Can Inflammatory Indexes Predict the Severity of Mucosal Inflammation in Ulcerative Colitis?

Year 2024, Issue: Early Access

İrfan Küçük , Ersin Tural

https://doi.org/10.18678/dtfd.1486718

Abstract

Aim: Inflammatory indexes can relate to disease activity in ulcerative colitis (UC). This study aimed to evaluate whether the inflammatory indexes of neutrophil-lymphocyte ratio (NLR), C-reactive protein (CRP)-albumin ratio (CAR), CRP-lymphocyte ratio (CLR), and systemic immune-inflammation index (SIII) might predict the severity of mucosal inflammation in UC.
Material and Methods: This retrospective case-control study included 184 UC patients and 101 healthy controls. The Mayo clinical score and Mayo endoscopic score were used for the clinical and endoscopic features of UC. Truelove and Richards’s method for the severity of mucosal inflammation determined the histological activity index (HAI).
Results: The inflammatory index values, were higher in UC patients compared to the control group (p=0.007 for NLR, and p<0.001 for the others). The patients having endoscopic, clinic, and histologically active disease had higher inflammatory index values than those in remission (p<0.001 for all). UC patients with extensive disease had higher inflammatory index values than the patients who had limited disease (p<0.001 for all). The HAI values were positively correlated to all inflammatory indexes, and the correlation was the strongest between the HAI and CLR (rho=0.737, p<0.001). Regarding HAI, the diagnostic accuracy of all inflammatory indexes for detecting the clinically active disease was statistically significant, and there was no significant difference between them in terms of diagnostic accuracy.
Conclusion: The inflammatory indexes of NLR, CAR, CLR, and SII might predict the severity of histological inflammation in UC.

Keywords

Ulcerative colitis, inflammatory indexes, mucosal inflammation.

İnflamatuar İndeksler Ülseratif Kolitte Mukozal İnflamasyonun Şiddetini Tahmin Edebilir mi?

Abstract

Amaç: İnflamatuar indekslerin ülseratif kolitte (ÜK) hastalık aktivitesi ile ilişkili oldukları bilinmektedir. Bu çalışma nötrofil-lenfosit oranı (NLR), C-reaktif protein (CRP)-albümin oranı (CAR), CRP-lenfosit oranı (CLR) ve sistemik immün-inflamasyon indeksini (SIII) içeren inflamatuar indekslerin ÜK’de mukozal inflamasyonun şiddetini tahmin edip edemeyeceğinin değerlendirilmesi amaçlanmıştır.
Gereç ve Yöntemler: Bu retrospektif vaka kontrol çalışmasına 184 ÜK hastası ve 101 sağlıklı kontrol dahil edilmiştir. ÜK’nin klinik ve endoskopik özellikleri için Mayo klinik skoru ve Mayo endoskopik skoru kullanılmıştır. Mukozal inflamasyon şiddeti, Truelove ve Richards yöntemine göre histolojik aktivite indeksi (HAI) ile belirlenmiştir.
Bulgular: ÜK hastalarında, inflamatuar indeks değerleri kontrol grubuna göre daha yüksek bulunmuştur (NLR için p=0,007 ve diğerleri için p<0,001). Endoskopik, klinik ve histolojik olarak aktif hastalığı olan vakaların inflamatuar indeks değerleri remisyonda olan vakalardan daha yüksek idi (tümü için p<0,001). Yaygın hastalığı olan ÜK hastalarının sınırlı hastalığı olan hastalardan daha yüksek inflamatuar indeks değerleri vardı (tümü için p<0,001). HAI değerleri tüm inflamatuar indekslerle pozitif korelasyon göstermekteydi ve en güçlü korelasyon HAI ile CLR arasında idi (rho=0,737; p<0,001). HAI ile ilişkili olarak, klinik olarak aktif hastalığın tespiti için tüm inflamatuvar indekslerin tanısal doğruluğu istatistiksel olarak anlamlıydı ve tanısal doğruluk açısından aralarında anlamlı bir fark yoktu.
Sonuç: NLR, CAR, CLR ve SIII’i içeren inflamatuar indeskler, ÜK’de histolojik inflamasyonun şiddetini tahmin edebilir.

Keywords

Ülseratif kolit, inflamatuar indeksler, mukozal inflamasyon

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