PDF(Pubmed)
Abstract：
The wide range of clinical and serological manifestations in systemic lupus erythematosus (SLE) and the lack of accepted diagnostic criteria warrant the identification of novel, more accurate biomarkers. Hematological indices derived from full blood cell counts, particularly the neutrophil-to-lymphocyte ratio (NLR) and the platelet-to-lymphocyte ratio (PLR), have shown promise in SLE; however, a critical appraisal of their diagnostic accuracy is lacking. We sought to address this issue by conducting a systematic review and meta-analysis of the diagnostic accuracy of the NLR and PLR in SLE. The electronic databases PubMed, Scopus, and Web of Science were systematically searched from inception to 15 March 2024 for studies reporting the sensitivity and specificity of the NLR and PLR, obtained by receiver operating characteristic (ROC) curve analysis, for the presence of SLE, disease severity, organ involvement (lupus nephritis, pericarditis, and pleural disease), and complications (infections). The risk of bias was assessed using the JBI Critical Appraisal Checklist (PROSPERO registration number: CRD42024531446). The NLR exhibited good accuracy for the diagnosis of SLE (eight studies; area under the curve, AUC = 0.81, 95% CI 0.78-0.85) and lupus nephritis (nine studies; AUC = 0.81, 95% CI 0.77-0.84), but not for severe disease (nine studies; AUC = 0.69, 95% CI 0.65-0.73) or infections (six studies; AUC = 0.73, 95% CI 0.69-0.77). The PLR exhibited good accuracy for the diagnosis of severe disease (six studies; AUC = 0.85, 95% CI 0.81-0.87). There were an insufficient number of studies to assess the accuracy of the PLR for the diagnosis of SLE, lupus nephritis, or infections. No study investigated the NLR and PLR in SLE patients with pericarditis or pleural disease. Therefore, the NLR and the PLR have a relatively high diagnostic accuracy for the presence of SLE and lupus nephritis (NLR) and severe disease (PLR). Further studies are warranted to determine whether the NLR and PLR, in combination with clinical evaluation and other serological biomarkers, can enhance the diagnosis and management of SLE.
摘要：
系统性红斑狼疮（SLE）的临床和血清学表现广泛，缺乏公认的诊断标准，更准确的生物标志物。来自全血细胞计数的血液学指标，特别是中性粒细胞与淋巴细胞比率（NLR）和血小板与淋巴细胞比率（PLR），在SLE中表现出希望；然而，缺乏对其诊断准确性的严格评估。我们试图通过对SLE中NLR和PLR的诊断准确性进行系统评价和荟萃分析来解决这一问题。电子数据库PubMed，Scopus,和WebofScience从开始到2024年3月15日系统地检索了报告NLR和PLR的敏感性和特异性的研究，通过受试者工作特性(ROC)曲线分析获得，对于SLE的存在，疾病严重程度,器官受累（狼疮性肾炎，心包炎,和胸膜疾病)，和并发症（感染）。使用JBI关键评估清单（PROSPERO注册号：CRD42024531446）评估偏倚风险。NLR对SLE的诊断表现出良好的准确性(8项研究；曲线下面积，AUC=0.81，95％CI0.78-0.85）和狼疮性肾炎（九项研究；AUC=0.81，95％CI0.77-0.84），但不适用于严重疾病（9项研究；AUC=0.69，95％CI0.65-0.73）或感染（6项研究；AUC=0.73，95％CI0.69-0.77）。PLR对严重疾病的诊断具有良好的准确性（六项研究；AUC=0.85，95％CI0.81-0.87）。没有足够的研究来评估PLR诊断SLE的准确性。狼疮性肾炎,或感染。没有研究调查患有心包炎或胸膜疾病的SLE患者的NLR和PLR。因此,NLR和PLR对SLE和狼疮性肾炎(NLR)以及严重疾病(PLR)的诊断准确率相对较高.需要进一步的研究来确定NLR和PLR是否，结合临床评估和其他血清学生物标志物，可以提高SLE的诊断和管理。
