Effective immune-inFLammation index for ulcerative colitis and activity assessments

BACKGROUND The inverse association between systemic immune-inFLammation index (SII) and overall survival in tumors has been studied. AIM To evaluate the hematological indexes for assessing the activity of ulcerative colitis (UC). METHODS 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. RESULTS 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). CONCLUSION SII has a certain value in confirming UC and identifying its activity.

Automated summary

The study found that SII, NLR, and PLR values were higher in UC patients compared to healthy controls and were positively correlated with endoscopic scores, extent of inflammation, and severity index. NLR cut-off value of 562.22 predicted UC with 79.65% sensitivity and 76.16% specificity. High SII and NLR levels were associated with an increased risk of UC.