Neutrophil-to-lymphocyte ratio for predicting postoperative recurrence in Crohn’s disease patients with isolated anastomotic lesions
Background: Patients with isolated anastomotic lesions (iAL) are common in postoperative Crohn’s disease (CD) and have heterogeneous prognosis. Objectives: To investigate the prognostic value of neutrophil-to-lymphocyte ratio (NLR) in CD patients with iAL. Design: A bicenter retrospective cohort stu...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2023-03-01
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| Series: | Therapeutic Advances in Gastroenterology |
| Online Access: | https://doi.org/10.1177/17562848231165129 |
| _version_ | 1827975665120444416 |
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| author | Rirong Chen Chao Li Kang Chao Yizhe Tie Jieqi Zheng Huili Guo Zhirong Zeng Li Li Minhu Chen Shenghong Zhang |
| author_facet | Rirong Chen Chao Li Kang Chao Yizhe Tie Jieqi Zheng Huili Guo Zhirong Zeng Li Li Minhu Chen Shenghong Zhang |
| author_sort | Rirong Chen |
| collection | DOAJ |
| description | Background: Patients with isolated anastomotic lesions (iAL) are common in postoperative Crohn’s disease (CD) and have heterogeneous prognosis. Objectives: To investigate the prognostic value of neutrophil-to-lymphocyte ratio (NLR) in CD patients with iAL. Design: A bicenter retrospective cohort study. Methods: CD patients who received ileocolonic resection from 2013 and 2020 and had a modified Rutgeerts score of i2a were recruited. NLR was determined within 1 week around the initial endoscopy after ileocolectomy. The primary outcome was clinical recurrence. Kaplan–Meier method and Cox hazard regression analysis were utilized to assess the association between candidate variables and outcomes of interest. Results: In total, 411 postoperative CD patients were preliminarily reviewed and 83 patients were eligible. In total, 36 (48.6%) patients experienced clinical recurrence with a median follow-up time of 16.3 (interquartile range, 9.7–26.3) months. NLR > 2.45 and age at surgery >45 years had higher cumulative incidence of clinical recurrence in the Kaplan–Meier analysis. After adjusted for potential confounders, NLR > 2.45 was the only independent risk factor for clinical recurrence, with an adjusted hazard ratio (HR) of 2.88 [95% confidence interval (CI), 1.39–6.00; p = 0.005]. Furthermore, a risk score based on NLR and age at surgery were built to further stratify patients. Compared to those who scored 0, patients with a score of 1 and 2 had an adjusted HR of 2.48 (95% CI, 1.22–5.02) and 6.97 (95% CI, 2.19–22.16) for developing clinical recurrence, respectively. Conclusions: NLR is a promising prognostic biomarker for CD patients with iAL. The utilization of NLR and the risk score to stratify patients may facilitate the personalized management in patients with iAL. |
| first_indexed | 2024-04-09T20:15:02Z |
| format | Article |
| id | doaj.art-1e84ac7cbd7447dc8057604b1fd71582 |
| institution | Directory Open Access Journal |
| issn | 1756-2848 |
| language | English |
| last_indexed | 2024-04-09T20:15:02Z |
| publishDate | 2023-03-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Therapeutic Advances in Gastroenterology |
| spelling | doaj.art-1e84ac7cbd7447dc8057604b1fd715822023-03-31T10:06:23ZengSAGE PublishingTherapeutic Advances in Gastroenterology1756-28482023-03-011610.1177/17562848231165129Neutrophil-to-lymphocyte ratio for predicting postoperative recurrence in Crohn’s disease patients with isolated anastomotic lesionsRirong ChenChao LiKang ChaoYizhe TieJieqi ZhengHuili GuoZhirong ZengLi LiMinhu ChenShenghong ZhangBackground: Patients with isolated anastomotic lesions (iAL) are common in postoperative Crohn’s disease (CD) and have heterogeneous prognosis. Objectives: To investigate the prognostic value of neutrophil-to-lymphocyte ratio (NLR) in CD patients with iAL. Design: A bicenter retrospective cohort study. Methods: CD patients who received ileocolonic resection from 2013 and 2020 and had a modified Rutgeerts score of i2a were recruited. NLR was determined within 1 week around the initial endoscopy after ileocolectomy. The primary outcome was clinical recurrence. Kaplan–Meier method and Cox hazard regression analysis were utilized to assess the association between candidate variables and outcomes of interest. Results: In total, 411 postoperative CD patients were preliminarily reviewed and 83 patients were eligible. In total, 36 (48.6%) patients experienced clinical recurrence with a median follow-up time of 16.3 (interquartile range, 9.7–26.3) months. NLR > 2.45 and age at surgery >45 years had higher cumulative incidence of clinical recurrence in the Kaplan–Meier analysis. After adjusted for potential confounders, NLR > 2.45 was the only independent risk factor for clinical recurrence, with an adjusted hazard ratio (HR) of 2.88 [95% confidence interval (CI), 1.39–6.00; p = 0.005]. Furthermore, a risk score based on NLR and age at surgery were built to further stratify patients. Compared to those who scored 0, patients with a score of 1 and 2 had an adjusted HR of 2.48 (95% CI, 1.22–5.02) and 6.97 (95% CI, 2.19–22.16) for developing clinical recurrence, respectively. Conclusions: NLR is a promising prognostic biomarker for CD patients with iAL. The utilization of NLR and the risk score to stratify patients may facilitate the personalized management in patients with iAL.https://doi.org/10.1177/17562848231165129 |
| spellingShingle | Rirong Chen Chao Li Kang Chao Yizhe Tie Jieqi Zheng Huili Guo Zhirong Zeng Li Li Minhu Chen Shenghong Zhang Neutrophil-to-lymphocyte ratio for predicting postoperative recurrence in Crohn’s disease patients with isolated anastomotic lesions Therapeutic Advances in Gastroenterology |
| title | Neutrophil-to-lymphocyte ratio for predicting postoperative recurrence in Crohn’s disease patients with isolated anastomotic lesions |
| title_full | Neutrophil-to-lymphocyte ratio for predicting postoperative recurrence in Crohn’s disease patients with isolated anastomotic lesions |
| title_fullStr | Neutrophil-to-lymphocyte ratio for predicting postoperative recurrence in Crohn’s disease patients with isolated anastomotic lesions |
| title_full_unstemmed | Neutrophil-to-lymphocyte ratio for predicting postoperative recurrence in Crohn’s disease patients with isolated anastomotic lesions |
| title_short | Neutrophil-to-lymphocyte ratio for predicting postoperative recurrence in Crohn’s disease patients with isolated anastomotic lesions |
| title_sort | neutrophil to lymphocyte ratio for predicting postoperative recurrence in crohn s disease patients with isolated anastomotic lesions |
| url | https://doi.org/10.1177/17562848231165129 |
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