文章：

中性粒细胞与淋巴细胞比值是多发性红细胞增多症静脉血栓形成的新型预测指标

Neutrophil-to-lymphocyte ratio is a novel predictor of venous thrombosis in polycythemia vera

原文发布日期：2022-02-10

DOI: 10.1038/s41408-022-00625-5

类型: Article

开放获取: 是

英文摘要：

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.
 

摘要翻译： 

我们研究了中性粒细胞与淋巴细胞比值（NLR）作为真性红细胞增多症（PV）患者血栓形成预测因子的价值。在ECLAP研究中纳入的1508例PV患者经过中位2.51年随访后，分别有82例和84例发生动脉血栓与静脉血栓。通过广义加性模型（GAM）分析白细胞、中性粒细胞、淋巴细胞、血小板的绝对计数及NLR值，评估其在连续尺度上的血栓风险变化趋势。仅对于静脉血栓，我们发现基线中性粒细胞绝对计数平均较高（中位数：6.8×10⁹/L，p=0.002），淋巴细胞绝对计数平均较低（中位数：1.4×10⁹/L，p=0.001），导致NLR值升高（中位数：5.1，p=0.002）。多变量分析显示，静脉血栓风险与既往静脉事件（HR=5.48，p≤0.001）及NLR值≥5（HR=2.13，p=0.001）独立相关。此外，在标准风险分级的高危与低危组中，当NLR≥5时相对风险均近似翻倍。这些发现在两个意大利独立外部队列（佛罗伦萨队列282例，罗马队列175例）的当代PV患者中得到验证。我们的数据支持近期实验研究提出的静脉血栓受先天免疫细胞调控的观点，并强调NLR是成本低廉且易于获取的静脉血栓预后生物标志物。

原文链接：

Neutrophil-to-lymphocyte ratio is a novel predictor of venous thrombosis in polycythemia vera