Systematic review of the diagnostic role of neutrophil to lymphocyte ratio in sarcoidosis NLR and sarcoidosis

Main Article Content

Masoumeh Ghasempour Alamdari
Niusha Kalami
Horieh Shojaan
Sarina Aminizadeh
Arshin Ghaedi
Aida Bazrgar
Shokoufeh Khanzadeh

Keywords

sarcoidosis, Neutrophil to Lymphocyte Ratio, NLR, Review

Abstract

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.

Abstract 624 | PDF Downloads 421

References

1. Kemal CT, Aylin OA, Volkan K, Seda M, Recep B, Can S. The importance of PET/CT findings and hematological parameters in prediction of progression in sarcoidosis cases. Sarcoidosis Vasc Diffuse Lung Dis. 2017;34(3):242-50. Epub 2017/01/01. doi: 10.36141/svdld.v34i3.5299. PubMed PMID: 32476852; PubMed Central PMCID: PMC7170101.
2. Abedini A, Naderi Z, Kiani A, Marjani M, Mortaz E, Ghorbani F. The evaluation of interleukin-4 and interleukin-13 in the serum of pulmonary sarcoidosis and tuberculosis patients. J Res Med Sci. 2020;25.
3. Spagnolo P, Rossi G, Trisolini R, Sverzellati N, Baughman RP, Wells AU. Pulmonary sarcoidosis. Lancet Respir Med. 2018;6(5):389-402. doi: 10.1016/S2213-2600(18)30064-X.
4. Dirican N, Anar C, Kaya S, Bircan HA, Colar HH, Cakir M. The clinical significance of hematologic parameters in patients with sarcoidosis. Clin Respir J. 2016;10(1):32-9.
5. Ocal N, Dogan D, Ocal R, et al. Effects of radiological extent on neutrophil/lymphocyte ratio in pulmonary sarcoidosis. Eur Rev Med Pharmacol Sci. 2016;20(4):709-14.
6. Kocak ND, Gungor S, Akturk UA, et al. Analysis of age distribution and disease presentation of 1269 patients with sarcoidosis. Eurasian J. Med. 2017;49(3):161.
7. Korkmaz C, AKDAĞ T. Plasma levels of protachykinin-1 (TAC1) in patients with sarcoidosis. Fam. Pract. Palliat. Care. 2020;5(3):76-81.
8. Korkmaz C, Demircioglu S. The association of neutrophil/lymphocyte and platelet/lymphocyte ratios and hematological parameters with diagnosis, stages, extrapulmonary involvement, pulmonary hypertension, response to treatment, and prognosis in patients with sarcoidosis. Can. Respir. J. 2020;2020.
9. Grunewald J, Grutters JC, Arkema EV, Saketkoo LA, Moller DR, Müller-Quernheim J. Sarcoidosis. Nat Rev Dis Primers. 2019;5(1):45. Epub 20190704. doi: 10.1038/s41572-019-0096-x. PubMed PMID: 31273209.
10. BALCI A, AYDIN S. A novel approach in the diagnosis and follow-up of sarcoidosis. J Surg Med. 2020;4(11):1077-81.
11. Tana C, Mantini C, Donatiello I, et al. Clinical Features and Diagnosis of Cardiac Sarcoidosis. J. Clin. Med. 2021;10(9). Epub 2021/06/03. doi: 10.3390/jcm10091941. PubMed PMID: 34062709; PubMed Central PMCID: PMC8124502.
12. Rana GD, d’Alessandro M, Rizzi L, et al. Clinical phenotyping in sarcoidosis management. Sarcoidosis Vasc Diffuse Lung Dis. 2021;38(2).
13. Sève P, Pacheco Y, Durupt F, et al. Sarcoidosis: A Clinical Overview from Symptoms to Diagnosis. Cells. 2021;10(4):766. doi: 10.3390/cells10040766. PubMed PMID: 33807303.
14. Shahgaldi S, Abbasi A, Rahmani-Kukia N. A rapid qualitative review of sarcoidosis: Clinical manifestations, Immunopathogenesis, Diagnosis, and Treatment. Mini-Rev. Med. Chem. 2021. Epub 2021/10/15. doi: 10.2174/1389557521666211013112211. PubMed PMID: 34645371.
15. Mukhopadhyay S, Gal AA. Granulomatous lung disease: an approach to the differential diagnosis. Arch. Path. Lab. 2010;134(5):667-90. Epub 2010/05/06. doi: 10.5858/134.5.667. PubMed PMID: 20441499.
16. Henrickson SE, Jongco AM, Thomsen KF, Garabedian EK, Thomsen IP. Noninfectious Manifestations and Complications of Chronic Granulomatous Disease. J. Pediatric Infect. Dis. Soc. 2018;7(suppl_1):S18-s24. Epub 2018/05/11. doi: 10.1093/jpids/piy014. PubMed PMID: 29746679; PubMed Central PMCID: PMC5946858.
17. Shah KK, Pritt BS, Alexander MP. Histopathologic review of granulomatous inflammation. J Clin Tuberc Other Mycobact Dis. 2017;7:1-12. Epub 2017/02/10. doi: 10.1016/j.jctube.2017.02.001. PubMed PMID: 31723695; PubMed Central PMCID: PMC6850266.
18. Franquet T, Franks TJ, Galvin JR, et al. Non-Infectious Granulomatous Lung Disease: Imaging Findings with Pathologic Correlation. Korean J Radiol. 2021;22(8):1416-35. Epub 2021/06/17. doi: 10.3348/kjr.2020.1082. PubMed PMID: 34132073; PubMed Central PMCID: PMC8316771.
19. Kerget B, Aydin Y, Özmen S, Afşin DE, Yılmazel Uçar E, Sağlam L. Can hematological parameters guide the differentiation between sarcoidosis and tuberculous lymphadenitis? Eurasian J. Pulmonol. 2021;23(1):19.
20. Ungprasert P, Ryu JH, Matteson EL. Clinical Manifestations, Diagnosis, and Treatment of Sarcoidosis. Mayo Clin. Proc. Innov. Qual. Outcomes. 2019;3(3):358-75. Epub 2019/09/06. doi: 10.1016/j.mayocpiqo.2019.04.006. PubMed PMID: 31485575; PubMed Central PMCID: PMC6713839.
21. Consensus conference: activity of sarcoidosis. Third WASOG meeting, Los Angeles, USA, September 8-11, 1993. Eur Respir J. 1994;7(3):624-7. Epub 1994/03/01. PubMed PMID: 8013622.
22. Bonham CA, Strek ME, Patterson KC. From granuloma to fibrosis: sarcoidosis associated pulmonary fibrosis. Curr Opin Pulm Med. 2016;22(5):484-91. Epub 2016/07/06. doi: 10.1097/mcp.0000000000000301. PubMed PMID: 27379967; PubMed Central PMCID: PMC5532138.
23. Pirozzolo G, Gisbertz SS, Castoro C, van Berge Henegouwen MI, Scarpa M. Neutrophil-to-lymphocyte ratio as prognostic marker in esophageal cancer: a systematic review and meta-analysis. J Thorac Dis. 2019;11(7):3136-45. doi: 10.21037/jtd.2019.07.30. PubMed PMID: 31463142.
24. Hajibandeh S, Hajibandeh S, Hobbs N, Mansour M. Neutrophil-to-lymphocyte ratio predicts acute appendicitis and distinguishes between complicated and uncomplicated appendicitis: A systematic review and meta-analysis. Am. J. Surg. 2020;219(1):154-63. doi: 10.1016/j.amjsurg.2019.04.018.
25. Tan TP, Arekapudi A, Metha J, Prasad A, Venkatraghavan L. Neutrophil-lymphocyte ratio as predictor of mortality and morbidity in cardiovascular surgery: a systematic review. ANZ J Surg. 2015;85(6):414-9. Epub 20150317. doi: 10.1111/ans.13036. PubMed PMID: 25781147.
26. Chen D, Xiao D, Guo J, Chahan B, Wang Z. Neutrophil-lymphocyte count ratio as a diagnostic marker for acute kidney injury: a systematic review and meta-analysis. Clin. Exp. Nephrol. 2020;24(2):126-35. Epub 2019/10/28. doi: 10.1007/s10157-019-01800-y. PubMed PMID: 31650334.
27. Yalnız E, Karadeniz G, Üçsular FD, Erbay Polat G, Şahin GV. Predictive value of platelet-to-lymphocyte ratio in patients with sarcoidosis. Biomark Med. 2019;13(3):197-204. Epub 20190103. doi: 10.2217/bmm-2018-0252. PubMed PMID: 30604642.
28. Iliaz S, Iliaz R, Ortakoylu G, Bahadir A, Bagci BA, Caglar E. Value of neutrophil/lymphocyte ratio in the differential diagnosis of sarcoidosis and tuberculosis. Ann Thorac Med. 2014;9(4):232-5. doi: 10.4103/1817-1737.140135. PubMed PMID: 25276243; PubMed Central PMCID: PMC4166071.
29. d'Alessandro M, Bergantini L, Cameli P, Carleo A, Sestini P, Bargagli E. Neutrophil-to-lymphocyte ratio in IPF patients: a novel prognostic biomarker? : Eur Respiratory Soc; 2020.
30. Forget P, Khalifa C, Defour J-P, Latinne D, Van Pel M-C, De Kock M. What is the normal value of the neutrophil-to-lymphocyte ratio? BMC Res Notes. 2017;10(1):12-. doi: 10.1186/s13104-016-2335-5. PubMed PMID: 28057051.
31. Wang Q, Ma J, Jiang Z, Ming L. Prognostic value of neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio in acute pulmonary embolism: a systematic review and meta-analysis. Int Angiol. 2018;37(1):4-11. Epub 2017/05/26. doi: 10.23736/s0392-9590.17.03848-2. PubMed PMID: 28541022.
32. Cupp MA, Cariolou M, Tzoulaki I, Aune D, Evangelou E, Berlanga-Taylor AJ. Neutrophil to lymphocyte ratio and cancer prognosis: an umbrella review of systematic reviews and meta-analyses of observational studies. BMC Med. 2020;18(1):360-. doi: 10.1186/s12916-020-01817-1. PubMed PMID: 33213430.
33. Huang Z, Fu Z, Huang W, Huang K. Prognostic value of neutrophil-to-lymphocyte ratio in sepsis: A meta-analysis. Am. J. Emerg. Med. 2020;38(3):641-7.
34. Phan T, Brailovsky Y, Fareed J, Hoppensteadt D, Iqbal O, Darki A. Neutrophil-to-Lymphocyte and Platelet-to-Lymphocyte Ratios Predict All-Cause Mortality in Acute Pulmonary Embolism. Clin Appl Thromb Hemost. 2020;26:1076029619900549-. doi: 10.1177/1076029619900549. PubMed PMID: 31960711.
35. Üçsular F, Polat G, Karadeniz G, et al. Predictive value of platelet-to-lymphocyte ratio and neutrophil-to-lymphocyte ratio in patients with hypersensitivity pneumonia. Sarcoidosis Vasc Diffuse Lung Dis. 2020;37(4):e2020012. Epub 20201216. doi: 10.36141/svdld.v37i4.9966. PubMed PMID: 33597799; PubMed Central PMCID: PMC7883515.
36. Karakurt Z, Aka Akturk U, Durmus Kocak N, et al. Is The Neutrophil-To-Lympocyte Ratio Different In Sarcoidosis And Interstitial Lung Diseases? C40 SARCOIDOSIS: UNDERSTANDING THIS MULTI-SYSTEM DISORDER: Am Thorac Soc; 2016. p. A5031-A.
37. Erol M, Önner H. Sarkoidozun Yaygınlığının Değerlendirilmesinde FDG PET/ BT Bulguları ile Nötrofil/Lenfosit Oranının Karşılaştırılması. Selcuk Tip Dergisi. 2021;2:101-5. doi: 10.30733/std.2021.01473.
38. Mirsaeidi M, Mortaz E, Omar HR, Camporesi EM, Sweiss N. Association of Neutrophil to Lymphocyte Ratio and Pulmonary Hypertension in Sarcoidosis Patients. Tanaffos. 2016;15(1):44-7. PubMed PMID: 27403178; PubMed Central PMCID: PMC4937761.
39. Kocak ND, Gungor S, Akturk UA, et al. Analysis of age distribution and disease presentation of 1269 patients with sarcoidosis. Eurasian J Med. 2017;49(3):161.
40. Prasse A. The Diagnosis, Differential Diagnosis, and Treatment of Sarcoidosis. Dtsch Arztebl Int. 2016;113(33-34):565-74. doi: 10.3238/arztebl.2016.0565. PubMed PMID: 27598883; PubMed Central PMCID: PMC5015588.
41. Paramothayan NS, Lasserson TJ, Jones PW. Corticosteroids for pulmonary sarcoidosis. Cochrane Database Syst. Rev. 2005;2005(2):Cd001114. Epub 2005/04/23. doi: 10.1002/14651858.CD001114.pub2. PubMed PMID: 15846612; PubMed Central PMCID: PMC6464973.
42. Gungor S, Akturk UA, Yalcinsoy M, et al. What is the neutrophil/lymphocyte ratio in sarcoidosis? Bratisl. Lek. Listy. 2016;117(3):152-5. Epub 2016/03/02. doi: 10.4149/bll_2016_030. PubMed PMID: 26925745.