Role of Neutrophil to Lymphocyte Ratio and IL-6 as Novel Prognostic Markers in Varicose Veins

Varicose veins represent one of the most frequent vascular diseases. Their pathogenic mechanisms are not well understood. Role of inflammation in pathophysiology of varicose veins is an area of ongoing research. In varicose veins, there are increased levels of inflammatory markers. The purpose of study was to evaluate role of inflammatory marker, neutrophil to lymphocyte ratio (NLR), and IL-6 in blood in disease progression, development of complications, and recurrence after treatment in patients with varicose veins. This study was conducted in the Department of General Surgery, Banaras Hindu University, Varanasi. A total of 40 patients with varicose veins were enrolled between June 2018 and September 2020. Serum concentration of IL‐6 was determined by DIA source Immuno Assays, Belgium IL-6 ELISA kit KAP126 . This kit is based on the standard sandwich enzyme‐linked immunosorbent assay technology which employs a monoclonal antibody specific for human IL‐6 coated on a 96‐well plate. This ELISA kit showed no cross-reactivity with other relevant proteins. Complete blood counts were done in automated analyzer. Blood smear was stained, fixed, and differential leucocyte counts calculated using microscopy. In our study, mean NLR at presentation in patients with and without postoperative complications was 4.33 ± 0.40 and 3.22 ± 0.80 respectively, with statistically significant difference ( p = 0.001). Mean serum IL-6 levels at presentation in patients with and without postoperative complications were 4.02 ± 0.54 and 2.65 ± 1.32 pg/ml respectively, with statistically significant difference ( p = 0.007). Thus, NLR and IL-6 levels at presentation may have a role as a prognostic factor. NLR and IL-6 levels can be utilized to screen patients likely to develop postoperative complications and recurrence.