The role of blood lymphocyte levels in evaluating endoscopic remission of inflammatory bowel disease

Inflammatory bowel disease (IBD) is chronic intestinal inflammation involving multiple etiologies. Lymphocyte migration contributes to its pathogenesis. This study aims to evaluate whether lymphocyte levels can discriminate against contemporaneous endoscopic status. This study enrolled IBD patients who were admitted to our hospital between March 2024 and November 2025. To compare the differences in serum-related parameters between IBD patients in endoscopic remission and those in endoscopic activity. If significant differences exist, further analyze the correlations between these parameters and endoscopic scores. Meanwhile, compare the serum concentrations of CXCL10 and CCL25 between IBD patients in endoscopic remission and those in endoscopic activity. A total of 195 patients (27 remission Crohn's disease (CD) patients, 82 active CD patients, 23 remission ulcerative colitis (UC) patients, 63 active UC patients) were enrolled. Lymphocyte percentage was significantly higher in remission groups of both CD and UC patients (all P <0.001), with optimal predictive thresholds of 30.3% (CD: AUC=0.890, sensitivity=81.5%, specificity = 89.0%) and 29.45% (UC: AUC=0.830, sensitivity=91.3%, specificity=71.0%). Serum CXCL10 and CCL25 levels were lower in remission CD patients ( P =0.024, P =0.050) but showed no difference in UC ( P > 0.05). Active UC patients’ lymphocyte percentage negatively correlated with UCEIS (r=− 0.363, P =0.001), while no correlation was found between blood indices and SES-CD in active CD. Peripheral blood lymphocyte percentage is a convenient, non-invasive indicator with high sensitivity and specificity for discrimination for contemporaneous endoscopic status. Serum CXCL10 and CCL25 concentrations in remission CD patients were significantly lower than those in active patients, whereas no such difference was observed in UC patients.