Neutrophils to Lymphocytes Ratio and Platelets to Lymphocytes Ratio as Predictors of Small Intestinal Lesions Detected by Video Capsule Endoscopy

Abstract

Abstract Background Capsule endoscopy (CE), also known as wireless capsule endoscopy or video capsule endoscopy, is a gastrointestinal study that uses a pill camera to take images of the intestinal lumen. Objective: Patients and Methods The study was conducted on 93 subjects from the Gastroenterology and Hepatology Department of Ain Shams University Hospital. They were divided into three different groups as following: Crohn’s disease group, arteriovenous malformation group and small intestinal tumor group. All patients and controls were subjected to routine laboratory tests and NLR and PLR was estimated. Results There was statistically significant difference between control group and AVM group and Crohn's group as regard N/L ratio, while this difference is less significant in tumor group patient. Receiver operating characteristic curve (ROC) shows that the best cut off point of N/L ratio to detect AVM group was found >1.97 with sensitivity of 67.74, specificity of 72.04% and total accuracy of 73%, and the best cut off point of P/L ratio to detect AVM group was found >158.02 with sensitivity of 61.29%, specificity of 96.77%, and total accuracy of 78%. Receiver operating characteristic curve (ROC) shows that the best cut off point of N/L ratio to detect Tumor group was found >1.97 with sensitivity of 45.16%, specificity of 72.04% and total accuracy of 59%, and Receiver operating characteristic curve (ROC) shows that the best cut off point of P/L ratio to detect Tumor group was found >145.83 with sensitivity of 32.26%, specificity of 91.40% and total accuracy of 62%. Receiver operating characteristic curve (ROC) shows that the best cut off point of N/L ratio to detect Crohn's group was found >2.44 with sensitivity of 100.0%, specificity of 84.95 and total accuracy of 96%, and Receiver operating characteristic curve (ROC) shows that the best cut off point of P/L ratio to detect Crohn's group was found >138.35 with sensitivity of 80.65%, specificity of 89.25% and total accuracy of 92%. Conclusion N/L ratio and P/L ratio can be used as non- invasive and cheap predictors for severity of crohn's disease, arteriovenous malformations and stage of malignancy in small intestinal tract.