Abstract Background The neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) are promising inflammatory markers in inflammatory bowel disease (IBD), but their correlation with objective disease activity is not well established.1 We aimed to assess their association with endoscopic and histological findings. Methods This retrospective study reviewed medical records of patients followed in our department from January 2020 to October 2025. Demographic data, endoscopic findings, and histology results were collected. Patients with confirmed IBD were included if they underwent endoscopy in our unit and blood count parameters (neutrophils, lymphocytes, platelets) available within two weeks of the procedure. Endoscopic activity was classified as remission/mild or moderate/severe using the Mayo endoscopic score for ulcerative colitis (UC) and the Simple Endoscopic Score for Crohn’s Disease (CD) and histological activity as present or absent. Comparisons between activity groups, correlation analyses, logistic regression, and ROC curve evaluation were performed to assess the association and predictive value of NLR and PLR for endoscopic and histologic disease activity. All analyses were conducted in RStudio. Results A total of 104 patients met the inclusion criteria (mean age 47.6 years; 66 males; 38 females), including 42 with CD and 62 with UC. PLR demonstrated a statistically significant association with endoscopic disease activity (β0 = –1.2774, β₁ = 0.0063). ROC analysis showed an AUC of 0.608, with an optimal threshold of 145.09 corresponding to a sensitivity of 64.44% and a specificity of 59.32%. PLR did not correlate with histological inflammation (p = 0.18). NLR was significantly associated with histologic inflammation in a probit regression model (β0 = –0.02707, β₁ = 0.23253, p = 0.041), with an AUC of 0.629 and an optimal cut-off of 2.7 (sensitivity 52%, specificity 80%). However, NLR did not correlate significantly with endoscopic disease activity (p = 0.10). Conclusion NLR and PLR may serve as useful, accessible biomarkers, showing potential correlations with endoscopic and histological activity. Their non-invasive and cost-effective nature supports their role as adjunct tools in the assessment of IBD inflammation. Reference: 1. Li P, Wu Y, Xiong W, Cao J, Chen M, Yuan Z, Guo W, Yang B. Association between the immune-inflammation index and the severity and clinical outcomes of patients with inflammatory bowel disease: a systematic review and meta-analysis. BMC Gastroenterol. 2025 May 29;25(1):414. doi: 10.1186/s12876-025-04033-4. PMID: 40442599; PMCID: PMC12121125. Conflict of interest: Rellou, Sofia: No conflict of interest Kordalis, Leonidas: No conflict of interest Panagaris, Stefanos: None Efstathiou, Stylianos: No conflict of interest Lamprou, Stefanos: No conflict of interest Masina, Vasiliki: No conflict of interest Manou, Despoina: No conflict of interest Sdonas, Theodosios: No conflict of interest Tasovasili, Athanasia: Nothing to declare
Rellou et al. (Thu,) studied this question.