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Liu Y, Xie S, Zhou J, Cai Y, Zhang P, Li J, Ming Y. Using blood routine indicators to establish a machine learning model for predicting liver fibrosis in patients with Schistosoma japonicum. Sci Rep 2024; 14:11485. [PMID: 38769391 PMCID: PMC11106071 DOI: 10.1038/s41598-024-62521-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 05/17/2024] [Indexed: 05/22/2024] Open
Abstract
This study intends to use the basic information and blood routine of schistosomiasis patients to establish a machine learning model for predicting liver fibrosis. We collected medical records of Schistosoma japonicum patients admitted to a hospital in China from June 2019 to June 2022. The method was to screen out the key variables and six different machine learning algorithms were used to establish prediction models. Finally, the optimal model was compared based on AUC, specificity, sensitivity and other indicators for further modeling. The interpretation of the model was shown by using the SHAP package. A total of 1049 patients' medical records were collected, and 10 key variables were screened for modeling using lasso method, including red cell distribution width-standard deviation (RDW-SD), Mean corpuscular hemoglobin concentration (MCHC), Mean corpuscular volume (MCV), hematocrit (HCT), Red blood cells, Eosinophils, Monocytes, Lymphocytes, Neutrophils, Age. Among the 6 different machine learning algorithms, LightGBM performed the best, and its AUCs in the training set and validation set were 1 and 0.818, respectively. This study established a machine learning model for predicting liver fibrosis in patients with Schistosoma japonicum. The model could help improve the early diagnosis and provide early intervention for schistosomiasis patients with liver fibrosis.
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Affiliation(s)
- Yang Liu
- Transplantation Center, The Third Xiangya Hospital, Central South University, No. 138 Tongzipo Road, Changsha, 410013, Hunan, China
- Engineering and Technology Research Center for Transplantation Medicine of National Health Comission, Changsha, Hunan, China
- Hunan Province Clinical Research Center for Infectious Diseases, Changsha, Hunan, China
| | - Shudong Xie
- Transplantation Center, The Third Xiangya Hospital, Central South University, No. 138 Tongzipo Road, Changsha, 410013, Hunan, China
- Engineering and Technology Research Center for Transplantation Medicine of National Health Comission, Changsha, Hunan, China
- Hunan Province Clinical Research Center for Infectious Diseases, Changsha, Hunan, China
| | - Jie Zhou
- Hunan Institute of Schistosomiasis Control, Yueyang, Hunan, China
| | - Yu Cai
- Hunan Institute of Schistosomiasis Control, Yueyang, Hunan, China
| | - Pengpeng Zhang
- Transplantation Center, The Third Xiangya Hospital, Central South University, No. 138 Tongzipo Road, Changsha, 410013, Hunan, China
- Engineering and Technology Research Center for Transplantation Medicine of National Health Comission, Changsha, Hunan, China
- Hunan Province Clinical Research Center for Infectious Diseases, Changsha, Hunan, China
| | - Junhui Li
- Transplantation Center, The Third Xiangya Hospital, Central South University, No. 138 Tongzipo Road, Changsha, 410013, Hunan, China
- Engineering and Technology Research Center for Transplantation Medicine of National Health Comission, Changsha, Hunan, China
- Hunan Province Clinical Research Center for Infectious Diseases, Changsha, Hunan, China
| | - Yingzi Ming
- Transplantation Center, The Third Xiangya Hospital, Central South University, No. 138 Tongzipo Road, Changsha, 410013, Hunan, China.
- Engineering and Technology Research Center for Transplantation Medicine of National Health Comission, Changsha, Hunan, China.
- Hunan Province Clinical Research Center for Infectious Diseases, Changsha, Hunan, China.
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Koroglu M, Ayvaz MA, Bakan SB, Sirin A, Akyuz U. Can quantitative surface antigen levels and systemic immune-inflammation index be predictive as a new indicator for the initiation of treatment in chronic hepatitis b? Eur J Gastroenterol Hepatol 2024; 36:489-497. [PMID: 38407853 DOI: 10.1097/meg.0000000000002737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/27/2024]
Abstract
OBJECTIVES The natural history of chronic HBV infection (CHB) is generally divided into four phases: HBeAg-positive chronic HBV infection (EPCI) and -hepatitis (EPCH), HBeAg-negative chronic HBV infection (ENCI) and -hepatitis (ENCH). This study aimed to investigate changes in serum quantitative surface antigen (qHBsAg), systemic immune-inflammation index (SII) and systemic inflammatory response index (SIRI) in a large number of CHB patients. METHOD Three hundred seventy-two CHB patients who underwent liver biopsy between January 2015 and February 2020 were evaluated. RESULTS The SII-values were strongly significant between EPCI-EPCH ( P = 0.002), however, there was significant difference between ENCI-ENCH ( P = 0.025). Considering the SIRI results, there was a significant difference between both EPCI-EPCH ( P = 0.009) and ENCI-ENCH ( P = 0.118). In HBeAg-positive patients HBV-DNA, qHBsAg, and SII were found to be predictive ( P = 0.029, P = 0.039, P = 0.027, respectively) while in HBeAg-negative patients, age, AST, HBV-DNA, qHBsAg, SII, and SIRI were found to be predictive ( P = 0.047, P = 0.084, P = <0.001, P = 0.001, P = 0.012, P = 0.002, respectively). In EPCH phase, whereby accuracy rate results of HBV-DNA, qHBsAg, and SII were 75.3%, 73.4%, and 60.4%, respectively, while in the ENCH phase the accuracy rates of age, AST, HBV-DNA, qHBsAg, SII, and SIRI values were 57.8%, 65.6%, 68.3%, 63.8%, 57.3% and 53.2%, respectively. CONCLUSION HBV-DNA, qHBsAg, and SII are predictive in EPCH patients. Age, AST, HBV-DNA, qHBsAg, SII and SIRI are all predictive in ENCH patients. In patients with CHB, we recommend using SII to distinguish between EPCI-EPCH and ENCI-ENCH. Based on its sensitivity and features, we believe that qHBsAg and SII are suitable measuring instruments in discrimination both of EPCI-EPCH and ENCI-ENCH.
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Affiliation(s)
- Mehmet Koroglu
- University of Health Sciences, Fatih Sultan Mehmet Training and Research Hospital, Department of Gastroenterology, Istanbul, Turkey
| | - Muhammed Ali Ayvaz
- Klinikum Fuessen, Department of Gastroenterology, Teaching hospital of the Ludwig-Maximilian University, Munich, Germany
| | - Suat Baran Bakan
- University of Health Sciences, Fatih Sultan Mehmet Training and Research Hospital, Department of Internal Medicine, Istanbul
| | - Abdullatif Sirin
- Duzce University Hospital, Department of Gastroenterology, Duzce
| | - Umit Akyuz
- University of Health Sciences, Fatih Sultan Mehmet Training and Research Hospital, Department of Gastroenterology, Istanbul, Turkey
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Ekmen MO, Uzman M. The Relationship between Mean Platelet Volume and Neutrophil-Lymphocyte Ratio and Liver Fibrosis in Patients with Chronic Hepatitis B. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1287. [PMID: 37512098 PMCID: PMC10384412 DOI: 10.3390/medicina59071287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 07/04/2023] [Accepted: 07/05/2023] [Indexed: 07/30/2023]
Abstract
Objective: The neutrophil-lymphocyte ratio (NLR) can be helpful both in demonstrating acute and chronic liver injury and predicting malignant potential. The mean platelet volume (MPV) is also a marker that can be used as a risk indicator in atherosclerosis-associated diseases, reflecting inflammation. Within the scope of this research, we aimed to elucidate the relationship between the mean platelet volume and neutrophil-lymphocyte ratio in liver fibrosis in chronic hepatitis B patients. Materials and Methods: A total of 84 patients who were followed up with the diagnosis of chronic hepatitis B and who underwent liver biopsy were included in this prospective study. Complete blood count parameters (neutrophil, lymphocyte, neutrophil-lymphocyte ratio, hemoglobin, thrombocyte, MCV, and MPV values), demographic data, biochemistry panel (AST, ALT), HBV DNA, and liver biopsy fibrosis scores obtained from hospital database were analyzed. Since the follow-up period of chronic hepatitis B patients is six months, patients were screened in order to include a full 3-year screening pool. Results: A total of 84 patients were enrolled within the scope of this study. The chronicity index was '0' in 7.1% (n = 6), '1' in 23.8% (n = 20), '2' in 56% (n = 47), and '3' in 13.1% (n = 11)of the patients. According to the chronicity index groups, there was a statistically significant difference between the medians of the hepatitis activity index (HAI) values at the 5% significance level (p < 0.001). The correlation analysis revealed a statistically significant relationship between the chronicity index and the mean platelet volume to lymphocyte ratio (MPVL). However, considering the degree of the relationship, it can be said that it was a positive and weak relationship (p = 0.046, r = 0.218). Conclusions: Regarding the outcomes of this research, a significant relationship was found between the neutrophil-lymphocyte ratio, mean platelet volume, and fibrosis.
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Affiliation(s)
- Mehmet Onder Ekmen
- Gastroenterology Department, Ankara Ataturk Sanatoriıum Training and Research Hospital, 06290 Ankara, Turkey
| | - Metin Uzman
- Gastroenterology Department, Ankara Ataturk Sanatoriıum Training and Research Hospital, 06290 Ankara, Turkey
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KALYON S, GÖKDEN Y. Kronik Hepatit B Hastalarında Hematolojik Parametrelerin Karaciğer İnflamasyonu ve Fibrozu ile ilişkisi. MUSTAFA KEMAL ÜNIVERSITESI TIP DERGISI 2022. [DOI: 10.17944/mkutfd.972572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Amaç: Bu çalışmada, Kronik Hepatit B hastalarında karaciğerdeki inflamasyonu ve fibrozisin derecesini öngörebilecek hematolojik parametreleri değerlendirmek amaçlandı.
Yöntem: Hastanemiz iç hastalıkları ve gastroenteroloji polikliniğinde Kronik Hepatit B tanısıyla takip edilen ve karaciğer biyopsisi yapılan 237 hasta çalışmaya alındı. Karaciğer biopsisi yapılmadan hemen önceki Nötrofil/Lenfosit, Platelet/Lenfosit, MPV, MPV/Platelet ve MPV/Lenfosit değerleri hesaplandı. Bu parametreler ile viral serolojik bulgular, karaciğer fibrozisi ve histolojik aktivite dereceleriyle karşılaştırıldı.
Bulgular: 101’i (%43) kadın, 136’sı (%57) erkek 237 hastanın yaş ortalaması 42,56±11,7 yıl idi. MPV/Platelet, MPV/Lenfosit, HBeAg, HBV-DNA değerleri ile HAİ arasında pozitif yönde istatistiksel olarak anlamlı korelesyon bulundu (P
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Ding R, Zhou X, Huang D, Wang Y, Li X, Yan L, Lu W, Yang Z, Zhang Z. Predictive Performances of Blood Parameter Ratios for Liver Inflammation and Advanced Liver Fibrosis in Chronic Hepatitis B Infection. BIOMED RESEARCH INTERNATIONAL 2021; 2021:6644855. [PMID: 33937406 PMCID: PMC8055419 DOI: 10.1155/2021/6644855] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 03/19/2021] [Accepted: 03/29/2021] [Indexed: 02/08/2023]
Abstract
OBJECTIVE Blood parameter ratios, including neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), and monocyte to lymphocyte ratio (MLR), have been reported that they are correlated to the progression of liver disease. This study is aimed at evaluating the predictive value of PLR, NLR, and MLR for liver inflammation and fibrosis in patients with chronic hepatitis B (CHB). METHODS We recruited 457 patients with CHB who underwent a liver biopsy and routine laboratory tests. Liver histology was assessed according to the Scheuer scoring system. The predictive accuracy for liver inflammation and fibrosis was assessed by receiver operating characteristics (ROC) analysis. RESULTS PLR and NLR presented significantly reverse correlation to liver inflammation and fibrosis. However, these correlations were not observed for MLR and liver histology. The AUROCs of PLR for assessing G2-3 and G3 were 0.676 and 0.705 with cutoffs 74.27 and 68.75, respectively. The AUROCs of NLR in predicting inflammatory scores G2-3 and G3 were 0.616 and 0.569 with cutoffs 1.36 and 1.85, respectively. The AUROCs of PLR for evaluating fibrosis stages S3-4 and S4 were 0.723 and 0.757 with cutoffs 79.67 and 74.27, respectively. The AUROCs of NLR for evaluating fibrosis stages S3-4 and S4 were 0.590 with cutoff 1.14. CONCLUSION Although PLR has similar predictive power of progressive liver fibrosis compared with APRI, FIB-4, and GPR in CHB patients, it has the advantage of less cost and easy application with the potential to be widely used in clinical practice.
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Affiliation(s)
- Rongrong Ding
- 1Department of Hepatobiliary Medicine, Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, China
| | - Xinlan Zhou
- 1Department of Hepatobiliary Medicine, Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, China
| | - Dan Huang
- 1Department of Hepatobiliary Medicine, Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, China
| | - Yanbing Wang
- 1Department of Hepatobiliary Medicine, Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, China
| | - Xiufen Li
- 1Department of Hepatobiliary Medicine, Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, China
| | - Li Yan
- 1Department of Hepatobiliary Medicine, Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, China
| | - Wei Lu
- 1Department of Hepatobiliary Medicine, Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, China
| | - Zongguo Yang
- 2Department of Integrative Medicine, Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, China
| | - Zhanqing Zhang
- 1Department of Hepatobiliary Medicine, Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, China
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Meng J, Xu H, Liu X, Wu R, Niu J. Increased red cell width distribution to lymphocyte ratio is a predictor of histologic severity in primary biliary cholangitis. Medicine (Baltimore) 2018; 97:e13431. [PMID: 30508955 PMCID: PMC6283214 DOI: 10.1097/md.0000000000013431] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
Primary biliary cholangitis (PBC) is a chronic disease that is increasingly being recognized in recent years. In this study, we sought to identify noninvasive markers of the severity of cirrhosis in patients with PBC based on routinely investigated laboratory parameters.Ninety-four patients with histologically-confirmed PBC based on liver biopsy performed between January 2013 and December 2017 at the First Hospital of Jilin University were divided into 2 groups: early-stage cirrhosis (fibrosis stage F1 and F2; n = 74) and advanced-stage cirrhosis (fibrosis stage F3 and F4; n = 20).Patients with advanced-stage had significantly higher red blood cell distribution width (RDW) (15.2 vs 13.7; P = .003) and significantly lower platelet (163.35 vs 202.73; P = .032) and lymphocyte counts (1.47 vs 1.79; P = .018) as compared with patients with early-stage cirrhosis. Advanced-stage cirrhosis was associated with significantly higher RDW to platelet ratio (RPR), RDW to lymphocyte ratio (RLR), aspartate aminotransferase to platelet ratio index (APRI), and fibrosis index based on the 4 factors (FIB-4) as compared with early-stage cirrhosis. RLR showed the highest area under receiver operating characteristic curve (AUROC) (0.744). The sensitivity and specificity of RLR were 65% and 78.3%, respectively. RLR had higher AUROC than the other 3 noninvasive markers.The noninvasive markers RPR, RLR, APRI, and FIB-4 showed good diagnostic accuracy for advanced-stage cirrhosis. These markers are easily acquired by routine laboratory tests and are reproducible predictors of the severity of PBC. RLR is a novel marker that may serve as a valuable supplement to APRI and FIB-4 for predicting the severity of cirrhosis.
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Affiliation(s)
- Jing Meng
- Department of Hepatology, First Hospital of Jilin University, Jilin University
| | - Hongqin Xu
- Department of Hepatology, First Hospital of Jilin University, Jilin University
- Jilin Province Key Laboratory of Infectious Disease, Laboratory of Molecular Virology
| | - Xu Liu
- Department of Hepatology, First Hospital of Jilin University, Jilin University
| | - Ruihong Wu
- Department of Hepatology, First Hospital of Jilin University, Jilin University
- Jilin Province Key Laboratory of Infectious Disease, Laboratory of Molecular Virology
| | - Junqi Niu
- Department of Hepatology, First Hospital of Jilin University, Jilin University
- Jilin Province Key Laboratory of Infectious Disease, Laboratory of Molecular Virology
- Ministry of Education Key Laboratory of Zoonosis, Changchun, China
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Peng Y, Li Y, He Y, Wei Q, Xie Q, Zhang L, Xia Y, Zhou X, Zhang L, Feng X, Chen K, Chen S, Chen W, Long Q, Chai J. The role of neutrophil to lymphocyte ratio for the assessment of liver fibrosis and cirrhosis: a systematic review. Expert Rev Gastroenterol Hepatol 2018; 12:503-513. [PMID: 29629626 DOI: 10.1080/17474124.2018.1463158] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Neutrophil to lymphocyte ratio (NLR) is widely used to assess inflammatory diseases. We performed a systematic review to explore the prognostic role of NLR for the assessment of liver fibrosis and cirrhosis. Areas covered: We searched the PubMed and EMBASE databases for the eligible papers which explored the association between NLR and liver fibrosis/cirrhosis or investigated the prognostic value of NLR in cirrhotic patients. Expert commentary: In accordance with assessment of liver fibrosis stage, we classified papers into four subgroups by etiology. For the patients with nonalcoholic fatty liver disease (NAFLD) there was a significant association between NLR and fibrosis stage and nonalcoholic fatty liver disease activity score (NAS), while NLR had a negative correlation with fibrosis stage for the patients with chronic hepatitis B (CHB). As for the patients with and chronic hepatitis C (CHC), NLR might not be significantly associated with fibrosis stage. Moreover, NLR seemed to be significantly useful for predicting outcomes in cirrhotic patients. Hence, NLR might be associated with liver fibrosis stage, especially in patients with NAFLD. Furthermore, NLR might be a useful biomarker for evaluating the prognosis in cirrhotic patients.
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Affiliation(s)
- Ying Peng
- a Cholestatic Liver Diseases Center, Southwest Hospital , Third Military Medical University , Chongqing , China.,b Department of Gastroenterology, Southwest Hospital , Third Military Medical University , Chongqing , China
| | - Yan Li
- a Cholestatic Liver Diseases Center, Southwest Hospital , Third Military Medical University , Chongqing , China.,b Department of Gastroenterology, Southwest Hospital , Third Military Medical University , Chongqing , China
| | - Yonghong He
- a Cholestatic Liver Diseases Center, Southwest Hospital , Third Military Medical University , Chongqing , China.,b Department of Gastroenterology, Southwest Hospital , Third Military Medical University , Chongqing , China
| | - Qinglin Wei
- a Cholestatic Liver Diseases Center, Southwest Hospital , Third Military Medical University , Chongqing , China.,b Department of Gastroenterology, Southwest Hospital , Third Military Medical University , Chongqing , China
| | - Qiaoling Xie
- a Cholestatic Liver Diseases Center, Southwest Hospital , Third Military Medical University , Chongqing , China.,b Department of Gastroenterology, Southwest Hospital , Third Military Medical University , Chongqing , China
| | - Liangjun Zhang
- a Cholestatic Liver Diseases Center, Southwest Hospital , Third Military Medical University , Chongqing , China.,b Department of Gastroenterology, Southwest Hospital , Third Military Medical University , Chongqing , China
| | - Yiju Xia
- a Cholestatic Liver Diseases Center, Southwest Hospital , Third Military Medical University , Chongqing , China.,b Department of Gastroenterology, Southwest Hospital , Third Military Medical University , Chongqing , China
| | - Xueqian Zhou
- a Cholestatic Liver Diseases Center, Southwest Hospital , Third Military Medical University , Chongqing , China.,b Department of Gastroenterology, Southwest Hospital , Third Military Medical University , Chongqing , China
| | - Lu Zhang
- a Cholestatic Liver Diseases Center, Southwest Hospital , Third Military Medical University , Chongqing , China.,b Department of Gastroenterology, Southwest Hospital , Third Military Medical University , Chongqing , China
| | - Xinchan Feng
- a Cholestatic Liver Diseases Center, Southwest Hospital , Third Military Medical University , Chongqing , China.,b Department of Gastroenterology, Southwest Hospital , Third Military Medical University , Chongqing , China
| | - Kun Chen
- b Department of Gastroenterology, Southwest Hospital , Third Military Medical University , Chongqing , China
| | - Sheng Chen
- c Department of Pediatrics, Southwest Hospital , Third Military Medical University , Chongqing , China
| | - Wensheng Chen
- a Cholestatic Liver Diseases Center, Southwest Hospital , Third Military Medical University , Chongqing , China.,b Department of Gastroenterology, Southwest Hospital , Third Military Medical University , Chongqing , China
| | - Qinglin Long
- b Department of Gastroenterology, Southwest Hospital , Third Military Medical University , Chongqing , China
| | - Jin Chai
- a Cholestatic Liver Diseases Center, Southwest Hospital , Third Military Medical University , Chongqing , China.,b Department of Gastroenterology, Southwest Hospital , Third Military Medical University , Chongqing , China
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Lin L, Piao M, Jiang X, Lv H, Zhao N, Yang F, Sun C. Does neutrophil-to-lymphocyte ratio predict 1-year mortality in patients with primary biliary cholangitis? Results from a retrospective study with validation cohort. BMJ Open 2017; 7:e015304. [PMID: 28706093 PMCID: PMC5734576 DOI: 10.1136/bmjopen-2016-015304] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
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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Affiliation(s)
- Lin Lin
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin, China
- Tianjin Institute of Digestive Disease, Tianjin Medical University General Hospital, Tianjin, China
| | - Meiyu Piao
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin, China
- Tianjin Institute of Digestive Disease, Tianjin Medical University General Hospital, Tianjin, China
| | - Xihui Jiang
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin, China
- Tianjin Institute of Digestive Disease, Tianjin Medical University General Hospital, Tianjin, China
| | - Houning Lv
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin, China
- Tianjin Institute of Digestive Disease, Tianjin Medical University General Hospital, Tianjin, China
| | - Ningning Zhao
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin, China
- Tianjin Institute of Digestive Disease, Tianjin Medical University General Hospital, Tianjin, China
| | - Fang Yang
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin, China
- Tianjin Institute of Digestive Disease, Tianjin Medical University General Hospital, Tianjin, China
| | - Chao Sun
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin, China
- Tianjin Institute of Digestive Disease, Tianjin Medical University General Hospital, Tianjin, China
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Neutrophil-to-lymphocyte ratio as a predictor of fibrosis in inactive hepatitis B carriers. Eur J Gastroenterol Hepatol 2015; 27:475-6. [PMID: 25874526 DOI: 10.1097/meg.0000000000000311] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
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Assessment of the neutrophil to lymphocyte ratio in inactive hepatitis B carriers. Eur J Gastroenterol Hepatol 2015; 27:184-5. [PMID: 25533435 DOI: 10.1097/meg.0000000000000262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
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Should the neutrophil-lymphocyte ratio be used as a noninvasive marker? Eur J Gastroenterol Hepatol 2015; 27:108. [PMID: 25426987 DOI: 10.1097/meg.0000000000000235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
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