Association between systemic inflammatory markers and recurrence risk in benign paroxysmal positional vertigo: a retrospective cohort study

There are many applications to emergency services due to acute colonic diverticulitis. It is necessary to decide whether these patients are complicated, to quickly predict their prognosis, and to decide whether medical or invasive treatment is necessary. We planned to research effectiveness NLR, NLR, SII, and SIRI values calculated using hemogram data can predict the prognosis of acute diverticulitis. We managed a retrospective scanning with patients who applied with a diagnosis of acute diverticulitis between 06/2020 and 04/2023. Demographic data (age, gender, previous surgery, comorbid diseases), tomographic Hinchey classification, location of diverticulitis, applied treatment, and obtained from blood parameters at presentation to the emergency department WBC, CRP, NLR, dNLR, SII, SIRI parameters were recorded from the electronically registered patient files. According to the Hinchey classification, those with Hinchey 0 and 1a were included in the noncomplicated group A class because they were followed up with outpatient medical follow-up. Those with Hinchey 1b,2,3,4 were included in the complicated GROUP B class. Differences in WBC, CRP, NLR, dNLR, SIRI, SII values between the complicated and noncomplicated groups were evaluated statistically. There were 286 patients with acute diverticulitis on the dates indicated. The number of patients eligible for the study was eighty-two. According to Hinchey's classification, 56 patients had noncomplicated acute diverticulitis (SAD) and 26 patients had complicated diverticulitis (CAD). These diagnoses were given based on tomography findings and clinical evaluations. The hospital stay was longer in the CAD group compared to the SAD group (p < 0.001) statistically significantly. The rate of surgical procedures and percutaneous interventions in the CADs was higher than SADs (p: 0.040) statistically significantly. WBC (white blood cell), NLR, dNLR, SIRI, SII and CRP parameters were higher in CADs than in SADs as statistically significant. Spearman's correlation analysis showed between the Hinchey classification and the NLR, dNLR, SII, SIRI, CRP, WBC parameters with high correlation as positive. Determination of values SIRI (2.42), NLR (3.35), SII (907.44) dNLR (4.63), CRP (15.25) WBC (11.16) and specificity and fractionation of these values ROC analysis was performed for this purpose. Highest AUC (area under the curve) value was found in WBC [0.807 0.703-0.910)], SIRI [0.786 (, 0.681-0.892)], SII [0.767 (0.654-0.880)], NLR [0.740 (0.624-0.854)], dNLR [0.739 (0.625-0.853)]. This study showed that there are SII, SIRI dNLR, NLR, CRP, and WBC values in patients presenting with acute diverticulitis a very high correlation with Hinchey classification in distinguishing complicated and non-complicated acute diverticulitis (p < 0.01). These data were higher in CADs than in SADs statistically significantly. The use of these data can both prevent unnecessary radiation in patients suspected of acute diverticulitis by reducing unnecessary tomography scans and can be valuable in predicting the prognosis of diverticulitis at a low cost.

Our study aimed to compare the systemic immune inflammation index (SII), one of the hematological inflammation parameters, between pregnant women diagnosed with threatened abortion (TA) and healthy pregnant women, and to evaluate the prediction of abortion in pregnant women with TA. This retrospective study compared 150 patients with TA group and 150 age- and gestational week-matched healthy pregnant women (control group). Complete blood count parameters were assessed. SII, white blood cells (WBC), neutrophil to lymphocyte ratio (NLR), red cell distribution width (RDW), plateletcrit (PCT), platelet distribution width and monocyte to lymphocyte ratio (MLR) values were calculated. The SII value was calculated as follows: platelet count × (neutrophil/lymphocyte). SII, NLR, MLR, WBC, RDW, and PCT values were significantly higher in the TA group compared to the control group (923 ± 683 vs. 579 ± 364 [p < 0.001], 3.3 ± 2.0 vs. 2.1 ± 1.1 [p < 0.001], 0.3 ± 0.1 vs. 0.2 ± 0.2 [p < 0.001], 9.84 ± 2.87 vs. 8.6 ± 1.6 [p < 0.001], 13.9 ± 1.9 vs. 14.4 ± 2.3 [p = 0.032] and 0.3 ± 0.1 vs. 0.2 ± 0.0 [p < 0.001], respectively). Using receiver operating characteristics curve analysis to predict abortion in AI patients, the highest area under the curve was found for SII (0.727 for SII and 0.666 for NLR). SII, NLR, MLR, RDW, and platelet to lymphocyte ratio (PLR) levels were significantly increased in patients with TA. This study supports the idea that several inflammatory pathways may play an important role in the pathogenesis of this disorder. SII may be a much better marker than NLR and PLR for predicting the inflammatory status of the disease and abortion in an ongoing pregnancy.

AimVascular dysfunction, oxidative stress and systemic inflammation are considered responsible for the pathophysiology of Obstructive sleep apnea syndrome (OSAS). It is thought that desaturation due to apnea–hypopnea attacks in OSAS patients activates inflammatory pathways. In this study, we aimed to reveal the relationship between inflammation parameters Systemic immune inflammation index (SII), neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratios (PLR) severity of OSAS in patients who underwent polysomnography in our hospital’s sleep laboratory.MethodsWe grouped our 171 patients who were followed up in our sleep laboratory with the diagnosis of OSAS according to their AHI values. We evaluated the correlation of SII, NLR, and PLR values obtained from the complete blood tests of our patients with OSAS diagnosis and OSAS severity.ResultsThe mean NLR, PLR and SII values of patients with OSAS were statistically significantly higher than those without OSAS (p < 0.05). A positive correlation of 18% was found between the presence of OSAS and the SII value (p = 0.016). No statistically significant difference was found when comparing OSAS severity and NLR, PLR and SII values (p > 0.05).ConclusionWe observed that SII, NLR and PLR parameters, which are rapidly assessable systemic inflammation markers of this process, were independently associated in patients diagnosed with OSAS and that there was no change in SII, NLR, and PLR parameters with OSAS severity.

Systemic immune-inflammation index (SII) and neutrophil-to-lymphocyte ratio (NLR) are novel inflammatory markers based on neutrophil, platelet and lymphocyte counts. Atherosclerosis is a chronic inflammatory vascular disease. This study aimed to verify the predictive value of the clinical parameters such as systemic immune-inflammation index (SII) and neutrophil-to-lymphocyte ratio (NLR) for the severity in Large Artery Atherosclerosis (LAA) stroke patients. The SII is defined as platelet × (neutrophil count/lymphocyte count), the NLR is defined as neutrophil count/lymphocyte count. Univariate logistic regression was used to analyze the association between SII and NLR and NIHSS score in patients with LAA stroke. Multiple logistic regression was used to analyze the risk factors for the severity of LAA stroke. We plotted receiver operating characteristic curves to determine the diagnostic role of SII and NLR in differentiating stroke disease severity. We included 283 LAA stroke patients, the SII and NLR in the moderate-to-severe stroke group were significantly higher than the mild stroke group. Multiple logistic regression analysis showed that SII (OR 1.051 95% CI (1.035-1.066), P < 0.001), NLR (OR 1.077,95% CI (1.032-1.123), P < 0.001) were significantly associated with stroke severity. The SII values under the receiver operating characteristic curve (0.701, 95% CI (0.649-0.791, P < 0.001, cut-off value 912.97) and NLR values under the receiver operating characteristic curve (0.604,5% CI (0.519-0.689), P < 0.01, cut-off value 1.461), and SII values had high discrimination ability. Both SII and NLR had high diagnostic and predictive value for stroke severity, and SII was better than NLR. The higher SII and NLR, the more severity in LAA stroke patients. SII and NLR are independent risk factors for LAA stroke, and they can also effectively predict stroke severity; moreover, SII has a higher diagnostic efficacy than NLR. However, multicenter studies with large sample size are still needed to confirm this conclusion.

Aim: In this study, the correlation between the change in bone mineral density (BMD) and the numerical value of the systemic immune inflammation index (SII) in postmenopausal Turkish women was investigated.Material and methods: The study comprised patients who had undergone menopause for at least one year and whose blood samples were examined by dual-energy X-ray absorptiometry (DEXA) on the same day. A retrospective evaluation of 527 postmenopausal women was performed. Age, body mass index (BMI), BMD, t score, neutrophil-lymphocyte-platelet-monocyte counts, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), and SII (platelet count x neutrophil count/lymphocyte count) values were calculated and recorded.Results: When the data were analyzed with the Statistical Package for the Social Sciences (SPSS; IBM SPSS Statistics for Windows, version 26.0. Armonk, NY: IBM Corp.), neutrophil (p<0.001), lymphocyte (p=0.004), monocytes (p=0.002), platelet distribution width (PDW) (p=0.02), procalcitonin (PCT) (p=0.04), erythrocyte sedimentation rate (ESR) (p=0.001), C-reactive protein (CRP) (p=0.001), NLR (p=0.001), PLR (p=0.004), MLR (p=0.003), and SII (p=0.001) values were found to be higher in the postmenopausal osteoporosis (PMO) group than in the normal and osteopenia groups (p<0.05). When the platelet (p=0.15), mean platelet volume (MPV) (p=0.07), and 25-OH vitamin-D (p=0.15) values were compared, no correlation was found between the groups (normal, osteopenia, and PMO) (p>0.05).Conclusion: This study revealed that NLR, PLR, MLR, and SII values were inversely correlated with the change in BMD in postmenopausal Turkish women. These biomarkers, which are obtained from a simple, affordable, and accessible routine blood examination, may play an effective role in the early diagnosis and prevention of PMO in the future.

The role of first-trimester NLR (neutrophil to lymphocyte ratio), systemic immune-inflammation index (SII), and, systemic immune-response index (SIRI) in the prediction of composite adverse outcomes in pregnant women with systemic lupus erythematosus

Neuroblastoma (NB) is a common pediatric solid tumor, particularly in children under 2 years. While survival rates for low- and intermediate-risk NB have improved, the prognosis for high-risk patients remains poor. Inflammation plays a crucial role in tumor progression, and systemic inflammation markers have prognostic value in various cancers. This study investigates the prognostic significance of neutrophil-to-lymphocyte ratio (NLR), systemic immune-inflammation index (SII), and albumin-to-fibrinogen ratio (AFR) in NB patients. A retrospective analysis was conducted on 166 NB patients diagnosed between January 2013 and November 2024 at Hebei Provincial Children’s Hospital. Preoperative blood parameters, including neutrophil, lymphocyte, platelet counts, albumin, and fibrinogen levels, were used to calculate NLR, SII, and AFR. ROC curves assessed the relationship between these markers and patient outcomes. Kaplan-Meier survival analysis and Cox regression were performed to evaluate their prognostic value. NLR and SII had high predictive value for mortality, with ROC AUCs of 0.90 and 0.89, respectively. AFR had lower predictive value (AUCs of 0.73 and 0.74). Kaplan-Meier analysis showed that high NLR, low AFR, and high SII correlated with poorer overall survival (OS) and event-free survival (EFS). Both univariate and multivariate Cox regression identified NLR and SII as independent risk factors for OS and EFS. This study demonstrates the prognostic value of NLR, SII, and AFR in the evaluation of NB prognosis, particularly highlighting the efficacy of NLR and SII in predicting mortality and recurrence risks.

Introduction/BackgroundThe primary endpoint of the present study was to assess the role of systemic inflammatory and molecular markers on DFS in patients with apparent early-stage endometrial cancer.MethodologyRetrospective, single-center, observational study....

IntroductionInflammatory processes and neurodegeneration are common features of Alzheimer's disease (AD). The systemic immune-inflammation index (SII), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) are easily accessible, cost-effective prognostic indicators of inflammation status. We assessed the diagnostic value of SII and compared the efficacies of NLR, PLR, and SII in predicting AD severity.Materials and MethodsBetween January 2021 and December 2022, this prospective, cross-sectional clinical study included 175 patients with AD and 61 controls. SII, NLR, and PLR were calculated.ResultsAge, white blood cell and lymphocyte counts, and NLR and PLR values were significantly different between the patient and control groups (P <.05). Age, hemoglobin, neutrophil, NLR, and SII values were significantly different among dementia severity subgroups (P <.05). Compared with PLR and SII, NLR was more strongly correlated with dementia severity. In the analysis of adjusted data by gender, it was found that hemoglobin level is significantly negatively associated with dementia severity in males, while in females, age and PLR are significantly positively associated with dementia severity, and lymphocyte count and SII are negatively associated.ConclusionSII, a novel inflammatory marker, was associated with dementia severity in patients with AD. Compared with PLR and SII, NLR was more strongly correlated with dementia severity. In future studies with larger populations, SII and NLR values can be used to determine dementia severity and establish follow-up plans for patients with high dementia risk.

Preoperative Systemic Inflammatory Indices and Their Association with Tumor Burden and Surgical Outcomes in High-Grade Serous Ovarian Cancer.

PurposeTo investigate the role of inflammatory factors including systemic immune-inflammation index (SII) and neutrophil to lymphocyte ratio (NLR) in predicting Gleason Score (GS) and Gleason Score upgrading (GSU) in localized prostate cancer (PCa) after radical prostatectomy (RP).MethodsThe data of 297 patients who underwent prostate biopsy and RP in our center from January 2014 to March 2020 were retrospectively analyzed. Preoperative clinical characteristics including age, values of tPSA, total prostate volume (TPV), f/t PSA ratio, body mass index (BMI), biopsy GS and inflammatory factors including SII, NLR, lymphocyte to monocyte (LMR), neutrophil ratio (NR), platelet to lymphocyte ratio (PLR), lymphocyte ratio (LR), mean platelet volume (MPV) and red cell distribution (RDW) as well as pathological T (pT) stage were collected and compared according to the grades of RP GS (GS ≤ 6 and GS≥7), respectively. ROC curve analysis was used to confirm the discriminative ability of inflammatory factors including SII, NLR and their combination with tPSA for predicting GS and GSU. By using univariate and multivariate logistic regression analysis, the association between significant inflammatory markers and grades of GS were evaluated.ResultsPatients enrolled were divided into low (GS ≤ 6) and high (GS≥7) groups by the grades of GS. The median values of clinical factors were 66.08 ± 6.04 years for age, 36.62 ± 23.15 mL for TPV, 26.16 ± 33.59 ng/mL for tPSA and 0.15 ± 0.25 for f/t PSA ratio, 22.34 ± 3.14 kg/m2 for BMI, 15 (5.1%) were pT1, 116 (39.1%) were pT2 and 166 (55.9%) were pT3. According to the student’s t test, patients in high GS group had a greater proportion of patients with pT3 (P<0.001), and higher NLR (P=0.04), SII (P=0.037) and tPSA (P=0.015) compared with low GS group, the distribution of age, TPV, f/t PSA ratio, BMI, LMR, NR, PLR, LR, MPV and RDW did not show any significantly statistical differences. The AUC for SII, NLR and tPSA was 0.732 (P=0.007), 0.649 (P=0.045) and 0.711 (P=0.015), with threshold values of 51l.08, 2.3 and 10.31ng/mL, respectively. According to the multivariable logistic regression models, NLR ≥ 2.3 (OR, 2.463; 95% CI, 0.679-10.469, P=0.042), SII ≥ 511.08 (OR, 3.519; 95% CI 0.891-12.488; P=0.003) and tPSA ≥ 10.31 ng/mL (OR, 4.146; 95% CI, 1.12-15.35; P=0.033) were all independent risk factors associated with higher GS. The AUC for combination of SII, NLR with tPSA was 0.758 (P=0.003) and 0.756 (P=0.003), respectively. GSU was observed in a total of 48 patients with GS ≤ 6 (55.17%). Then patients were divided into 2 groups (high and low) according to the threshold value of SII, NLR, tPSA, SII+tPSA and NLR+tPSA, respectively, when the GSU rates were compared with regard to these factors, GSU rate in high level group was significantly higher than that in low level group, P=0.001, 0.044, 0.017, <0.001 and <0.001, respectively.ConclusionHigh SII, NLR and tPSA were associated with higher GS and higher GSU rate. SII was likely to be a more favorable biomarker for it had the largest AUC area compared with tPSA and NLR; the combination of SII or NLR with tPSA had greater values for predicting GS and GSU compared with NLR, SII or tPSA alone, since the AUC area of combination was much higher. SII, NLR were all useful inflammatory biomarkers for predicting GS and detecting GSU among localized PCa patients with biopsy GS ≤ 6.

To determine the correlations between six serological inflammatory markers, namely the systemic immune-inflammation index (SII), systemic inflammatory response index (SIRI), aggregate index of systemic inflammation (AISI), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and monocyte-to-lymphocyte ratio (MLR), and various stages of type 2 diabetic retinopathy (T2DR). Additionally, the diagnostic value of these markers in T2DR was evaluated. Clinical data were collected from a total of 397 patients with type 2 diabetes who visited the ophthalmology department at Mian Yang Central Hospital and the Affiliated Hospital of Southwest Medical University from January 2023 to December 2023. Based on the results of fundus photography, patients were categorized into a non-diabetic retinopathy group (NDR, n = 121), a non-proliferative diabetic retinopathy group (NPDR, n = 77), and a proliferative diabetic retinopathy group (PDR, n = 199). General patient information and systemic inflammatory markers, including the SII, SIRI, AIRI, NLR, PLR, and MLR, were compared among the groups, and their correlations with T2DR were analyzed. The SII values were found to be significantly higher in the PDR group compared to the NPDR group, which in turn were higher than those in the NDR group (P < 0.05). Similarly, the AISI values were significantly elevated in the PDR group compared to both the NPDR and NDR groups (P < 0.05). The SIRI and MLR values were significantly higher in the PDR group than in the NDR group (P < 0.05). Furthermore, the NLR and PLR values were significantly higher in the NPDR and PDR groups compared to the NDR group (P < 0.05). The Mantel‒Haenszel chi-square test revealed a significant linear trend between the SII and PLR and the incidence of PDR (P < 0.001), with the incidence of PDR increasing as the quartile levels of the SII and PLR increased. Multivariate logistic regression analysis indicated that, compared with NDR, a higher SII was found to be an independent risk factor for NPDR (ORSII = 1.002, p = 0.001) and PDR (ORSII = 1.002, P < 0.001). The ROC curve analysis suggested that the combined assessment of the six inflammatory indices had the highest accuracy in the evaluation of DR, with an area under the curve (AUC) of 0.69, a sensitivity of 54%, and a specificity of 75%. The results of this study indicate that the SII is an independent risk factor for T2DR. A close correlation was observed between the SII and PLR and the occurrence and progression of T2DR. The high accuracy of the combined diagnosis of T2DR via various serological inflammatory markers underscores their potential as early biological indicators for the diagnosis of T2DR.

IntroductionThe platelet-lymphocyte ratio (PLR), neutrophil-lymphocyte ratio (NLR), and systemic immune-inflammation index (SII) are markers for systemic inflammatory responses and have been shown by numerous studies to correlate with the prognosis of gastric cancer (GC). However, the diagnostic value of these three markers in GC is unclear, and no research has examined them in combination. In this study, we investigated the value of the PLR, NLR, and SII individually or in combination for GC diagnosis and elucidated the connection of these three markers with GC patients’ clinicopathological features.MethodsThis retrospective study was conducted on 125 patients diagnosed with GC and 125 healthy individuals, whose peripheral blood samples were obtained for analysis. The preoperative PLR, NLR, and SII values were subsequently calculated.ResultsThe results suggest that the PLR, NLR, and SII values of the GC group were considerably higher than those of the healthy group (all P ≤ 0.001); moreover, all three parameters were notably higher in early GC patients (stage I/II) than in the healthy population. The diagnostic value of each index for GC was analyzed using receiver operating characteristic (ROC) curve analysis and area under the curve (AUC) calculation. The diagnostic efficacy of the SII alone (AUC: 0.831; 95% confidence interval [CI], 0.777–0.885) was expressively better than those of the NLR (AUC: 0.821; 95% CI: 0.769–0.873, P = 0.017) and PLR (AUC: 0.783; 95% CI: 0.726–0.840; P = 0.020). The AUC value of the combination of the PLR, NLR, and SII (AUC: 0.843; 95% CI: 0.791–0.885) was significantly higher than that of the combination of the SII and NLR (0.837, 95% CI: 0.785–0.880, P≤0.05), PLR (P = 0.020), NLR (P = 0.017), or SII alone (P ≤ 0.001). The optimal cut-off values were determined for the PLR, NLR, and SII using ROC analysis (SII: 438.7; NLR: 2.1; PLR: 139.5). Additionally, the PLR, NLR, and SII values were all meaningfully connected with the tumor size, TNM stage, lymph node metastasis, and serosa invasion (all P ≤ 0.05). Elevated levels of the NLR and SII were linked to distant metastasis (all P ≤ 0.001).DiscussionThese data suggest that the preoperative PLR, NLR, and SII could thus be utilized as diagnostic markers for GC or even early GC. Among these three indicators, the SII had the best diagnostic efficacy for GC, and the combination of the three could further improve diagnostic efficiency.

To investigate the predictive value of the systemic immune-inflammation index (SII) in patients with obstructive sleep apnea (OSA). Patients diagnosed with OSA formed the patient group, and those with a normal polysomnography (PSG) result formed the control group. The neutrophil, thrombocyte, monocyte, and lymphocyte counts obtained from the hemogram were used to calculate the neutrophil-to-lymphocyte ratio (NLR), thrombocyte-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), and the SII values. The two groups were compared with respect to the NLR, PLR, MLR, and SII values. Correlations were examined between the PSG parameters and the NLR, PLR, MLR, and SII values in the patient group. Evaluation included 146 subjects with 85 in the patient group and 61 in the control group. Statistically significantly higher SII and NLR values were found in the patient group (p = 0.037, p < 0.05; p = 0.015, p < 0.05). A statistically significant negative correlation was observed between the SII and the lowest O2 saturation measurements (r = - 0.246; p = 0.003; p < 0.01). A statistically significant negative correlation was found between the NLR and the lowest O2 saturation measurement (r = - 0.255; p = 0.002; p < 0.01). The cutoff value for SII was found to be 290, with 84.7% sensitivity and 29.5% specificity. A cutoff value of 1.71 for NLR was determined to have 61.2% sensitivity and 60.7% specificity. SII may be a new, rapid, low-cost, and easy-to-measure biomarker for the prediction of obstructivesleep apnea.

BackgroundRecurrence of genital warts remains a significant clinical challenge despite various treatment options. Systemic inflammatory indices derived from routine blood counts, such as the systemic immune-inflammation index (SII), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR), have recently been investigated as potential prognostic markers in HPV-related diseases.MethodsThis retrospective study included 217 male patients who underwent electrocauterisation for penoscrotal warts between March and September 2024. Patients were classified as having primary or recurrent lesions at presentation. Preoperative neutrophil, lymphocyte, and platelet counts were used to calculate inflammatory indices, and their associations with recurrence were analysed. Primary patients were also followed for 6months to assess post-treatment recurrence.ResultsRecurrent cases (44.2%) exhibited significantly higher SII, NLR, and PLR values compared with primary cases (p = 0.004, p = 0.011, and p = 0.047, respectively). Smoking prevalence was greater among recurrent patients (p = 0.008). Among primary patients, those who experienced recurrence at 6months had higher SII (p = 0.006) and NLR (p = 0.014). Multivariate analysis identified SII as an independent predictor of recurrence (OR = 1.42, 95% CI 1.08-1.91, p = 0.027).ConclusionsElevated SII and NLR levels are associated with an increased risk of genital wart recurrence, and SII independently predicts recurrence among primary cases. These inexpensive and readily available markers may aid in recurrence risk stratification and follow-up planning. Longer prospective studies incorporating HPV genotyping and behavioural risk factors are warranted to confirm these findings.