Does neutrophil-to-lymphocyte ratio predict 1-year mortality in patients with primary biliary cholangitis? Results from a retrospective study with validation cohort.
Does neutrophil-to-lymphocyte ratio predict 1-year mortality in patients with primary biliary cholangitis? Results from a retrospective study with validation cohort.
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中性粒细胞与淋巴细胞比率能否预测原发性胆汁性胆管炎患者的 1 年死亡率？
DOI：
10.1136/bmjopen-2016-015304
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发表时间：
2017-07-12
期刊：
影响因子：
2.9
通讯作者：
Sun C
中科院分区：
文献类型：
--
作者：
Lin L;Piao M;Jiang X;Lv H;Zhao N;Yang F;Sun C
目的中性粒细胞/淋巴细胞比值（NLR）已被用于多种肝病的预后判断，但其在原发性胆管炎（PBC）中的作用尚不明确。我们的目的是研究NLR对PBC患者1年死亡率的预测价值。方法回顾性队列研究88例PBC患者，前瞻性队列研究63例随访1年的PBC患者。通过多元回归模型分析NLR和其他实验室测量值，以确定早期死亡率的独立因素。通过计算受试者工作特征曲线下面积（AUROC）确定NLR的截止阈值，并用于随后的Kaplan-Meier生存分析。结果单因素和多因素分析显示，马约危险评分（MRS）、血肌酐和NLR是影响死亡率的独立指标。NLR产生的AUROC（0.86）显著高于血小板/淋巴细胞比值（0.58，p=0.03），但与MRS（0.87，p=0.88）相当。斯皮尔曼相关分析显示NLR的升高与Child-Pugh分级的加重呈正相关（r=0.44，p<0.001）。NLR <2.18的患者在1年随访期内表现出较高的生存率（100%的敏感性和67.1%的特异性），NLR ≥2.18表示较高的死亡率（对数秩检验，p<0.001）。此外，这些结果由验证队列进行内部确认。结论NLR与PBC患者近期病死率密切相关。
Objectives Neutrophil-to-lymphocyte ratio (NLR) has been used to predict prognosis in various liver diseases, but its role in primary biliary cholangitis (PBC) is not clarified. We aimed to investigate the prognostic usefulness of NLR for 1-year mortality in PBC. Methods The study recruited a retrospective cohort with 88 patients with PBC and a prospective validation cohort with 63 participants who were followed-up for 1 year. NLR and other laboratory measurements were analysed by multivariate regression model for identifying independent factors for early mortality. The cut-off threshold of NLR was determined by calculating the area under the receiver operating characteristics curve (AUROC) and used in a subsequent Kaplan-Meier survival analysis. Results Univariate and multivariate analyses showed that Mayo Risk Score (MRS), serum creatinine and NLR were independent indicators for mortality. NLR yielded significantly higher AUROC (0.86) than those of platelet-to-lymphocyte ratio (0.58, p=0.03), but comparable with MRS (0.87, p=0.88). Spearman’s correlation analysis represented a positive correlation between escalating NLR and aggravating Child-Pugh grade (r=0.44, p<0.001). Patients with NLR <2.18 exhibited higher survival (with 100% sensitivity and 67.1% specificity) within 1 year follow-up duration, and NLR ≥2.18 was indicative of higher mortality (log-rank test, p<0.001). In addition, these results were internally confirmed by a validation cohort. Conclusion NLR is closely related to short-term mortality in patients with PBC.
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影响因子：
--
作者：
Grosse-Steffen T;Giese T;Giese N;Longerich T;Schirmacher P;Hänsch GM;Gaida MM
通讯作者：
Gaida MM
影响因子：
3.8
作者：
Oh BS;Jang JW;Kwon JH;You CR;Chung KW;Kay CS;Jung HS;Lee S
通讯作者：
Lee S
影响因子：
3.7
作者：
Xue TC;Zhang L;Xie XY;Ge NL;Li LX;Zhang BH;Ye SL;Ren ZG
通讯作者：
Ren ZG
DOI：
10.1002/lt.24702
发表时间：
2017-03
期刊：
Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society
影响因子：
--
作者：
Kalra A;Wedd JP;Bambha KM;Gralla J;Golden-Mason L;Collins C;Rosen HR;Biggins SW
通讯作者：
Biggins SW
影响因子：
20.3
作者：
Schwaller, Juerg;Schneider, Pascal;Huard, Bertrand
通讯作者：
Huard, Bertrand