Predictive value of peripheral blood systemic immune-inflammation index and blood cell ratio for gastrointestinal polyp burden in patients with Peutz-Jeghers syndrome

Table 1 The burden of digestive tract polyps in Peutz-Jeghers syndrome patients

Polyp distribution site	Number and maximum diameter (mm)	Median	Interquartile range	Range (min, max)
Stomach (n = 490)	Number of polyps	10	(5, 10)	1, 100
	Diameter of polyps	10	(6, 15)	2, 80
Small intestine (n = 628)	Number of polyps	10	(5, 16)	1, 150
	Diameter of polyps	40	(25, 50)	3, 160
Colorectum (n = 525)	Number of polyps	7	(3, 11)	1, 147
	Diameter of polyps	25	(15, 40)	3, 120

Table 2 Correlation analysis of systemic immune-inflammation index, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and monocyte-to-lymphocyte ratio with polyp burden

Inflammatory indicator	Burden	Stomach	Small intestine	Colorectum
SII	Number	r = 0.032, P = 0.475	r = 0.206, P < 0.001	r = 0.115, P = 0.008
	Diameter	r = -0.020, P = 0.657	r = 0.058, P = 0.148	r = 0.077, P = 0.079
NLR	Number	r = 0.012, P = 0.792	r = 0.133, P = 0.001	r = 0.087, P = 0.047
	Diameter	r = -0.031, P = 0.492	r = 0.028, P = 0.479	r = 0.064, P = 0.144
PLR	Number	r = 0.025, P = 0.583	r = 0.128, P = 0.001	r = 0.023, P = 0.604
	Diameter	r = -0.044, P = 0.333	r = -0.022, P = 0.576	r = 0.004, P = 0.925
MLR	Number	r = 0.031, P = 0.486	r = 0.090, P = 0.024	r = 0.059, P = 0.181
	Diameter	r = -0.028, P = 0.532	r = 0.096, P = 0.017	r = 0.068, P = 0.123

SII: Systemic immune-inflammation index; NLR: Neutrophil-to-lymphocyte ratio; PLR: Platelet-to-lymphocyte ratio; MLR: Monocyte-to-lymphocyte ratio.

Table 3 Optimal cutoff, sensitivity, and specificity determined by the maximum Youden index

Indicator	Cut-off value	Sensitivity (%)	Specificity (%)	AUC (95%CI)	P value
SII	351.9	72.8	87.5	0.765 (0.702-0.828)	< 0.001
NLR	1.78	59.9	87.5	0.739 (0.674-0.804)	< 0.001
PLR	113	78.5	75	0.745 (0.681-0.809)	< 0.001
MLR	0.17	82.8	62.5	0.694 (0.625-0.763)	< 0.001
Number of small intestinal polyps	10	59.4	66.3	0.694 (0.621-0.767)	< 0.001
Diameter of small intestinal polyps (mm)	25	80.3	65.3	0.638 (0.561-0.715)	0.002

SII: Systemic immune-inflammation index; NLR: Neutrophil-to-lymphocyte ratio; PLR: Platelet-to-lymphocyte ratio; MLR: Monocyte-to-lymphocyte ratio; AUC: Area under the curve; CI: Confidence interval.

Table 4 Univariate and multivariate logistic regression analysis of high-risk polyps in Peutz-Jeghers syndrome patients

Factor	Large polyps (≥ 25 mm)		Multiple polyps (≥ 10)
	P value	Adjusted P value	P value	Adjusted P value
SII	0.302	-	0.003	0.815
NLR	0.749	-	0.007	0.804
PLR	0.467	-	< 0.001	0.012
MLR	0.028	0.053	0.087	0.899
Age	0.1	-	< 0.001	0.036
Family history	0.428	-	0.223	-
Number of intussusception episodes	0.004	0.04	< 0.001	0.004
Number of abdominal surgeries	0.042	0.919	< 0.001	0.133
Age at onset of mucocutaneous pigmentation	0.707	-	0.074	0.15

SII: Systemic immune-inflammation index; NLR: Neutrophil-to-lymphocyte ratio; PLR: Platelet-to-lymphocyte ratio; MLR: Monocyte-to-lymphocyte ratio.