Correlation of neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio and D-dimer with the severity of acute cholangitis

Chao LIU; Xiaonong ZHANG

ABSTRACT

Objective:

To correlate neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and D-dimer (DD) with the severity of acute cholangitis.

Methods:

The clinical data of 96 patients with acute cholangitis who received treatment in Panjin Central Hospital from September 2019 to March 2021 were retrospectively analyzed. These patients were divided into three groups according to the severity of acute cholangitis 36 patients with mild acute cholangitis (group A), 35 patients with moderate acute cholangitis (group B), and 25 patients with severe acute cholangitis (group C). The correlation between age, sex, NLR, PLR, DD, and the severity of acute cholangitis was compared among the three groups.

Results:

In groups A and B, the area under the receiver operating characteristic curve (AUC) showing the performance of DD, NLR, and PLR levels in predicting acute cholangitis was 0.800, 0.838, and 0.721, respectively, with the optimal cut-off value of 1.985 mg/L, 9.589, and 154.410, respectively. Among them, NLR had the largest AUC, and the highest sensitivity (82.9%), and had a high diagnostic value. In groups B and C, the AUC for DD, NLR, and PLR was 0.967, 0.915, and 0.543, respectively, with the optimal cut-off value of 6.000 mg/L, 22.390, and 264.220, respectively. DD and NLR had a diagnostic significance (both P < 0.05), but PLR had no diagnostic significance ( P > 0.05). The AUC for DD was the largest, and therefore DD had a great diagnostic significance. When NLR, PLR, and DD were jointly detected, the AUC was the highest and the diagnostic value was the highest. The AUC in groups A and B was 0.866, and that in groups B and C was 0.977.

Conclusion:

The levels of DD, NLR, and PLR increase in patients with acute cholangitis, which are related to the severity of the disease. DD, NLR, and PRL can be used as indicators to evaluate mild and moderate acute cholangitis, and NLR has the highest diagnostic value. DD and NLR can be used as indicators to evaluate moderate to severe acute cholangitis, and the effect of DD is superior to that of NLR. The combined detection of the three indicators can increase the value to evaluate the severity of acute cholangitis, and its effect is superior to that of a single detection. The combined detection of NLR, PLR, and DD is helpful for the clinical diagnosis and treatment of acute cholangitis.