What the study found
The study found that complete blood cell count-derived ratios, including the platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), and neutrophil-to-lymphocyte ratio (NLR), were higher in people with active tuberculosis. In people with rheumatic diseases, these measures had limited standalone value for diagnosing active tuberculosis, but they may help with risk stratification.
Why the authors say this matters
The authors say these ratios should be considered complementary tools, not replacements, for microbiological tests, because active tuberculosis often relies on clinical diagnosis when microbiologic testing has limited sensitivity. They also suggest these measures may be useful in resource-limited settings or to prompt further definitive testing.
What the researchers tested
The researchers enrolled 305 people with active tuberculosis and 171 healthy controls to evaluate diagnostic performance of CBC-derived ratios using receiver operating characteristic curves. They also validated the findings in a multi-center rheumatic disease cohort and used a nested case-control study to examine whether these ratios were linked to later development of active tuberculosis.
What worked and what didn't
Platelet, monocyte, and neutrophil counts increased, while lymphocyte count decreased, in people with active tuberculosis compared with healthy controls. PLR, MLR, and NLR were elevated, and the combination of monocyte count, PLR, and NLR showed good diagnostic efficiency with an area under the curve of 0.916; after anti-tuberculosis treatment, these indices were restored. In the rheumatic disease population, however, diagnostic efficiency was limited, with an area under the curve of 0.637, although PLR at or above 130.27 was associated with a higher one-year risk of developing active tuberculosis.
What to keep in mind
The abstract does not provide detailed limitations beyond noting limited standalone diagnostic value in rheumatic disease populations. The findings are presented within the studied groups and should not be taken as evidence that these ratios can replace microbiological testing.
Key points
- PLR, MLR, and NLR were higher in people with active tuberculosis than in healthy controls.
- A combination of monocyte count, PLR, and NLR had good diagnostic performance for active tuberculosis (AUC = 0.916).
- In people with rheumatic diseases, CBC-derived ratios had limited standalone diagnostic value for active tuberculosis (AUC = 0.637).
- PLR at or above 130.27 was associated with a higher one-year risk of developing active tuberculosis in the rheumatic disease cohort.
- The authors describe these ratios as complementary tools rather than replacements for microbiological tests.
Disclosure
- Research title:
- CBC-derived ratios show limited diagnostic value in rheumatic disease tuberculosis
- Authors:
- Fengying Wu, Xiaochun Shi, Yuanchun Li, Lantian Xie, Yuchen Liu, Ye Liu, Lifan Zhang, Xiaoqing Liu
- Institutions:
- Chinese Academy of Medical Sciences & Peking Union Medical College, Chinese Academy of Medical Sciences & Peking Union Medical College, Chinese Academy of Medical Sciences & Peking Union Medical College, Chinese Academy of Medical Sciences & Peking Union Medical College, Chinese Academy of Medical Sciences & Peking Union Medical College, Chinese Academy of Medical Sciences & Peking Union Medical College, Chinese Academy of Medical Sciences & Peking Union Medical College, Chinese Academy of Medical Sciences & Peking Union Medical College, Peking Union Medical College Hospital, Peking Union Medical College Hospital, Peking Union Medical College Hospital, Peking Union Medical College Hospital, Peking Union Medical College Hospital, Peking Union Medical College Hospital, Peking Union Medical College Hospital, Peking Union Medical College Hospital
- Publication date:
- 2026-02-25
- OpenAlex record:
- View
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