Defining the role of neutrophil-to-lymphocyte ratio in COPD: a systematic literature review
Yuliana Pascual-González,1 Marta López-Sánchez,1 Jordi Dorca,1 Salud Santos1,2 1Department of Respiratory Medicine, Bellvitge University Hospital – IDIBELL, University of Barcelona, L’Hospitalet de Llobregat, Barcelona, Spain; 2Biomedical Researc...
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doaj-d9585770f9a845a88f04615b884061b22020-11-24T21:06:51ZengDove Medical PressInternational Journal of COPD1178-20052018-11-01Volume 133651366242066Defining the role of neutrophil-to-lymphocyte ratio in COPD: a systematic literature reviewPascual-González YLópez-Sánchez MDorca JSantos SYuliana Pascual-González,1 Marta López-Sánchez,1 Jordi Dorca,1 Salud Santos1,2 1Department of Respiratory Medicine, Bellvitge University Hospital – IDIBELL, University of Barcelona, L’Hospitalet de Llobregat, Barcelona, Spain; 2Biomedical Research Networking Center Consortium – Respiratory Diseases (CIBERES), Barcelona, Spain Abstract: COPD is characterized by a pulmonary and systemic inflammatory process. Several authors have reported the elevation of multiple inflammatory markers in patients with COPD; however, their use in routine clinical practice has limitations. The neutrophil-to-lymphocyte ratio (NLR) is a useful and cost-effective inflammatory marker derived from routine complete blood count. We performed a systematic literature review using the PRISMA statement. Twenty-two articles were included, recruiting 7,601 COPD patients and 784 healthy controls. Compared with controls, COPD patients had significantly higher NLR values. We found a significant correlation between the NLR and clinical/functional parameters (FEV1, mMRC, and BODE index) in COPD patients. Elevation of the NLR is associated with the diagnosis of acute exacerbation of COPD (pooled data propose a cut-off value of 3.34 with a median sensitivity, specificity, and area under the curve of 80%, 86%, and 0.86, respectively). Additionally, increased NLR is also associated with the diagnosis of a bacterial infection in exacerbated patients, with a cut-off value of 7.30, although with a low sensitivity and specificity. The NLR is an independent predictor of in-hospital and late mortality after exacerbation. In conclusion, the NLR could be a useful marker in COPD patients; however, further studies are needed to better identify the clinical value of the NLR. Keywords: acute exacerbations of COPD, bacterial infection, mortality in COPD, inflammatory biomarkers, eosino­philia, GOLD stagehttps://www.dovepress.com/defining-the-role-of-neutrophil-to-lymphocyte-ratio-in-copd-a-systemat-peer-reviewed-article-COPDChronic obstructive pulmonary diseaseneutrophil-to-lymphocyte ratioacute exacerbations of COPDmortality in COPDinflammatory biomarkers |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Pascual-González Y López-Sánchez M Dorca J Santos S |
spellingShingle |
Pascual-González Y López-Sánchez M Dorca J Santos S Defining the role of neutrophil-to-lymphocyte ratio in COPD: a systematic literature review International Journal of COPD Chronic obstructive pulmonary disease neutrophil-to-lymphocyte ratio acute exacerbations of COPD mortality in COPD inflammatory biomarkers |
author_facet |
Pascual-González Y López-Sánchez M Dorca J Santos S |
author_sort |
Pascual-González Y |
title |
Defining the role of neutrophil-to-lymphocyte ratio in COPD: a systematic literature review |
title_short |
Defining the role of neutrophil-to-lymphocyte ratio in COPD: a systematic literature review |
title_full |
Defining the role of neutrophil-to-lymphocyte ratio in COPD: a systematic literature review |
title_fullStr |
Defining the role of neutrophil-to-lymphocyte ratio in COPD: a systematic literature review |
title_full_unstemmed |
Defining the role of neutrophil-to-lymphocyte ratio in COPD: a systematic literature review |
title_sort |
defining the role of neutrophil-to-lymphocyte ratio in copd: a systematic literature review |
publisher |
Dove Medical Press |
series |
International Journal of COPD |
issn |
1178-2005 |
publishDate |
2018-11-01 |
description |
Yuliana Pascual-González,1 Marta López-Sánchez,1 Jordi Dorca,1 Salud Santos1,2 1Department of Respiratory Medicine, Bellvitge University Hospital – IDIBELL, University of Barcelona, L’Hospitalet de Llobregat, Barcelona, Spain; 2Biomedical Research Networking Center Consortium – Respiratory Diseases (CIBERES), Barcelona, Spain Abstract: COPD is characterized by a pulmonary and systemic inflammatory process. Several authors have reported the elevation of multiple inflammatory markers in patients with COPD; however, their use in routine clinical practice has limitations. The neutrophil-to-lymphocyte ratio (NLR) is a useful and cost-effective inflammatory marker derived from routine complete blood count. We performed a systematic literature review using the PRISMA statement. Twenty-two articles were included, recruiting 7,601 COPD patients and 784 healthy controls. Compared with controls, COPD patients had significantly higher NLR values. We found a significant correlation between the NLR and clinical/functional parameters (FEV1, mMRC, and BODE index) in COPD patients. Elevation of the NLR is associated with the diagnosis of acute exacerbation of COPD (pooled data propose a cut-off value of 3.34 with a median sensitivity, specificity, and area under the curve of 80%, 86%, and 0.86, respectively). Additionally, increased NLR is also associated with the diagnosis of a bacterial infection in exacerbated patients, with a cut-off value of 7.30, although with a low sensitivity and specificity. The NLR is an independent predictor of in-hospital and late mortality after exacerbation. In conclusion, the NLR could be a useful marker in COPD patients; however, further studies are needed to better identify the clinical value of the NLR. Keywords: acute exacerbations of COPD, bacterial infection, mortality in COPD, inflammatory biomarkers, eosino­philia, GOLD stage |
topic |
Chronic obstructive pulmonary disease neutrophil-to-lymphocyte ratio acute exacerbations of COPD mortality in COPD inflammatory biomarkers |
url |
https://www.dovepress.com/defining-the-role-of-neutrophil-to-lymphocyte-ratio-in-copd-a-systemat-peer-reviewed-article-COPD |
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