Diagnostic utility of the neutrophil-platelet ratio as a novel marker of activity in patients with Ulcerative Colitis

PLoS One. 2020 Apr 21;15(4):e0231988. doi: 10.1371/journal.pone.0231988. eCollection 2020.

Abstract

Background: Ulcerative colitis (UC) is a chronic disease characterized by periods of activity and remission. The platelet, one of the main activators of neutrophils, contains Interleukin 8 (IL-8), a potent neutrophil chemo-attractant and P-selectin that induces excretion of superoxide in the neutrophils, forming platelet-neutrophil aggregates that are increased in individuals with active UC, hence an index of both cells could produce a monitoring tool. No previous studies have evaluated this ratio in UC.

Goal: To evaluate the clinical utility of the Neutrophil-Platelet (NeuPla) ratio in patients with UC.

Study: A total of 158 patients with a diagnosis of UC. This index was based on the ratio between platelets and the neutrophil differential in blood count. The activity was classified using Mayo endoscopic sub-score, histological (Riley score) and for clinical was used the Truelove-Witts, Montreal, Mayo and Yamamoto-Furusho scores.

Results: The correlation of the NeuPla ratio with activity scales were significant (P <0.05). An optimal cut-off point to classify patients with clinical activity was 14.94 with a sensitivity 87.95% and specificity 63.5 and endoscopy activity with a cut-off 14.64 with a sensibility of 70.5% and specificity of 61.8%.

Conclusions: The NeuPla ratio showed an adequate diagnostic utility to identify UC patients with clinical and endoscopy activity without the use of invasive studies like a colonoscopy or expensive fecal biomarkers such as calprotectin and have a better diagnostic performance in comparison to other serum biomarkers (C reactive protein, erythrocyte sedimentation rate and albumin).

MeSH terms

  • Adult
  • Biomarkers / blood*
  • Blood Platelets / pathology*
  • Colitis, Ulcerative / blood
  • Colitis, Ulcerative / diagnosis*
  • Female
  • Humans
  • Male
  • Neutrophils / pathology*
  • Prognosis
  • ROC Curve
  • Severity of Illness Index*

Substances

  • Biomarkers

Grants and funding

The authors received no specific funding for this work.