Neutrophil-to-lymphocyte ratio is a novel predictor of venous thrombosis in polycythemia vera.
Neutrophil-to-lymphocyte ratio is a novel predictor of venous thrombosis in polycythemia vera.
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中性粒细胞与淋巴细胞比率是真性红细胞增多症静脉血栓形成的新预测因子。
DOI：
10.1038/s41408-022-00625-5
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发表时间：
2022-02-10
影响因子：
12.8
通讯作者：
Barbui T
中科院分区：
文献类型：
--
作者：
Carobbio A;Vannucchi AM;De Stefano V;Masciulli A;Guglielmelli P;Loscocco GG;Ramundo F;Rossi E;Kanthi Y;Tefferi A;Barbui T
我们研究了中性粒细胞与淋巴细胞比率（NLR）作为真性红细胞增多症（PV）血栓形成的预测因子。经过中位随访 2.51 年，参加 ECLAP 研究的 1508 名真性红细胞增多症患者中，分别有 82 名和 84 名出现动脉血栓和静脉血栓。通过广义加性模型 (GAM) 测试总白细胞、中性粒细胞、淋巴细胞、血小板和 NLR 的绝对计数，以评估其血栓风险连续规模的趋势。仅针对静脉血栓形成，我们发现基线绝对中性粒细胞和淋巴细胞计数平均分别较高（中位数：6.8 × 109/L，p = 0.002）和较低（中位数：1.4 × 109/L，p = 0.001），导致NLR值增加（中位数：5.1， p = 0.002)。在多变量分析中，静脉血栓形成的风险与既往静脉事件（HR = 5.48，p ≤ 0.001）和NLR值≥5（HR = 2.13，p = 0.001）独立相关。此外，在存在 NLR 5 的情况下，低标准风险组和高标准风险组的相对风险几乎翻倍。这些发现在两个意大利独立外部队列（佛罗伦萨，n = 282 和罗马，n = 175）当代 PV 患者中得到了验证。我们的数据支持最近的实验工作，即静脉血栓形成由先天免疫细胞控制，并强调 NLR 是一种廉价且易于获得的静脉血栓形成的预后生物标志物。
We investigated the neutrophil-to-lymphocyte ratio (NLR) as a predictor of thrombosis in polycythemia vera (PV). After a median follow-up of 2.51 years, of 1508 PV patients enrolled in the ECLAP study, 82 and 84 developed arterial and venous thrombosis, respectively. Absolute counts of total leukocytes, neutrophils, lymphocytes, platelets, and the NLR were tested by generalized additive models (GAM) to evaluate their trend in continuous scale of thrombotic risk. Only for venous thrombosis, we showed that baseline absolute neutrophil and lymphocyte counts were on average respectively higher (median: 6.8 × 109/L, p = 0.002) and lower (median: 1.4 × 109/L, p = 0.001), leading to increased NLR values (median: 5.1, p = 0.002). In multivariate analysis, the risk of venous thrombosis was independently associated with previous venous events (HR = 5.48, p ≤ 0.001) and NLR values ≥5 (HR = 2.13, p = 0.001). Moreover, the relative risk in both low- and high-standard risk groups was almost doubled in the presence of NLR ≥ 5. These findings were validated in two Italian independent external cohorts (Florence, n = 282 and Rome, n = 175) of contemporary PV patients. Our data support recent experimental work that venous thrombosis is controlled by innate immune cells and highlight that NLR is an inexpensive and easily accessible prognostic biomarker of venous thrombosis.
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影响因子：
5.6
作者：
Di Battista V;Bochicchio MT;Giordano G;Napolitano M;Lucchesi A
通讯作者：
Lucchesi A
影响因子：
11.4
作者：
Tefferi A;Vannucchi AM;Barbui T
通讯作者：
Barbui T
影响因子：
20.3
作者：
Shahneh, Fatemeh;Grill, Alexandra;Becker, Christian
通讯作者：
Becker, Christian
影响因子：
158.5
作者：
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通讯作者：
Barbui, Tiziano
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作者：
Sankar, Kamya;Stein, Brady L;Rampal, Raajit K
通讯作者：
Rampal, Raajit K