Diagnostic value of CRP/Albumin-globulin ratio and monocyte-to-lymphocyte ratio in differentiating parapneumonic effusion types.

IF 3.3 4区医学 Q1 Medicine

European review for medical and pharmacological sciences Pub Date : 2025-08-01 DOI:10.26355/eurrev_202508_37358

N A Yetkin, F M Simsek, B Baran, B Rabahoglu, N Tutar, I Gulmez

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引用次数: 0

Abstract

OBJECTIVE: Parapneumonic effusion (PPE), a pneumonia-related complication, can progress to complicated PPE (CPPE) and often requires invasive treatment. Although early differentiation is essential, the diagnostic role of hematological inflammatory markers remains unclear. This study evaluated hematological inflammatory markers to distinguish between pleural effusion types, particularly CPPE and uncomplicated PPE (uCPPE), in order to identify the most reliable biomarkers. MATERIALS AND METHODS: This retrospective study analyzed 94 cases of pleural effusion classified as transudative, malignant, tuberculous, or PPE. PPE was further divided into CPPE and uCPPE. C-reactive protein (CRP) and procalcitonin (PCT) levels, systemic immune-inflammation index (SII), systemic inflammation response index (SIRI), CRP/albumin-globulin ratio (CAGR), albumin-globulin ratio (AGR), neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), and platelet-lymphocyte ratio (PLR) were analyzed. Receiver Operating Characteristic (ROC) curve analysis was used to determine the diagnostic accuracy via the area under the curve (AUC) and optimal cut-off values. RESULTS: Inflammatory markers effectively differentiated pleural effusion types, with CAGR showing the highest accuracy for PPE diagnosis (AUC, 0.866; cut-off: 13.75; sensitivity = 93.8%, specificity = 51.1%). Among the CPPE and uCPPE markers, MLR demonstrated the best performance (AUC: 0.707; cut-off: 3.615; sensitivity: 87.5%; specificity: 77.8%), followed by NLR (AUC: 0.702) and PLR (AUC: 0.704), whereas SIRI and SII had modest utility. Although MLR showed superior accuracy, the addition of SII improved the sensitivity. CONCLUSIONS: This study demonstrates that among hematological markers, CAGR is the most accurate for diagnosing PPE, while MLR best distinguishes CPPE from uCPPE. However, the limited specificity of CAGR highlights the need for the combined use of biomarkers. Prospective multicenter studies are warranted to validate and refine these findings.

Graphical abstract: https://www.europeanreview.org/wp/wp-content/uploads/Graphical-abstract-2-2-scaled.jpg.

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CRP/白蛋白/球蛋白比值及单核细胞/淋巴细胞比值在鉴别肺旁积液类型中的诊断价值。

目的：肺旁积液（PPE）是一种肺炎相关并发症，可发展为复杂的PPE (CPPE)，通常需要侵入性治疗。虽然早期鉴别是必要的，但血液学炎症标志物的诊断作用尚不清楚。本研究评估血液学炎症标志物来区分胸腔积液类型，特别是CPPE和单纯PPE (uCPPE)，以确定最可靠的生物标志物。材料和方法：本回顾性研究分析了94例胸腔积液，分类为透出性、恶性、结核性或PPE。PPE进一步分为cpppe和uCPPE。分析c反应蛋白（CRP）、降钙素原（PCT）水平、全身免疫-炎症指数（SII）、全身炎症反应指数（SIRI）、CRP/白蛋白-球蛋白比值（CAGR）、白蛋白-球蛋白比值（AGR）、中性粒细胞-淋巴细胞比值（NLR）、单核细胞-淋巴细胞比值（MLR）、血小板-淋巴细胞比值（PLR）。采用受试者工作特征（ROC）曲线分析，通过曲线下面积（AUC）和最佳截止值确定诊断准确性。结果：炎症标志物能有效鉴别胸腔积液类型，诊断PPE的CAGR准确率最高（AUC为0.866；cut-off为13.75；敏感性为93.8%，特异性为51.1%）。在CPPE和uCPPE标记中，MLR表现出最好的性能（AUC: 0.707; cut-off: 3.615；敏感性：87.5%；特异性：77.8%），其次是NLR （AUC: 0.702）和PLR (AUC: 0.704)，而SIRI和SII的效用一般。虽然MLR显示出优越的准确性，但SII的加入提高了灵敏度。结论：本研究表明血液学指标中，CAGR诊断PPE最准确，MLR区分CPPE和uCPPE最准确。然而，CAGR的有限特异性强调了联合使用生物标志物的必要性。有必要进行前瞻性多中心研究来验证和完善这些发现。图形摘要：https://www.europeanreview.org/wp/wp-content/uploads/Graphical-abstract-2-2-scaled.jpg。

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来源期刊

European review for medical and pharmacological sciences 医学-药学

CiteScore

5.30

自引率

6.10%

发文量

906

审稿时长

2-4 weeks

期刊介绍： European Review for Medical and Pharmacological Sciences, a fortnightly journal, acts as an information exchange tool on several aspects of medical and pharmacological sciences. It publishes reviews, original articles, and results from original research. The purposes of the Journal are to encourage interdisciplinary discussions and to contribute to the advancement of medicine. European Review for Medical and Pharmacological Sciences includes: -Editorials- Reviews- Original articles- Trials- Brief communications- Case reports (only if of particular interest and accompanied by a short review)