DYNAMIC CHANGES IN INFLAMMATORY INDICES AFTER LAPAROSCOPIC COMMON BILE DUCT EXPLORATION IN MALE AND FEMALE PATIENTS WITH COMPLEX COMMON BILE DUCT STONES

IntroductionWe analyzed the correlation between systemic immune inflammatory index (SII), systemic inflammatory response index (SIRI), systemic inflammatory index (AISI), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR) and mortality in patients with bloodstream infection to determine their application potential in predicting the prognosis of bloodstream infection.MethodsWe calculated SII, SIRI, AISI, NLR, PLR, and MLR in 469 patients with bloodstream infections. Logistic regression modeling, generalized additive modeling (GAM), and smoothed curve fitting were used to investigate the correlation of SII and other inflammatory markers with mortality in patients with bloodstream infections. Area under the curve (AUC) of ROC was used to assess the predictive effect of SII and other inflammatory markers.ResultsLevels of SII, SIRI, AISI, NLR, PLR, and MLR were significantly higher in the mortality group of this study (P < 0.05). There were significant differences in gender, age, diabetes, cardiovascular disease, respiratory disease, NEUT and LUMPH between the survival group and the death group (p < 0.05). Smooth curve fitting and GAM showed that SII and NLR had a non-linear relationship with death. After adjustment, the breakpoints (K) were 1711 and 7.22, respectively (P < 0.05), and there was a positive correlation on both sides of the breakpoint. The comparison of AUC values showed that SII and NLR had higher accuracy in predicting the risk of death in patients with bloodstream infection.ConclusionStudies demonstrates that SII and NLR are more predictive of mortality risk in patients with bloodstream infections. Patients with diabetes, cardiovascular disease, or respiratory disease should be monitored regularly for SII and NLR indicators to reduce the risk of death.

BackgroundCervical cerclage is a surgical procedure aimed at providing mechanical support to the cervix in patients with cervical insufficiency. This study aimed to investigate the relationship between preoperatively evaluated systemic inflammatory markers — the Systemic Immune-Inflammation Index (SII), Systemic Inflammatory Response Index (SIRI), Platelet-to-Lymphocyte Ratio (PLR), Neutrophil-to-Lymphocyte Ratio (NLR), Monocyte-to-Lymphocyte Ratio (MLR), and Neutrophil-to-Monocyte Ratio (NMR) — and perinatal outcomes in pregnant women undergoing cervical cerclage, as well as to compare the distribution of these markers across different cerclage indication groups (history, physical examination, ultrasound).Materials and methodsThis retrospective study included 116 singleton pregnancies who underwent cervical cerclage at Bursa City Hospital between January 1, 2021, and December 30, 2024. Systemic inflammatory markers were assessed using hemogram values obtained within 24 h before the surgical procedure. Demographic data, hematologic parameters, and perinatal outcomes of all patients were recorded. Inflammatory indices (SII, SIRI, PLR, etc.) were calculated. Correlation analyses were conducted to evaluate the relationship between inflammatory markers and perinatal outcomes. Inflammatory markers with significant correlations were further assessed via Receiver Operating Characteristic (ROC) analysis for their predictive performance. Comparisons between groups were also performed. Patients were divided into three groups based on the indication for cerclage: history-based, physical examination (PE) findings, and ultrasound (USG) findings.ResultsAmong all patients who underwent cervical cerclage, significant negative correlations were observed between SII, PLR, and SIRI values and both gestational age and Apgar scores. For predicting preterm birth before 37 weeks, SII had an AUC of 0.654; for SIRI, the AUC was 0.622. In the subgroup analysis for delivery before 34 weeks, predictive performance improved: SII (AUC: 0.673), PLR (AUC: 0.647), and SIRI (AUC: 0.634). For low 1st minute Apgar scores, SII (AUC: 0.636) and PLR (AUC: 0.626) showed predictive utility, while for 5th minute Apgar < 7, SII maintained the highest predictive value (AUC: 0.631).In the comparison across cerclage indication groups, SII and PLR values were also found to be significantly higher in the PE and USG groups compared to the history group (p < 0.05). Additionally, gestational age at delivery, birth weight, and Apgar scores were significantly lower in the PE group.ConclusionThe negative correlations observed between SII, PLR, SIRI values and gestational age and Apgar scores support the potential role of these markers as predictive biomarkers for preterm birth and adverse neonatal outcomes. Simple and cost-effective hematologic parameters may serve as valuable tools in the management of pregnant women undergoing cervical cerclage.

The study aimed to evaluate the accuracy with which various nutritional and inflammatory indicators, including Neutrophil-to-Lymphocyte Ratio (NLR), Platelet-to-Lymphocyte Ratio (PLR), Systemic Immune-Inflammation Index (SII), Monocyte-to-Lymphocyte Ratio (MLR), Systemic Inflammatory Response Index (SIRI), and Prognostic Nutritional Index (PNI), can predict the severity of acute calculus cholecystitis. 109 cases of chronic calculus cholecystitis (CCC) and 130 cases of acute calculus cholecystitis (ACC), including 62 cases of acute simple cholecystitis (ASC), 35 cases of acute purulent cholecystitis (APC), and 33 cases of acute gangrenous cholecystitis (AGC), were encompassed in the retrospective cohort study. The patients' clinical information and inflammatory-immune markers were collected for analysis. The optimal cut-off values for NLR, SIRI, SII, MLR, PLR, and PNI in distinguishing ACC from CCC were determined to be 2.499, 0.964, 593.5, 0.230, 148.0, and 141.3, respectively. NLR > 2.499 demonstrated the highest predictive capability, with an AUC of 0.896. Multivariate analysis indicated that NLR > 2.499 (OR: 4.69, p = 0.006) was the dominant factor in differentiating ACC from CCC. The optimal cut-off values for SII, SIRI, MLR, NLR, PLR, and PNI in distinguishing ASC from APC were 1098, 2.092, 0.304, 4.082, 191.1, and 135.3, respectively. SII > 1098 exhibited the highest predictive capability, with an AUC of 0.73. The optimal cut-off values for NLR, SIRI, MLR, SII, and PLR in differentiating APC from AGC were 7.232, 4.773, 0.557, 2417, and 221.5, respectively. NLR > 7.232 demonstrated the highest predictive capability, with an AUC of 0.826. Systemic inflammatory index and nutritional marker can serve as valuable indicators for predicting acute calculus cholecystitis and its severity. An elevated systemic inflammatory index and a declining nutritional marker suggest an increased risk of severe cholecystitis, warranting prompt and appropriate interventions.

Objective: To analyze the comprehensive blood inflammation index of the patients with stage I pneumoconiosis complicated with pulmonary infection, and to explore its value in predicting the patients' disease. Methods: In September 2023, 83 patients with stage I pneumoconiosis who were treated in Tianjin Occupational Diseases Precaution and Therapeutic Hospital from November 2021 to August 2023 were selected and divided into non-infected group (56 cases) and infected group (27 cases) according to whether they were combined with lung infection. Workers with a history of dust exposure but diagnosed without pneumoconiosis during the same period were selected as the control group (65 cases) . By referring to medical records and collecting clinical data such as gender, age, occupational history, past medical history, hematology testing, the differences in the comprehensive blood inflammation indexes among the three groups were compared, ROC curve was drawn, and the relationship between comprehensive blood inflammation indexes and stage I pneumoconiosis and its combined lung infection was analyzed. Results: There were significtant differences in the number of neutrophils (N) , the number of lymphocytes (L) , the number of monocytes (M) , C-reactive protein (CRP) , the neutrophil to lymphocyte ratio (NLR) , the monocyte to lymphocyte ratio (MLR) , the platelet to lymphocyte ratio (PLR) , the systemic immune-inflammatory index (SII) , the systemic inflammation response index (SIRI) , the aggregate index of systemic inflammation (AISI) , the derived neutrophil to lymphocyte ratio (dNLR) , the neutrophil to lymphocyte and platelet ratio (NLPR) , and the C-reactive protein to lymphocyte ratio (CLR) (P<0.05) . Compared with the control group, MLR, SIRI and AISI in the non-infected group were significantly increased (P<0.05) . NLR, MLR, PLR, SII, SIRI, AISI, dNLR, NLPR, CLR were significantly increased (P<0.05) . Compared with the non-infected group, NLR, PLR, SII, SIRI, AISI, dNLR, NLPR and CLR were significantly increased in the infected group (P<0.05) . ROC analysis showed that NLR, MLR, PLR, SII, SIRI and AISI had a certain predictive capability for stage I pneumoconiosis (P<0.05) , among which MLR had the highest efficacy, with an AUC of 0.791 (95% CI: 0.710-0.873) , the cut-off value was 0.18, the sensitivity was 71.4%, and the specificity was 78.5%. NLR, MLR, PLR, SII, SIRI, AISI, dNLR, NLPR and CLR all had a certain predictive capability forstage I pneumoconiosis combined lung infection (P<0.05) , among which CLR had the highest efficacy, with an AUC of 0.904 (95%CI: 0.824~0.985) , the cut-off value was 5.33, sensitivity was 77.8%, specificity was 98.2%. Conclusion: The comprehensive blood inflammation index may be an auxiliary predictor of stage I pneumoconiosis and its combined lung infections.

ObjectiveThis investigation intends to clarify the disparities in hematological parameters and ratios among different age groups,providing new insights for the diagnostic of Mycobacterium Avium Complex Pulmonary Disease (MAC-PD).Patients and MethodsA retrospective investigation was undertaken to examine the hematological parameters of elderly (n=88) and non-elderly (n=44) patients diagnosed with MAC-PD at Hebei Chest Hospital between 2020 and 2024. The study involved the calculation of the neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), platelet-to-lymphocyte ratio (PLR), hemoglobin-to-lymphocyte ratio (HLR),hemoglobin-to-platelet ratio (HPR),systemic inflammatory response index (SIRI) and systemic immune-inflammation index (SII). Statistical analyses were executed utilizing SPSS 27.0 and R (4.2.1) software.ResultsThe levels of absolute lymphocyte count (ALC),hemoglobin (Hb) and LMR were lower in Elderly MAC group compared to Non-elderly MAC group. Conversely,the levels of NLR, PLR,HLR,SIRI and SII were higher in Elderly MAC group than in Non-elderly MAC group. There was a certain correlation between the Ct value of MAC nucleic acid and NLR, LMR, SIRI and SII (P<0.05) in Elderly MAC group. In Non-elderly MAC group, the Ct value of MAC nucleic acid was correlated with absolute neutrophil count (ANC), LMR, SIRI and SII (P<0.05). Receiver operating characteristic curve (ROC) analysis indicated that NLR, LMR, SIRI and SII exhibited high diagnostic value in Elderly MAC group,while LMR, SIRI and SII demonstrated high diagnostic value in Non-elderly MAC group. The combined diagnostic value was even more prominent. Nevertheless,no significant diagnostic indicators were identified between Elderly MAC group and Non-elderly MAC group.ConclusionThe combination of NLR, LMR, SIRI and SII may serve as diagnostic markers for Elderly MAC-PD and the combination of LMR, SIRI and SII may serve as diagnostic markers for Non-lderly MAC-PD. But there were no significant diagnostic indicators differentiating Elderly MAC group from Non-elderly MAC group.

Correlation study of multiple inflammatory indices and vertebral compression fracture: A cross-sectional study

Background: Duchenne Muscular Dystrophy (DMD) is an X-linked recessive neuromuscular disorder that is characterized by progressive muscle weakness, musculoskeletal limitations, and pulmonary involvement, with cardiomyopathy and cardiovascular complications being a primary cause of morbidity and mortality. With advances in respiratory care, cardiac involvement has become the leading cause of death. There is growing interest in systemic inflammatory indices as potential predictors of cardiovascular involvement. This study aimed to evaluate the prognostic value of inflammatory markers—neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), platelet-to-lymphocyte ratio (PLR), systemic inflammatory response index (SIRI), systemic immune-inflammation index (SII), and pan-immune inflammation value (PIV)—in children with DMD and to explore their association with cardiac findings. Methods: In this retrospective study, 25 male patients diagnosed with DMD and 25 age-matched healthy male controls were evaluated between January 2021 and July 2024. Demographic and clinical data, hematologic and biochemical parameters, and inflammatory indices were recorded. Cardiovascular involvement was assessed using electrocardiography (ECG) and transthoracic echocardiography (TTE). Group comparisons were performed using independent t-tests, while ROC and Pearson correlation analyses were used for diagnostic performance and associations. Results: Pathological Q waves were the most frequent ECG abnormality (24%), and 16% of patients had echocardiographic abnormalities. While most systemic inflammatory indices (NLR, MLR, SIRI, SII, PIV) did not significantly distinguish cardiovascular involvement, PLR demonstrated a strong positive correlation with Pro-BNP levels (r = 0.86, p < 0.05), suggesting a potential link between systemic inflammation and subclinical cardiac stress. Conclusions: Although the overall diagnostic utility of inflammatory indices in predicting cardiovascular complications in DMD was limited, PLR showed a correlation with Pro-BNP in our cohort. However, given the small sample size and limited number of patients with ventricular dysfunction, this finding should be interpreted with caution. PLR may warrant further investigation as a potential marker of cardiovascular involvement in DMD, but larger prospective studies are needed to validate its clinical significance.

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.

Objectives:To uncover the predictive value of systemic immune-inflammatory index (SII) and systemic inflammatory response index (SIRI) on early pregnancy loss.Methods:A total of 535 individuals were enrolled in this retrospective analysis. The early pregnancy losses (EPL) group included patients between 18-35 years old who experienced EPL. The control group comprised healthy pregnant women who gave birth at ≥37 weeks.Results:The EPL group had significantly lower plateletcrit (p=0.04), platelet distribution width (PDW, p<0.0001), and RDW (p<0.0001) and higher monocyte (p<0.0001) and SIRI (p<0.0001) values than the control group. The hemoglobin, white blood cells, platelet count, neutrophil count, lymphocyte count, mean platelet volume, neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), and SII values were not significantly different between the EPL and control groups (p>0.05). The cut-off value for the SIRI that offers the best sensitivity/specificity balance was 1.48 (sensitivity of 63%; specificity of 63%) in the receiver operating characteristics curve. Among the inflammatory parameters for predicting EPL, PDW had highest specificity (84%), and RDW had the highest sensitivity (80%).Conclusion:This study provides compelling evidence that various inflammatory pathways may significantly contribute to EPL pathogenesis. Moreover, our findings suggest that SIRI could be a more effective marker than NLR, PLR, MLR, and SII in predicting EPL in an ongoing pregnancy, thereby potentially revolutionizing early pregnancy loss diagnostics.

The systemic immune-inflammatory index (SII) and systemic inflammatory response index (SIRI), as novel non-specific inflammatory markers, have recently drawn attention. At present, no studies have been conducted to investigate the value of SII and SIRI in gouty arthritis (GA), so we explored their possible association with GA disease activity. The study enrolled 474 patients with acute gouty arthritis (AG), 399 patients with intercritical gouty arthritis (IG) and 194 healthy controls (HC). The differences in Monocyte-to-lymphocyte ratio (MLR), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), SII, and SIRI levels among different groups were assessed. The changes in the above indicators before and after treatment in the AG and IG groups were evaluated. Multivariate logistic regression analysis was assessed influencing factors for the acute gout attack. ROC curves were plotted to evaluate their diagnostic value for AG. Compared with the IG group, the erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), PLR, and incidence of hyperlipidemia in the AG group were significantly higher, and the duration of disease was significantly shorter (P < 0.05). The MLR, NLR, SII and SIRI in the AG group were significantly higher than those in the IG and HC groups (P < 0.05). Compared with baseline, decreased MLR, NLR, PLR, SII and SIRI were observed in the AG group after treatment (P < 0.05), while there was no significant difference in the IG group before and after treatment (P > 0.05). SIRI was positively correlated with ESR and CRP (P < 0.05). Multivariate logistic regression analysis result showed that duration of disease, hyperlipidemia, ESR, CRP, and SIRI were influencing factors of acute gout attack (P < 0.05). The AUC of ESR, CRP and SIRI on the diagnosis in AG were 0.664, 0.755, and 0.674, respectively. SIRI may be used as a new inflammatory marker of disease activity with gouty arthritis.

Inflammation and nutritional markers have recently gained recognition for their roles in the fabrication of cognitive control centers demyelinating illnesses. Inflammatory indices such as the neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammatory index (SII), and systemic inflammatory response index (SIRI), along with nutritional markers like albumin (ALB), hemoglobin (HB), and body mass index (BMI), may predict disease occurrence. However, their potential in evaluating diseases such as multiple sclerosis (MS) and neuromyelitis optica spectrum disorder (NMOSD) remains unexplored. We retrospectively evaluated 249 NMOSD patients, 244 MS patients, and 249healthy controls (HC), calculating MLR, NLR, PLR, SII, and SIRI, and measuring ALB, HB, and BMI levels. Logistic regression and ROC curves were used to develop and validate models for diagnosing and differentiating MS and NMOSD. Further, 35 MS patients, 38 NMOSD patients, and 85 matched HC were recruited for validation, and marker changes were monitored over six months. Comparing MS and NMOSD groups with HC, MLR, NLR, SII, and SIRI were significantly greater, while ALB levels were lower (P<0.05). NMOSD patients exhibited higher MLR, NLR, SII, and SIRI, and lower HB and ALB levels contrasted with MS patients (P<0.05). These markers correlated negatively with total T lymphocytes and positively with C-reactive protein, the Expanded Disability Status Scale (EDSS), and MRI T2 lesion count. Following remission, NLR, SII, and SIRI decreased, while ALB increased over six months (P<0.05). Diagnostic models based on these markers showed AUCs of 0.840 (95% CI:0.806-0.875) for MS and 0.905 (95% CI:0.877-0.933) for NMOSD. Differential diagnosis between MS and NMOSD showed an AUC of 0.806 (95% CI: 0.750-0.863). Inflammatory and nutritional markers are promising for assessing disease activity in MS and NMOSD. Diagnostic models based on these markers enhance the accuracy and clinical value of differentiating between the two conditions.

We investigated the relationship between inflammatory indicators derived from complete blood cell (CBC) counts and all-cause mortality in individuals with rheumatoid arthritis (RA). Data were collected from the National Health and Nutrition Examination Survey (NHANES) database from 2007 to 2018, with a median follow-up duration of 78 months. The inflammatory indicators derived from CBC included several types: the systemic inflammatory response index (SIRI), the systemic immune-inflammation index (SII), the neutrophil-to-lymphocyte ratio (NLR), the platelet-to-lymphocyte ratio (PLR), and the monocyte-to-lymphocyte ratio (MLR). The multiple COX regression models were used to estimate adjusted hazard ratios (HRs) and 95% CIs concerning all-cause mortality of participants with RA, which focused on CBC-derived inflammatory indicators. Additionally, restricted cubic spline (RCS) curve was utilized to investigate non-linear associations. The research comprised a cohort of 1,314 individuals, among whom 246 with RA succumbed during a median follow-up duration of 78 months. After adjusting for key covariates, the mortality rate in patients with RA who had high SIRI, NLR, and MLR levels was considerably higher than in those with medium or low SIRI, NLR, and MLR levels. Compared with the lowest tertile, the highest tertiles of SIRI (HR 1.87, 95% CI: 1.12-3.13), NLR (HR 1.79, 95% CI: 1.10-2.92), and MLR (HR 1.88, 95% CI: 1.17-3.02) were associated with an increased risk of all-cause mortality. The Kaplan-Meier analysis indicated a significant decrease in the survival probability among individuals with elevated SIRI, NLR, and MLR levels. The RCS analysis revealed a linear association between SIRI, NLR, MLR, and RA-related all-cause mortality, whereas a non-linear relationship was identified between the SII, PLR, and mortality. This investigation revealed that the SIRI, NLR, and MLR are novel, valuable, and convenient inflammatory indicators. In the United States adults with RA, higher SIRI, NLR, and MLR were independently associated with an increased long-term mortality risk. These findings not only assist in uncovering the potential utility of predicting RA outcomes but also provide rheumatologists valuable guidance for disease management.

PurposeThe aim of this study was to investigate the level of peripheral blood systemic immune indexes in pseudoexfoliation syndrome (PXS) patients and to compare the results with healthy controls.MethodsThis study included 143 healthy controls (group 1) and 100 patients (group 2). Peripheral blood samples were collected from all participants. Neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), monocyte to lymphocyte ratio (MLR), systemic immune inflammation index (SIII), systemic inflammation response index (SIRI), systemic inflammation modulation index (SIMI) and aggregate systemic inflammation index (AISI) were calculated.ResultsAccording to complete blood count, leukocyte, monocyte and platelet counts showed a statistically significant difference between the two groups (p < 0.001 for all). Systemic immune indexes (NLR, PLR, SIII, SIRI, SIMI and AISI) in group 2 were statistically significantly higher compared to group 1 (PLR for p = 0.011, others p < 0.001).ConclusionIn conclusion, systemic immune indexes (NLR, MLR, PLR, SIII, SIRI, AISI and SIMI) were elevated in PXS patients compared to healthy controls. These indexes may serve as an easy, simple and cost-effective tool to assess the degree of systemic inflammation in patients, playing an important role in recognizing the underlying mechanisms of diseases and thus potentially guiding treatment.

Retinal vein occlusion (RVO) is the second most common retinal vascular disease after diabetic retinopathy. The study aimed to evaluate the association and the predictive value of inflammatory indicators in RVO. Sixty patients with RVO and 60 healthy individuals were enrolled in this retrospective study. Inflammatory indicators and other hematological parameters obtained from the peripheral venous sample were analyzed and compared among groups. White blood cell count (P = .003), neutrophil (P < .001), neutrophil-to-lymphocyte ratio (NLR) (P < .001), monocyte-to-lymphocyte ratio (MLR) (P < .001), platelet-to-lymphocyte ratio (PLR) (P = .014), systemic immune-inflammation index (SII) (P < .001), and systemic inflammatory response index (SIRI) (P < .001) were significantly higher; the lymphocyte count (P < .001) was significantly lower in patients with RVO. According to receiver operating characteristic analysis, NLR was significant at the good level (area under the curve [AUC] = 0.817, P < .001); SIRI, SII, and MLR were significant at the fair level (AUC = 0.774, P < .001; AUC = 0.733, P < .001, and AUC = 0.724, P < .001, respectively) and PLR (AUC = 0.630, P = .014) was significant at the weak level in terms of RVO prediction. SIRI was superior to other indicators, except NLR, to predict RVO. SIRI, NLR, SII, MLR, and PLR can be used as predictors for identifying the risk of RVO.

Immunoinflammatory response can participate in the development of cancer. To investigate the relationship between pretreatment systemic immune inflammatory response index (SII), systemic inflammatory response index (SIRI), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR) and lymph node metastasis in patients with papillary thyroid carcinoma (PTC). A retrospective analysis was performed on 547 PTC patients treated in Meizhou People's Hospital from January 2018 to December 2021. Clinicopathological data were collected, including gender, age, Hashimoto's thyroiditis, maximum tumor diameter, extra-membrane infiltration, disease stage, BRAF V600E mutation, pretreatment inflammatory index levels, and lymph node metastasis. The optimal cutoff values of SII, SIRI, NLR, PLR and LMR were calculated by receiver operating characteristic (ROC) curve, and the relationship between inflammatory indexes and other clinicopathological features and lymph node metastasis was analyzed. There were 303 (55.4%) PTC patients with lymph node metastasis. The levels of SII, SIRI, NLR, and PLR in patients with lymph node metastasis were significantly higher than those in patients without lymph node metastasis, while the levels of LMR were significantly lower than those in patients without lymph node metastasis (all p<0.05). When lymph node metastasis was taken as the endpoint, the critical value of SII was 625.375, the SIRI cutoff value was 0.705, the NLR cutoff value was 1.915 (all area under the ROC curve >0.6). The results of regression logistic analysis showed that age <55 years old (OR: 1.626, 95% CI: 1.009-2.623, p=0.046), maximum tumor diameter >1cm (OR: 2.681, 95% CI: 1.819-3.952, p<0.001), BRAF V600E mutation (OR: 2.709, 95% CI: 1.542-4.759, p=0.001), SII positive (≥625.375/<625.375, OR: 2.663, 95% CI: 1.560-4.546, p<0.001), and NLR positive (≥1.915/<1.915, OR: 1.808, 95% CI: 1.118-2.923, p=0.016) were independent risk factors for lymph node metastasis of PTC. Age <55 years old, maximum tumor diameter >1cm, BRAF V600E mutation, SII positive, and NLR positive were independent risk factors for lymph node metastasis in PTC.