Intestinal Research

Original Articles

Inflammatory Bowel Diseases

The role of platelet to lymphocyte ratio and neutrophil to lymphocyte ratio in ulcerative colitis: Yujin Jeong, Seong Ran Jeon, Hyun Gun Kim, Jung Rock Moon, Tae Hee Lee, Jae Young Jang, Jun-Hyung Cho, Jun Seok Park, Heesu Park, Ki-hun Lee, Jin-Oh Kim, Joon Seong Lee, Bong Min Ko, Suyeon Park; Intest Res 2021;19(1):62-70. Published online May 8, 2020; DOI: https://doi.org/10.5217/ir.2019.09156

Background/Aims
Neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) can serve as biomarkers for diagnosing and assessing disease activity in ulcerative colitis (UC). We investigated their clinical significance in UC.
Methods
We analyzed 48 patients with UC who underwent measurement of fecal calprotectin (FC) and endoscopy and 96 age- and sex-matched healthy controls. NLR and PLR were compared between the patients and healthy controls. The endoscopic activity was divided into 2 groups: group 1 (mild to moderate inflammation) and group 2 (severe inflammation) according to the Mayo endoscopic subscore in UC.
Results
To diagnose UC, the optimal cutoff of NLR and PLR was 2.26 (sensitivity 54.2%; specificity 90.6%; positive likelihood ratio 5.778, 95% confidence interval [CI] 2.944–11.339; area under the curve [AUC] 0.774, 95% CI, 0.690–0.859) and 179.8 (sensitivity 35.4%; specificity 90.6%; positive likelihood ratio 3.778, 95% CI 1.821–7.838; AUC 0.654, 95% CI 0.556–0.753), respectively. The optimal cutoff to differentiate group 1 and group 2 was 3.44, 175.9, and 453 µg/g for NLR, PLR, and FC, respectively (sensitivity, 63.6% vs. 90.9% vs. 81.8%; specificity, 81.1% vs. 78.4% vs. 73.0%; positive likelihood ratio, 3.364 vs. 4.205 vs. 3.027; AUC, 0.714 vs. 0.897 vs. 0.813). PLR had the highest AUC and positive likelihood ratio.
Conclusions
NLR and PLR help differentiate patients with UC from healthy controls. NLR, PLR, and FC indicate endoscopic activity and may reflect intestinal mucosal conditions.

Citations

Citations to this article as recorded by

Predictive Value of Albumin to Fibrinogen Ratio and CALLY Index for Diagnosis of Ulcerative Colitis and Mucosal Healing After Vedolizumab Treatment
Kairong Su, Sinan Xiao, Mei Wang, Kairuo Wang, Qing Fan, Sumei Sha, Yongli Cheng, Xin Liu, Haitao Shi
Journal of Inflammation Research.2025; Volume 18: 589. CrossRef
The ability of C-reactive protein-albumin ratio to predict disease activity in ulcerative colitis
Ibrahimhalil Dusunceli, Zeynep Gok Sargin, Umut Celik, Fatih Sargin
Biomarkers in Medicine.2025; 19(4): 113. CrossRef
Exploring the utility of cellular indices in the diagnosis of ulcerative colitis
Julio César Moreno Alfonso, Sharom Barbosa-Velásquez, Carlos Delgado-Miguel, Ada Molina Caballero, Sara Hernández-Martín, Alberto Pérez Martínez, María Concepción Yárnoz Irazábal
Gastroenterología y Hepatología.2025; : 502349. CrossRef
Clinical relevance of inflammatory markers in the evaluation of severity of ulcerative colitis: A retrospective study
Tao He, Lian-Qiang Song, Xiao-Yu Weng, Peng Pan, Hui Ding, Mei-Qin Liu, Shi-Lin Qiu, Shan-Ming Sun
Open Life Sciences.2025;[Epub] CrossRef
Development and validation of a nomogram for predicting endoscopic healing in crohn’s disease patients receiving infliximab treatment
Lixuan Li, Ting Feng, Xuanzhi Huang, Xiaoman Zu, Minhu Chen, Yun Qiu
BMC Gastroenterology.2025;[Epub] CrossRef
Ischemia-modified albumin: a novel blood marker of endoscopic mucosal healing in inflammatory bowel disease
Seung Bum Lee, Hyun-Ki Kim, Sang Hyuk Park, Ji-Hun Lim, Sang Hyoung Park
Intestinal Research.2024; 22(1): 75. CrossRef
Evaluation of the prognostic nutritional index (PNI) as a tool for assessing disease activity in rheumatoid arthritis patients
Nuran Öz, Halise Hande Gezer, Selin Cilli Hayıroğlu, Mehmet Tuncay Duruöz
Clinical Rheumatology.2024; 43(5): 1461. CrossRef
Progress in Biomarkers of Inflammatory Bowel Disease
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Advances in Clinical Medicine.2024; 14(03): 1418. CrossRef
Fecal calprotectin and platelet count predict histologic disease activity in pediatric ulcerative colitis: results from a projection-predictive feature selection
B. Schiller, E. Wirthgen, F. Weber, S. Schiller, M. Radke, M. Claßen, J. Däbritz, S. Buderus, P. Bufler, J. Däbritz, S. Dammann, J. de Laffolie, M. Friedt, A. Hauer, K. M. Keller, A. Krahl, M. Laaß, T. Lang, C. Posovszky, B. Rodeck, S. Trenkel
European Journal of Pediatrics.2024; 183(8): 3277. CrossRef
Association of Hemogram Parameters with Body Mass Index in Knee Osteoarthritis
Koksal Gundogdu, Gülşah Gündoğdu, Alper Kurtoğlu
Online Türk Sağlık Bilimleri Dergisi.2024; 9(3): 202. CrossRef
Systemic Immune-Inflammation Index: Unveiling the Diagnostic Potential in Ulcerative Colitis through a Comprehensive Systematic Review and Meta-Analysis
Anas Elgenidy, Omar Alomari, Tasbih Emad, Sara K. Kamal, Islam E. Al Ghanam, Aya Sherif, Mohammed Al-mahdi Al-kurdi, Abdallah A. Helal, Yusof Mohamed Omar, Mohamed Rafiek Ramadan
Gastroenterology & Endoscopy.2024;[Epub] CrossRef
CRP/Albumin Ratio as Potential Indicator for Assessment of Disease Activity in Inflammatory Bowel Disease Patients
Fatma Abdel-Kader Attia Mohamed, Eman Refaat Youness, Marwa M. Hassan, Nesma Hassan Hasanein Ashour
Biomedical and Pharmacology Journal.2024; 17(4): 2683. CrossRef
Cytomegalovirus Reactivation in Ulcerative Colitis Patients: Early Indicators
LN Altunal, AS Ozel, C AK
Nigerian Journal of Clinical Practice.2023; 26(6): 765. CrossRef
The role of platelet-to-lymphocyte ratio and neutrophil-to-lymphocyte ratio in the diagnosis and severity of inflammatory bowel disease in children
Arefeh Zahmatkesh, Mohammad Hassan Sohouli, Seyed Mahmoud Eshagh Hosseini, Pejman Rohani
European Journal of Pediatrics.2023; 182(9): 4263. CrossRef
Ülseratif kolit aktivitesi ve şiddetinin invaziv olmayan biyobelirteçler ile değerlendirilmesi
İlyas TENLİK, Orhan COŞKUN, Mustafa ÇAPRAZ, Volkan GÖKBULUT, Ömer ÖZTÜRK
Akademik Gastroenteroloji Dergisi.2023; 22(2): 59. CrossRef
Interrelation of Hypoxia-Inducible Factor-1 Alpha (HIF-1 α) and the Ratio between the Mean Corpuscular Volume/Lymphocytes (MCVL) and the Cumulative Inflammatory Index (IIC) in Ulcerative Colitis
Ioan Sabin Poenariu, Lidia Boldeanu, Bogdan Silviu Ungureanu, Daniel Cosmin Caragea, Oana Mariana Cristea, Vlad Pădureanu, Isabela Siloși, Anca Marinela Ungureanu, Răzvan-Cristian Statie, Alina Elena Ciobanu, Dan Ionuț Gheonea, Eugen Osiac, Mihail Virgil
Biomedicines.2023; 11(12): 3137. CrossRef
Effect of ozone therapy on neutrophil/lymphocyte, platelet/lymphocyte ratios, and disease activity in ankylosing spondylitis
Habibe İnci, Fatih İnci
Medical Gas Research.2023; 13(2): 53. CrossRef
Biomarker dynamics during infliximab salvage for acute severe ulcerative colitis: C-reactive protein (CRP)-lymphocyte ratio and CRP-albumin ratio are useful in predicting colectomy
Danny Con, Bridgette Andrew, Steven Nicolaides, Daniel R van Langenberg, Abhinav Vasudevan
Intestinal Research.2022; 20(1): 101. CrossRef
Personalized medicine in inflammatory bowel disease: Perspectives on Asia
Su Hyun Park, Sang Hyoung Park
Journal of Gastroenterology and Hepatology.2022; 37(8): 1434. CrossRef
The Usefulness of Extended Inflammation Parameters and Systemic Inflammatory Response Markers in the Diagnostics of Autoimmune Hepatitis
Weronika Domerecka, Anna Kowalska-Kępczyńska, Iwona Homa-Mlak, Agata Michalak, Radosław Mlak, Marcin Mazurek, Halina Cichoż-Lach, Teresa Małecka-Massalska
Cells.2022; 11(16): 2554. CrossRef
Complete Blood Count-Derived Inflammatory Markers Changes in Dogs with Chronic Inflammatory Enteropathy Treated with Adipose-Derived Mesenchymal Stem Cells
José Ignacio Cristóbal, Francisco Javier Duque, Jesús Usón-Casaús, Rafael Barrera, Esther López, Eva María Pérez-Merino
Animals.2022; 12(20): 2798. CrossRef
Evaluation of neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio as potential markers for ulcerative colitis: a retrospective study
Wan Feng, Yajun Liu, Lei Zhu, Luzhou Xu, Hong Shen
BMC Gastroenterology.2022;[Epub] CrossRef
Association of Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio with Diabetic Kidney Disease in Chinese Patients with Type 2 Diabetes: A Cross-Sectional Study
Lan Li, Qing Shen, Sijie Rao
Therapeutics and Clinical Risk Management.2022; Volume 18: 1157. CrossRef
Evaluation of Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio in Chronic Plaque Psoriasis
Sudeshna Mondal, Samudra Guha, Abanti Saha, Loknath Ghoshal, Debabrata Bandyopadhyay
Indian Journal of Dermatology.2022; 67(4): 477. CrossRef
Correlations of disease severity and age with hematology parameter variations in patients with COVID‐19 pre‐ and post‐treatment
Juanying Liang, Shaoyun Nong, Liejun Jiang, Xiaowei Chi, Dewu Bi, Jun Cao, Lida Mo, Xiaolu Luo, Huayi Huang
Journal of Clinical Laboratory Analysis.2021;[Epub] CrossRef
Elevated systemic immune inflammation index level is associated with disease activity in ulcerative colitis patients
Yiyi Xie, Tingting Zhuang, Ying Ping, Yingzhi Zhang, Xuchu Wang, Pan Yu, Xiuzhi Duan
Clinica Chimica Acta.2021; 517: 122. CrossRef
Endoscopy within 7 days after detecting high calprotectin levels can be useful for therapeutic decision-making in ulcerative colitis
Ho Min Yong, Sung-Jo Park, Seong Ran Jeon, Heesu Park, Hyun Gun Kim, Tae Hee Lee, Junseok Park, Jin-Oh Kim, Joon Seong Lee, Bong Min Ko, Hyeon Jeong Goong, Suyeon Park
Medicine.2021; 100(34): e27065. CrossRef
Inflammatory Bowel Disease and Neutrophil–Lymphocyte Ratio: A Systematic Scoping Review
Blake O. Langley, Sara E. Guedry, Joshua Z. Goldenberg, Douglas A. Hanes, Jennifer A. Beardsley, Jennifer Joan Ryan
Journal of Clinical Medicine.2021; 10(18): 4219. CrossRef
Lymphocyte-to-Monocyte Ratio as a Marker for Endoscopic Activity in Ulcerative Colitis
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Peripheral blood neutrophil-to-lymphocyte ratio in inflammatory bowel disease and disease activity: A meta-analysis
Wei Fu, Hu Fu, Weixia Ye, Yinsuo Han, Xianqiang Liu, Sirui Zhu, Hongmin Li, Rong Tang, Qin Wang
International Immunopharmacology.2021; 101: 108235. CrossRef
Neutrophil-to-Lymphocyte and Platelet-to-Lymphocyte Ratios as Noninvasive Predictors of the Therapeutic Outcomes of Systemic Corticosteroid Therapy in Ulcerative Colitis
Katsuya Endo, Tomonori Satoh, Yuki Yoshino, Shiho Kondo, Yoko Kawakami, Tomofumi Katayama, Yoshiteru Sasaki, Atsuko Takasu, Takayuki Kogure, Morihisa Hirota, Takayoshi Meguro, Kennichi Satoh
Inflammatory Intestinal Diseases.2021; 6(4): 218. CrossRef
Association between platelet count and mucosal healing in Japanese patients with ulcerative colitis: a cross-sectional study
Shinya Furukawa, Sen Yagi, Kana Shiraishi, Kenichirou Mori, Tomoyuki Ninomiya, Keitarou Kawasaki, Yuji Mizukami, Seiyuu Suzuki, Masayoshi Uraoka, Naozumi Shibata, Sanae Nakamura, Satoshi Imamine, Hidehiro Murakami, Katsuhisa Ohashi, Masamoto Torisu, Aki H
BMC Gastroenterology.2020;[Epub] CrossRef

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Practice patterns and clinical significance of use of capsule endoscopy in suspected and established Crohn's disease: Yonghyun Kim, Seong Ran Jeon, Sang Myung Choi, Hyun Gun Kim, Tae Hee Lee, Jun-Hyung Cho, Yunho Jung, Wan Jung Kim, Bong Min Ko, Jin-Oh Kim, Joon Sung Lee, Moon Sung Lee; Intest Res 2017;15(4):467-474. Published online October 23, 2017; DOI: https://doi.org/10.5217/ir.2017.15.4.467

Abstract PDF PubReader ePub

Background/Aims

Although the role of capsule endoscopy (CE) in Crohn's disease (CD) has expanded, CE is not used routinely for diagnosing and evaluating CD in Korea. We aimed to investigate current patterns of practice and evaluate the clinical significance of the use of CE in CD in Korean patients.

Methods

Among 651 CE procedures performed for various indications, we retrospectively analyzed the medical records of patients who underwent CE in 57 cases of suspected CD (sCD) and 14 cases of established CD (eCD).

Results

In the sCD group, CE was most commonly used for the initial diagnosis of CD (54.4%). Capsule retention was found in only 1 patient in the eCD group (1/71, 1.4%). In the sCD group, 28.1% of patients were diagnosed with CD on the basis of CE findings; other diseases diagnosed included tuberculous enteritis (7.0%), non-steroidal anti-inflammatory drug-induced enteropathy (5.3%), and other enteritis (17.5%). Only 11.5% of patients with eCD (14/122) underwent CE. The indication for CE in the 14 patients with eCD was to assess disease extent and activity. The overall diagnostic yield of CE was 59.7%. Therapeutic strategies were changed in 70.2% of patients in the sCD group and 50% of those in the eCD group based on CE findings.

Conclusions

In clinical practice, CE was most commonly indicated for the initial diagnosis of CD and was not generally performed in patients with eCD. CE appears to be an effective diagnostic modality for evaluating sCD and is useful for determining therapeutic strategies for patients with sCD and those with eCD.

Citations

Citations to this article as recorded by

Video capsule endoscopy in inflammatory bowel disease
Kenji J.L. Limpias Kamiya, Naoki Hosoe, Yukie Hayashi, Takaaki Kawaguchi, Kaoru Takabayashi, Haruhiko Ogata, Takanori Kanai
DEN Open.2022;[Epub] CrossRef
Enteroscopy in Crohn’s Disease: Are There Any Changes in Role or Outcomes Over Time? A KASID Multicenter Study
Seong Ran Jeon, Jin-Oh Kim, Jeong-Sik Byeon, Dong-Hoon Yang, Bong Min Ko, Hyeon Jeong Goong, Hyun Joo Jang, Soo Jung Park, Eun Ran Kim, Sung Noh Hong, Jong Pil Im, Seong-Eun Kim, Ja Seol Koo, Chang Soo Eun, Dong Kyung Chang
Gut and Liver.2021; 15(3): 375. CrossRef
Capsule Endoscopy in Crohn’s Disease—From a Relative Contraindication to Habitual Monitoring Tool
Adi Lahat, Ido Veisman
Diagnostics.2021; 11(10): 1737. CrossRef
Use of small bowel capsule endoscopy in clinical practice: how has it performed?
Seong Ran Jeon
The Korean Journal of Internal Medicine.2020; 35(4): 854. CrossRef
Pursuing therapeutic success in Crohn’s disease: A matter of definition, tools and longterm outcomes
Loredana Goran, Monica State, Ana Maria Negreanu, Lucian Negreanu
European Journal of Inflammation.2020; 18: 205873922096289. CrossRef
Capsule endoscopy: Current status and role in Crohn’s disease
Loredana Goran, Ana Maria Negreanu, Ana Stemate, Lucian Negreanu
World Journal of Gastrointestinal Endoscopy.2018; 10(9): 184. CrossRef
Role of capsule endoscopy in suspected or established Crohn's disease in real practice
Hyun Joo Jang
Intestinal Research.2017; 15(4): 431. CrossRef

6,788 View
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Double-Balloon Enteroscopy in Elderly Patients: Is It Safe and Useful?: Dae Han Choi, Seong Ran Jeon, Jin-Oh Kim, Hyun Gun Kim, Tae Hee Lee, Woong Cheul Lee, Byung Soo Kang, Jun-Hyung Cho, Yunho Jung, Wan Jung Kim, Bong Min Ko, Joo Young Cho, Joon Seong Lee, Moon Sung Lee; Intest Res 2014;12(4):313-319. Published online October 27, 2014; DOI: https://doi.org/10.5217/ir.2014.12.4.313

Abstract PDF PubReader ePub

Background/Aims

Providers may be hesitant to perform double-balloon enteroscopy (DBE) in the elderly because the increased number of co-morbidities in this population poses a greater risk of complications resulting from sedation. There are limited data on the use of DBE in the elderly. Here, we assessed the safety and efficacy of DBE in the elderly compared to those in younger patients.

Methods

We retrospectively analyzed the medical records of 158 patients who underwent 218 DBEs. Patients were divided into an elderly group (age ≥65 years; mean 71.4±5.4; n=34; 41 DBEs) and a younger group (age <65 years; mean 39.5±13.5; n=124; 177 DBEs).

Results

In both groups, the most common indication for DBE was obscure gastrointestinal bleeding. Mucosal lesions (33.3% vs. 60.9%; P=0.002) were the most common finding in both groups, followed by tumors (30.8% vs. 14.1%; P=0.036). The elderly were more likely to receive interventional therapy (51.3% vs. 23.5%; P=0.001). The diagnostic yield of DBE was slightly higher in the elderly group (92.3% vs. 86.5%; P=0.422), but was not statistically significant. The therapeutic success rate of DBE was 100% in the elderly group compared to 87.5% in the younger group (P=0.536). The overall DBE complication rate was 1.8% overall, and this rate did not differ significantly between the groups (2.6% vs. 1.7%; P=0.548).

Conclusions

DBE is safe and effective in the elderly, and has a high diagnostic yield and high therapeutic success rate.

Citations

Citations to this article as recorded by

Clinical outcomes in frail elderly patients undergoing small-bowel capsule endoscopy
Rebecca K Grant, Alexander R Robertson, Kirsty A Lennon, Eksha Gupta, Ursula E Walton, Ross J Porter, Niall T Burke, Solomon Ong, Atul Anand, Sarah Douglas, Alice Corbett, William M Brindle, Rahul Kalla, John N Plevris
Frontline Gastroenterology.2025; 16(1): 30. CrossRef
Outcomes of Double Balloon-Enteroscopy in Elderly vs. Adult Patients: A Retrospective 16-Year Single-Centre Study
Margherita Trebbi, Cesare Casadei, Silvia Dari, Andrea Buzzi, Mario Brancaccio, Valentina Feletti, Alessandro Mussetto
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Stefania Chetcuti Zammit, David S. Sanders, Reena Sidhu
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J.J.E. García-Correa, J.J. Ramírez-García, L.F. García-Contreras, C. Fuentes-Orozco, L. Irusteta-Jiménez, L.R. Michel-Espinoza, A.S. Carballo Uribe, J.A. Torres Chávez, A. González-Ojeda
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Hey-Long Ching, Federica Branchi, David S Sanders, David Turnbull, Reena Sidhu
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Efficacy and Safety of Single-Balloon Enteroscopy in Elderly Patients
Chen-Wang Chang, Ching-Wei Chang, Wei-Chen Lin, Chia-Hsien Wu, Horng-Yuan Wang, Tsang-En Wang, Cheng-Hsin Chu, Ming-Jen Chen
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Diagnostic yield and safety of double balloon-assisted enteroscopy in the elderly: A systematic review and meta-analysis
Y. Chen, G. Liu, T. Zhang, K. Yang, H. Yu, Y. Tie, J. Liang, J. Zhou, H. Gan
European Geriatric Medicine.2017; 8(4): 354. CrossRef
Clinical outcome after enteroscopy for small bowel angioectasia bleeding: A Korean Associateion for the Study of Intestinal Disease (KASID) multiceter study
Seong Ran Jeon, Jeong‐Sik Byeon, Hyun Joo Jang, Soo Jung Park, Jong Pil Im, Eun Ran Kim, Ja Seol Koo, Bong Min Ko, Dong Kyung Chang, Jin‐Oh Kim, Su Yeon Park
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Ahilan Arulanandan, Parambir S Dulai, Siddharth Singh, William J Sandborn, Denise Kalmaz
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Current status and future perspectives of capsule endoscopy
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Author's Reply
Seong Ran Jeon
Intestinal Research.2015; 13(1): 99. CrossRef
Clinical Characteristics and Treatment Outcomes of Cryptogenic Multifocal Ulcerous Stenosing Enteritis in Korea
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Questions About Sedation Protocols for Double-Balloon Enteroscopy
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