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Abstract：
OBJECTIVE: To investigate inflammation indices and erythropoietin levels for their potential role in distinguishing polycythemia vera from secondary polycythemia and to compare different parameter combinations in terms of the diagnostic accuracy.
METHODS: This retrospective cohort was created from patients assessed for polycythemia from January 2020 to December 2023. Polycythemia vera diagnosis was made according to the 2016 World Health Organization criteria (n = 145). Those who did not fulfill the criteria were defined as having secondary polycythemia (n = 84).
RESULTS: The neutrophil lymphocyte ratio, platelet lymphocyte ratio and systemic immune-inflammation index were significantly higher in the polycythemia vera group (p < 0.001 for all). Erythropoietin had the highest area under the curve in the analysis to distinguish groups, followed by the systemic immune-inflammation index. The platelet lymphocyte ratio (≥135) had the highest specificity to detect polycythemia vera, followed closely by the systemic immune-inflammation index. The sensitivity for polycythemia vera detection was highest with the erythropoietin and systemic immune-inflammation index combination, followed by erythropoietin and the neutrophil lymphocyte ratio. All the single and combinatory variables exhibited significant performance in predicting polycythemia vera after adjusting for age and sex. However, the erythropoietin and systemic immune-inflammation index combination had the highest odds ratio, followed by erythropoietin alone.
CONCLUSIONS: These are promising findings supporting the usability of these biomarkers, especially the systemic immune-inflammation index, as minor criteria in the diagnosis of polycythemia vera. It is especially crucial to note that using erythropoietin in combination with these markers may improve diagnostic accuracy.
METHODS: This retrospective cohort was created from patients assessed for polycythemia from January 2020 to December 2023. Polycythemia vera diagnosis was made according to the 2016 World Health Organization criteria (n = 145). Those who did not fulfill the criteria were defined as having secondary polycythemia (n = 84).
RESULTS: The neutrophil lymphocyte ratio, platelet lymphocyte ratio and systemic immune-inflammation index were significantly higher in the polycythemia vera group (p < 0.001 for all). Erythropoietin had the highest area under the curve in the analysis to distinguish groups, followed by the systemic immune-inflammation index. The platelet lymphocyte ratio (≥135) had the highest specificity to detect polycythemia vera, followed closely by the systemic immune-inflammation index. The sensitivity for polycythemia vera detection was highest with the erythropoietin and systemic immune-inflammation index combination, followed by erythropoietin and the neutrophil lymphocyte ratio. All the single and combinatory variables exhibited significant performance in predicting polycythemia vera after adjusting for age and sex. However, the erythropoietin and systemic immune-inflammation index combination had the highest odds ratio, followed by erythropoietin alone.
CONCLUSIONS: These are promising findings supporting the usability of these biomarkers, especially the systemic immune-inflammation index, as minor criteria in the diagnosis of polycythemia vera. It is especially crucial to note that using erythropoietin in combination with these markers may improve diagnostic accuracy.
摘要：
目的：探讨炎症指标和促红细胞生成素水平在区分真性红细胞增多症和继发性红细胞增多症方面的潜在作用，并比较不同参数组合在诊断准确性方面的差异。
方法：该回顾性队列研究来自2020年1月至2023年12月评估的红细胞增多症患者。根据2016年世界卫生组织标准（n=145）进行真性红细胞增多症诊断。不符合标准的人被定义为继发性红细胞增多症(n=84)。
结果：中性粒细胞淋巴细胞比率，真性红细胞增多症组的血小板淋巴细胞比率和全身免疫炎症指数显著高于对照组(均p<0.001).促红细胞生成素在区分组的分析中具有最高的曲线下面积,其次是全身免疫炎症指数。血小板淋巴细胞比例(≥135)检测真性红细胞增多症的特异性最高,紧随其后的是全身免疫炎症指数。促红细胞生成素和全身免疫-炎症指数联合检测真性红细胞增多症的敏感性最高，其次是促红细胞生成素和中性粒细胞淋巴细胞比率。调整年龄和性别后，所有单个变量和组合变量在预测真性红细胞增多症方面均表现出显着性能。然而,促红细胞生成素和全身免疫炎症指数组合的比值比最高，其次是促红细胞生成素。
结论：这些是支持这些生物标志物可用性的有希望的发现，尤其是全身免疫炎症指数，作为真性红细胞增多症诊断的次要标准。特别重要的是要注意使用促红细胞生成素与这些标志物的组合可以提高诊断准确性。
方法：该回顾性队列研究来自2020年1月至2023年12月评估的红细胞增多症患者。根据2016年世界卫生组织标准（n=145）进行真性红细胞增多症诊断。不符合标准的人被定义为继发性红细胞增多症(n=84)。
结果：中性粒细胞淋巴细胞比率，真性红细胞增多症组的血小板淋巴细胞比率和全身免疫炎症指数显著高于对照组(均p<0.001).促红细胞生成素在区分组的分析中具有最高的曲线下面积,其次是全身免疫炎症指数。血小板淋巴细胞比例(≥135)检测真性红细胞增多症的特异性最高,紧随其后的是全身免疫炎症指数。促红细胞生成素和全身免疫-炎症指数联合检测真性红细胞增多症的敏感性最高，其次是促红细胞生成素和中性粒细胞淋巴细胞比率。调整年龄和性别后，所有单个变量和组合变量在预测真性红细胞增多症方面均表现出显着性能。然而,促红细胞生成素和全身免疫炎症指数组合的比值比最高，其次是促红细胞生成素。
结论：这些是支持这些生物标志物可用性的有希望的发现，尤其是全身免疫炎症指数，作为真性红细胞增多症诊断的次要标准。特别重要的是要注意使用促红细胞生成素与这些标志物的组合可以提高诊断准确性。
