Histologic Activity Modifies the Predictive Value of Systemic Inflammatory Markers in Ulcerative Colitis

What To Know

This study assessed whether simple blood ratios — neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), and neutrophil-to-platelet ratio (NPR) — predict clinical relapse in ulcerative colitis (UC) patients who had endoscopic improvement (Mayo endoscopic subscore 0–1).

Histologic activity was measured with the Geboes score and patients were grouped as histologic improvement (<3.1) or histologic activity (≥3.1). Key findings reported in the abstract: baseline NLR predicted relapse only among patients with histologic activity, not among those with histologic improvement; LMR and NPR were not associated with relapse.

The authors conclude that combining NLR with histologic assessment could improve relapse risk stratification. What this means for patients and clinicians This is an observational, retrospective cohort study reported as an abstract/full text in Diagnostics (MDPI).

The result suggests that a routinely available blood test (NLR) may have more prognostic value when interpreted alongside biopsy-based histology in patients who look improved on endoscopy. It does not alone establish a new standard of care.

Practical next steps Clinicians and researchers may consider these findings as hypothesis-generating: prospective validation would be needed before changing monitoring or treatment decisions. Patients can discuss with their gastroenterologist whether blood inflammatory indices and histology are being used together at their clinic for risk assessment.