Published online Jan 16, 2021. doi: 10.12998/wjcc.v9.i2.334
Peer-review started: July 4, 2020
First decision: September 14, 2020
Revised: September 28, 2020
Accepted: November 21, 2020
Article in press: November 21, 2020
Published online: January 16, 2021
The inverse association between systemic immune-inﬂammation index (SII) and overall survival in tumors has been studied.
To evaluate the hematological indexes for assessing the activity of ulcerative colitis (UC).
In this case-control study, 172 UC patients and healthy participants were included. Comparisons were made among groups of white blood cells, hemoglobin, platelets, neutrophils, lymphocytes, monocytes, SII, neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR). The relationship with hematological inflammation was verified by Spearman correlation analyses. The efficiency of SII, NLR, and PLR for distinguishing between UC and severe disease status was assessed by the receiver operator curve and logistic regression analyses.
The values of SII, NLR, and PLR were higher in UC patients than in controls (P < 0.001) and were positively correlated with the Mayo endoscopic score, extent, Degree of Ulcerative Colitis Burden of Luminal Inflammation (DUBLIN) score, and Ulcerative Colitis Endoscopic Index of Severity (UCEIS). The cut-off NLR value of 562.22 predicted UC with a sensitivity of 79.65% and a specificity of 76.16%. Logistic regression analysis revealed that patients with SII and NLR levels above the median had a significantly higher risk of UC (P < 0.05). Risk factors independently associated with DUBLIN ≥ 3 included SII ≥ 1776.80 [odds ratio (OR) = 11.53, P = 0.027] and NLR value of 2.67-4.23 (OR = 2.96, P = 0.047) on multivariate analysis. Compared with the first quartile, SII ≥ 1776.80 was an independent predictor of UCEIS ≥ 5 (OR = 18.46, P = 0.012).
SII has a certain value in confirming UC and identifying its activity.
Core Tip: Although endoscopy examination is the standard for assessing ulcerative colitis (UC) relapse, it is invasive, intolerable, and weakly repeatable. Non-invasive parameters can be used to assess the disease activity of UC. However, the value of routine blood testing for predicting UC severity has not been studied in depth. This study evaluated the differential leucocytic ratio, such as systemic immune-inﬂammation index, neutrophil-to-lymphocyte ratio, and platelet-to-lymphocyte ratio, to provide easy and reliable methods for disease activity.