Application Of Neutrophil To Lymphocyte Ratio In Differential Diagnosis Of Pulmonary Sarcoidosis And Pulmonary Tuberculosis

Background and purposePulmonary sarcoidosis is a non-caseous necrotizing granulomatous disease with unclear etiology,which is difficult to distinguish from tuberculosis.Analyze the differences in peripheral blood neutrophilia lymphocyte ratio(NLR)between patients with pulmonary sarcoidosis and pulmonary tuberculosis,so as to clarify their value in the identification and evaluation of pulmonary sarcoidosis and tuberculosis,at the same time,combine with the results of clinical characteristics,ESR,CRP,ALB,and T-SPOT,to improve the ability to discriminate between the two diseases.Subjects and Methods60 cases of pulmonary sarcoidosis and 40 cases of pulmonary tuberculosis were selected,both of them were diagnosed by histopathology in the First Affiliated Hospital of Zhengzhou University,from January 1,2013 to October 31,2017.We retrospectively analyzed the clinical manifestations and laboratory examination indexes(neutrophil count,lymphocyte count,NLR,ALB,ESR,CRP,and T-SPOT)in two groups of patients,and summarized the comparisons.Results1.There were 60 patients with pulmonary sarcoidosis,including 17 males and 43 females.The average age was(51.07±10.68)years.There were 40 patients with pulmonary tuberculosis,26 males and 14 females.The average age was(45.18±18.63)years.There was a significant difference in gender and age between the two groups(all P<0.05).Compared with the pulmonary tuberculosis group,women in the pulmonary sarcoidosis group were more than men.2.Patients with pulmonary sarcoidosis were more likely to have cough,chest pain,and shortness of breath than pulmonary tuberculosis patients(all P<0.05),while,pulmonary tuberculosis patients had a high incidence of fever,hemoptysis,and wasting(all P<0.05).3.The NLR in the pulmonary sarcoidosis group was(3.06±1.18),and the NLR in the pulmonary tuberculosis group was(2.14±1.24),the difference was statistically significant(P<0.05);when NLR = 2.196,its largest index was 0.533,and the area under the curve was 0.779.The sensitivity for diagnosis of pulmonary sarcoidosis was 88.3%,and the specificity was 65%.4.The ALB value in the pulmonary sarcoidosis group was higher than that in the pulmonary tuberculosis group,and the difference was statistically significant(P<0.05).ESR and CRP values were lower in the pulmonary sarcoidosis group than in the pulmonary tuberculosis group,there was a significant difference between the two groups(P<0.05).The positive rate of T-SPOT in lung sarcoidosis group was 12.5 %,which was significantly lower than that of pulmonary tuberculosis group(72.5%)(P<0.05).ConclusionSerum NLR is helpful for the identification of pulmonary sarcoidosis and pulmonary tuberculosis.Other serological indicators such as ALB,ESR,CRP,and T-SPOT are also used to assist differential diagnosis.NLR may be used as an independent inflammatory marker for the diagnosis of pulmonary sarcoidosis,providing a new idea for the diagnosis of sarcoidosis,assessment of disease status,and the need for treatment.