Analysis on the Relationship Between NLR,Procalcitonin and Poor Prognosis of Autoimmune Encephalitis Based on ROC Curve

Wang Weihua; Zhang Tian; Li Hao

doi:10.3969/j.issn.1004-5775.2025.23.005

Abstract：Objective:To analyze the correlation between the neutrophil-to-lymphocyte ratio(NLR),procalcitonin(PCT)levels,and poor prognosis in autoimmune encephalitis(AE)patients based on receiver operating characteristic(ROC)curve analysis.Methods:Selecting 80 AE patients treated at Nanyang Central Hospital from May 2021 to December 2023.Clinical data,peripheral blood NLR,serum PCT levels,and other laboratory test results were collected.The modified Rankin Scale(mRS)was used to assess post-treatment outcomes,with patients categorized into a good prognosis group(n=47)and a poor prognosis group(n=33).Clinical data,NLR,and PCT levels were compared between the two groups.Spearman's correlation analysis was conducted to examine the relationship between NLR,PCT levels,and AE prognosis.Logistic regression was employed to identify factors influencing AE prognosis.ROC curves were constructed to evaluate the predictive value of NLR and PCT levels for poor outcomes in AE patients.Results:The poor prognosis group exhibited higher NLR,PCT and mRS scores levels than the good prognosis group,the difference was statistically significant(P＜0.05).Spearman's correlation analysis revealed a positive correlation between NLR,PCT levels,and mRS scores(P＜0.05).Univariate regression analysis indicated significant differences in hospital stay duration,prevalence of psychiatric and behavioral abnormalities,NLR,PCT,C-reactive protein(CRP),cerebrospinal fluid(CSF)antibody positivity rate,CSF oligoclonal band positivity rate,and CSF-IgG index between the two groups,the differences were all statistically significant(P＜0.05).Logistic regression identified increased NLR,elevated PCT levels,CSF antibody positivity,and a rise in the CSF-IgG index were risk factors for poor prognosis in AE patients(P＜0.05).ROC curve analysis showed that the areas under the curve(AUC)for NLR and PCT were 0.724 and 0.805,respectively,with a combined detection AUC of 0.885,indicating that combined testing had greater predictive value than individual tests(P＜0.05).Conclusion:There is a positive correlation between NLR and PCT levels and poor outcomes in AE(P＜0.05).Increased NLR,elevated PCT levels,CSF antibody positivity,and a rise in the CSF-IgG index are risk factors for poor prognosis in AE patients.Both NLR and PCT levels can serve as predictive indicators for poor prognosis in AE patients,with combined testing offering even greater prognostic significance.