseases, the datas of the patients in the endoscopic remission periods compared with their own datas in the activation periods. Results: Eighty-seven patients who met the study criteria were included in the study, of which 69% were male and 31% were female. The most common localization was left-side (48.3%) and the median endoscopic activity index was 8 (6 - 12) in the active period. During the endoscopically active disease period, leukocyte, neutrophil, monocytes, thrombocyte, sedimentation, and C-reactive protein levels were significantly higher, while hemoglobin and albumin levels were significantly lower (p < 0.05). Median platelet/lymphocyte ratio [152.4 (70.1 - 422.7) and 137.5 (36 - 1212), p = 0.009)], monocyte/ lymphocyte ratio [(0.06 (0.01 - 1.54) and 0.04 (0.01 - 0.9), p = 0.03], neutrophil/lymphocyte ratio [2.47 (0.73 - 9.92) and 2.08 (0.55 - 6.54), p = 0.007] and C-reactive protein/albumin ratio [2.3 (0.1 - 80) and 0.51 (0.04 - 8.48), p < 0.001] values were higher in the endoscopically active period compared to the inactive period. In the ROC analysis, only neutrophil/lymphocyte ratio and C-reactive protein/albumin ratio were sensitive and specific enough to predict endoscopic active disease. When the cutoff value of neutrophil/lymphocyte ratio was taken as 2.35, sensitivity for active disease was 59.8%, specificity was 66.7%, and area under the curve was 0.619 (p = 0.007). And, when the cutoff value of C-reactive protein/albumin ratio was taken as 0.87, the sensitivity for active disease was 74.7%, the specificity was 72.4%, and the area under the curve was 0.806 (p < 0.001). Conclusions: Although neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, monocyte/lymphocyte ratio, and C-reactive protein/albumin ratio values increase significantly in active disease in ulcerative colitis, only neutrophil/lymphocyte ratio and C-reactive protein/albumin ratio are useful in the estimation of endoscopic active disease and have sufficient sensitivity and specificity.
