RESUMO
Background: We conducted a systematic review and meta-analysis, based on Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines, to evaluate current literature on diagnostic value of neutrophil to lymphocyte ratio (NLR) in discrimination between tuberculosis (TB) and bacterial community acquired pneumonia (B-CAP). Methods: Literature search was conducted from July 20, 2023 using Scopus, PubMed, and Web of Science databases. STATA software (version 12.0; Stata Corporation) was used for all analyses. Results: We found that patients with TB had significantly lower levels of NLR compared to those with B-CAP (SMD = -1.09, 95 %CI = -1.78- -0.40, P = 0.002). In the quality subgroup analysis, we found that patients with TB had significantly lower level of NLR compared to those with B-CAP consistent in moderate (SMD = -0.86, 95 %CI = -2.30, 0.57, P = 0.23) and high-quality studies (SMD = -1.25, 95 %CI = -2.07, -0.42). In the subgroup analysis based on continent, we found that patients with TB had significantly lower level of NLR compared to those with B-CAP in studies performed in Asian populations (SMD = -1.37, 95 %CI = -2.13, -0.61, P < 0.001), but not on African population (SMD = -0.02, 95 %CI = -1.06, 1.02, P = 0.97). The result of this study did not change after execution of sensitivity analysis. The pooled sensitivity of NLR was 0.86 (95% CI = 0.80, 0.91), and the pooled specificity was0.88 (95% CI = 0.69, 0.95). Conclusion: Patients with TB had a significantly lower NLR levels compared to those with B-CAP, so we utilized this biomarker for distinguishing between the disorders.
RESUMO
BACKGROUND AND AIM: To outline the observations of studies evaluating the prominence of Neutrophil to Lymphocyte Ratio (NLR) in sarcoidosis. METHODS: The search was performed on PubMed, Scopus, and web of science up until November 21, 2021. Eventually, a number of 17 papers were incorporated into this review. RESULTS: The results of this analysis showed no significant difference of NLR values between sarcoidosis patients and tuberculosis patients (SMD=-0.36, 95% CI= -0.92-0.21). The results showed high heterogeneity (I2=90.83%, p<0.001). So, we used random-effects model. However, NLR can be utilized to identify the radiological severity and staging of pulmonary sarcoidosis due to statistically significant variations. An elevation in NLR values may assist both sarcoidosis diagnosis and lung parenchyma involvement. Also, extra-pulmonary involvement was just more probable to be found in individuals diagnosed with sarcoidosis inhibiting high rates of NLR. High NLR levels were found to be associated with an accelerated rate of progression, revealing that NLR might be used to detect Pulmonary Hypertension (PH) as a complication of sarcoidosis. CONCLUSIONS: In the visualizations of the disease, NLR was revealed to be a beneficial and straightforward fundamental laboratory biomarker connected to disease severity and requirement for therapy.