Evaluation of systemic immune inflammation index, HALP score, neutrophil-lymphocyte ratio and platelet-lymphocyte ratio in pediatric burned patients

Background: Both neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) are cost-effective and readily available biomarkers. An increment in either NLR or PLR is an indicative of a prolonged chronic inflammatory condition and increased host inflammatory response. Iron deficiency anemia (IDA) is frequently associated in chronic disorders.Aims: We decided to investigate whether the efficient treatment of IDA should affect NLR and/or PLR values in an adult population with IDA.Methods: This was a retrospective (case-series) observational study conducted at an adult Hematology clinic in Turkey. Patients were ≥ 18 years-old, with IDA defined according to the World Health Organisation criteria. The hematological parameters, NLR, and PLR levels were noted before and after oral iron (Fe+2) repletion treatment.Results: A total of 200 patients with IDA (median age 44 years, IQR 32-52 years, women 91%) were included. NLR values did not differ significantly in terms of IDA treatment (2.07 vs. 2.01, p= .558). PLR levels were significantly decreased after IDA treatment (170.63 vs. 140.32, p< .001). The NLR and PLR were positively correlated (p= .01). A low-unremarkable inverse correlation between NLR, and serum iron levels (p= .024) and Tfsat (p= .038) was observed; a similar negative correlation was also observed between PLR, and serum iron (p= .002) and Tfsat (p= .013) levels.Conclusion: The treatment of IDA did not affect NLR, whereas it was associated with significant decrease in PLR. The NLR and PLR were positively correlated. However, both the NLR and PLR were inversely correlated with serum iron and Tfsat levels.

Purpose: Non- cyctic fibrosis bronchiectasis (non-CFBE) is a chronic inflammatory lung disease which causes significant morbidity in children. Exacerbations in non-CFBE are associated with worsening lung function. Several laboratory parameters such as neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and mean platelet volume (MPV) have been suggested to be as an indicator in various chronic inflammatory diseases. We aimed to asses the value of the NLR, PLR and MPV as markers of acute exacerbation in pediatric patients with non-CFBE. Methods: The NLR, PLR, and MPV values of 55 non-CFBE patients (during exacerbation and stable state periods) and 79 healthy control subjects were analyzed. Results: The mean ages for the patient and control group were 13.62±3.5 and 12.72±2.68 years, respectively. 64% of patients and 54% of control subjects were male. The white blood cell count, absolute neutrophil count, and NLR values were significantly higher in the exacerbation group than in the healthy control group (p<0.05). MPV and PLR values were not significantly different between the two groups. Only forced expiratory volume in one second (FEV1) and C-reactive protein level were significantly different (p<0.001) between the acute exacerbation and stable state periods in the Purpose: Non- cyctic fibrosis bronchiectasis (non-CFBE) is a chronic inflammatory lung disease which causes significant morbidity in children. Exacerbations in non-CFBE are associated with worsening lung function. Several laboratory parameters such as neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and mean platelet volume (MPV) have been suggested to be as an indicator in various chronic inflammatory diseases. We aimed to asses the value of the NLR, PLR and MPV as markers of acute exacerbation in pediatric patients with non-CFBE. Methods: The NLR, PLR, and MPV values of 55 non-CFBE patients (during exacerbation and stable state periods) and 79 healthy control subjects were analyzed. Results: The mean ages for the patient and control group were 13.62±3.5 and 12.72±2.68 years, respectively. 64% of patients and 54% of control subjects were male. The white blood cell count, absolute neutrophil count, and NLR values were significantly higher in the exacerbation group than in the healthy control group ( p <0.05). MPV and PLR values were not significantly different between the two groups. Only forced expiratory volume in one second (FEV1) and C-reactive protein level were significantly different ( p <0.001) between the acute exacerbation and stable state periods in the patient group. Conclusion: Despite the NLR value being significantly higher in children with non-CFBE than in healthy control subjects, it did not differentiate between the steady-state and acute exacerbations periods of the disease. PLR and MPV values also cannot be used as markers of acute exacerbation in children with non-CFBE.

Gastric cancer is the fourth most frequent cancer and the second cause of cancer-related deaths worldwide. China has a high incidence of gastric cancer. Inflammation is a critical component of tumor progression. It has been widely accepted that gastric cancer is an inflammation-driven cancer. In this study, we investigated the application value of systemic inflammatory response (SIR) markers, platelet to lymphocyte ratio (PLR) and neutrophil to lymphocyte ratio (NLR), in early diagnosis and prognostic prediction in patients with resectable gastric cancer. One hundred and sixty-two patients with resectable gastric cancer were included and separated into groups according to median pre-operative PLR or NLR values (PLR low: < 208 or PLR high: ≥ 208, and NLR low: < 4.02 or NLR high: ≥ 4.02, respectively). To evaluate the changes in PLR or NLR values after operation, we introduced the concept of postpre-operative PLR or NLR ratios (< 1 indicated PLR or NLR values were decreased after operation, while ≥ 1 suggested not decreased PLR or NLR values). Pre-operative PLR and NLR levels were significantly higher in gastric cancer patients compared with the healthy subjects. Low pre-operative PLR and NLR levels correlated with better clinicopathological features, including decreased depth of invasion, less lymph node metastasis and early tumor stage. Kaplan-Meier plots illustrated that higher pre-operative NLR and PLR had decreased overall survival (OS) and disease-free survival (DFS). Surgical tumor resection resulted in a significant PLR and NLR measurements can provide important diagnostic and prognostic results in patients with resectable gastric cancer.

Urinary tract infections are common diseases especially seen in bedridden patients. Urine culture, which is the gold standard in the diagnosis of this disease, is an expensive examination, results take a long time, and not available in every center. The objective of this study is to explain the role of neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) in urinary tract infections. For the research, urine culture, NLR, and PLR values of 406 patients, who had urinary tract infections and were registered in Antalya Training and Research Hospital home health services unit, were examined from the health records. In the study, NLR and PLR were studied in blood. In addition, NLR and PLR values of 414 participants were examined as the control group. The mean NLR and PLR values of the participants with urinary tract infection were 4.624 ± 5.818 and 176.645 ± 110.051. The mean NLR and PLR values of the participants without urinary tract infection were 2.117 ± 1.266 and 121.945 ± 53.735. NLR and PLR values of the participants with and without urinary tract infection were compared, and the result was statistically significant (p = 0.000 and p = 0.000, respectively). Urine culture, NLR and PLR values were compared in the patients with urinary system infection. NLR and PLR were lower in the patients with positive urine culture than the patients with negative urine culture; however, the result was statistically insignificant (p = 0.610 and p = 0.702, respectively). According to our results, NLR and PLR were higher in the patients with urinary tract infection than the in healthy volunteer control group. Therefore, it is thought that the clinical judgement of symptoms and complaints comes first and then the NLR and PLR can be used as inflammatory markers in patients with urinary tract infection.

BackgroundBrucellosis is still endemic in many developing countries and frequently leads to misdiagnosis and treatment delays. Indirect inflammatory markers such as mean platelet volume (MPV), platelet distribution width (PDW), red cell distribution width (RDW), neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) have been identified as markers of inflammation. The present study aimed to evaluate and compare the levels of these markers for prognostic purposes, and to assess the correlation of C-reactive protein (CRP) with brucellosis in adults and children.MethodsThe study included 137 adults and 141 age- and gender-matched healthy controls, as well 71 children and 81 age- and gender-matched healthy controls. Hematological parameters and CRP were retrospectively recorded and compared between the adult and pediatric patients.ResultsThe mean age of the adult patients (54% female) was 43.1 ± 15.4 years, whereas the mean age of the pediatric patients (50.7% male) was 9.5 ± 3.6 years. Significantly higher lymphocyte count, and lower neutrophil count, platelet count, RDW, MPV, NLR and PLR values were found in adult brucellosis patients compared with their healthy subjects, whereas higher lymphocyte count, PDW and lower neutrophil count, platelet count, MPV, NLR and PLR values were observed in pediatric brucellosis patients compared with the control subjects. Significantly higher neutrophil count (p=0.019) and NLR (p<0.001) were found in adult patients compared with the pediatric patients. Positive correlation was found between CRP and NLR (R2 = 0.052, P = 0.011), PLR (R2 = 0.061, P = 0.006) in adult patients.ConclusionBased on our findings, we consider that the use of complementary indirect markers such as MPV, NLR, PLR and RDW together with the CRP test – which is used concomitantly with serological diagnostic tests in situations where brucellosis is suspected – might be helpful in the diagnosis and follow-up of brucellosis, as well as in the evaluation of complications and response to therapy, in both adult and pediatric brucellosis patients.DisclosuresAll authors: No reported disclosures.

The purpose of this trial was to explore the effects of the ultrasound-guided transverse abdominal plane block (TAPB) on the systemic immune-inflammatory index (SII), peripheral blood neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR) in patients undergoing radical resection of endometrial carcinoma. This trail was registered in the Chinese Clinical Trial Registry (ChiCTR2300072186, www.chictr.org/; approval date: 2023-06-06). In the study, a total of 90 patients who were scheduled for radical resection of endometrial carcinoma were selected, and they were randomized to receive ultrasound-guided TAPB combined with general anesthesia (GA) or either GA. The primary outcomes were the values of NLR、PLR and SII which were obtained at postoperative 24 hours and 72 hours. Other observational indicators included: the counts of neutrophil, lymphocyte, and platelet; the numbers of effective press of the analgesic pump; postoperative pain intensity; remifentanil consumption; and adverse reactions. The values of preoperative peripheral blood neutrophil, platelet, lymphocyte, NLR, PLR, and SII did not differ between the two groups (P>0.05). The TAP+GA group exhibited significantly reduced levels of neutrophil, NLR, and SII at 24 and 72 hours post-surgery than the GA group (P<0.05). However, there were no significant differences in the values of PLR between the two groups (P>0.05). Compared with the GA group, the VAS scores at 6 hours, 12 hours, and 24 hours after surgery in the TAP+GA group were significantly decreased, and the intraoperative consumption of remifentanil and the numbers of postoperative analgesic pump presses were significantly reduced (P<0.05). Moreover, the incidence of postoperative nausea and vomiting was reduced considerably in the TAP+GA group (P<0.05). Ultrasound-guided TAPB can effectively lower the values of postoperative neutrophil, NLR, and SII, improve postoperative pain intensity, decrease opioid consumption, and reduce the incidence of postoperative nausea and vomiting.

e18773 Background: The neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) has been of prognostic interest in lung cancer. Sustained NLR and PLR after initial chemoradiotherapy (CRT) has been shown to correlate with worse prognosis in other solid organ malignancies. This study aims to add to the available evidence by describing the survival outcomes for patients with stage III NSCLC who are treated with consolidation Durvalumab when stratified by baseline or sustained NLR and PLR. Methods: We conducted a retrospective observational cohort study involving 6 sites across Sydney, Australia, including all patients diagnosed with stage III NSCLC treated with chemoradiation (CRT) and at least one cycle of durvalumab between January 2018 to September 2021. Patients had NLR and PLR collected prior to their first treatment of CRT and prior to their first treatment with Durvalumab. We used NLR and PLR values of 3 and 185 respectively to stratify patients into high and low groups. Patients with sustained NLR or PLR were defined as those with values &gt; = 3 or &gt; = 185 at both pre-CRT and pre-Durvalumab time points. Results: 148 patients were included in the study. The median follow-up from the start of Durvalumab was 15.1 months. The median age was 66 years. 61% (n = 90) of patients were male. The median PFS was 17.6 months in the pre-CRT NLR high cohort and not reached in the pre-CRT NLR low cohort (HR 1.99; 95% CI 1.16 – 3.41; p = 0.01). Median OS was 35.5 months versus 42.0 months in high and low pre-CRT NLR groups respectively (HR 2.62; 95% CI 1.23 – 5.56; p &lt; 0.01). The median PFS was 19.9 months in the pre-CRT high PLR cohort versus and not reached in the pre-CRT low PLR cohort (HR 1.98; 95% CI 1.15 – 3.42; p = 0.02). The median OS was 39.9 months versus 42.0 months in high and low pre-CRT PLR groups respectively (HR 2.29; 95% CI 1.08– 4.88; p = 0.03). Median PFS for sustained NLR elevation was 17.1 months versus NR (HR 1.5, 95% CI 1.1 – 2.2, p &lt; 0.01). Similarly median PFS for sustained PLR elevation was 16.6 months versus NR (HR 1.7, 95% CI 1.1 – 2.4, p &lt; 0.01). Conclusions: Pre-CRT NLR and pre-CRT PLR are associated with OS and PFS outcomes in stage III unresectable NSCLC treated with CRT and Durvalumab. Those with sustained NLR or sustained PLR also have worse progression free survival outcomes.

The study aimed to evaluate the predictive value of the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) for 28-day mortality in patients treated with extracorporeal membrane oxygenation (ECMO). Patients receiving ECMO treatment were selected from the Department of Intensive Care Medicine of Zhejiang Hospital from January 2019 to February 2022. The moment when patients started receiving ECMO treatment was set as the starting point, and death at 28 days was set as the endpoint. The patients were divided into survivors and deaths. Laboratory tests, such as neutrophil, lymphocyte, and platelet counts, using the peripheral blood of all patients were collected within 24 h after ECMO treatment. NLR and PLR were calculated. The risk factors influencing prognosis were analyzed by logistic regression. The correlation between NLR, PLR, acute physiology, and chronic health score Ⅱ (APACHE Ⅱ) was investigated. Receiver operating characteristic (ROC) curve analysis was used to analyze the value of NLR and PLR in predicting the 28-day mortality of patients treated with ECMO. Kaplan-Meier method was used to analyze the cumulative survival of patients at 28 days. The results showed that of 53 patients, 20 survived, and 33 died. The NLR and PLR of the deceased were higher than those of the survivors (NLR: 30.67±14.48 vs. 17.41±7.06;PLR: 303.34±159.23 vs. 191.54±106.03;P<0.001). NLR and PLR were positively correlated with APACHE Ⅱ (r=0.296, r=0.284, P<0.05). ROC curve analysis showed that the area under the curve (AUC) of NLR and PLR to predict the 28 d death of ECMO-treated patients was 0.805 and 0.714, respectively, and the optimal cutoff values of NLR and PLR were 18.93 and 253.0, respectively. The 28-day fatality rate in patients with NLR≥18.93 was higher than that in patients with NLR<18.93 [86.20%(25/29) vs. 33.33%(8/24), χ2=15.625, P<0.01],that in patients with a PLR≥253.0 was higher than that in patients with PLR<253.0 [82.61%(19/23) vs. 46.67%(14/30), χ2=7.158, P<0.01]. Kaplan-Meier survival curve showed that the 28-day cumulative survival rate of NLR≥18.93 was lower than that of NLR<18.93 [9.00 (2.00, 19.50) d vs. 28.00 (10.75, 28.00) d, Z=-3.124, P<0.01], and that of PLR≥253.0 was lower than that of PLR<253.0 [6.00 (2.00, 19.00) d vs. 28.00 (6.25, 28.00) d, Z=-2.673, P<0.01]. Thus, NLR and PLR have good predictive value for 28-day mortality in patients treated with ECMO.

BackgroundInflammation-based prognostic scores including systemic immune-inflammation index (SII), platelet to lymphocyte ratio (PLR) and neutrophil to lymphocyte ratio (NLR) have prognostic value in various cancers. We investigated the prognostic value of SII, PLR and NLR in patients who underwent liver transplantation (LT) for HBV-related hepatocellular carcinoma (HCC).MethodsWe retrospectively analyzed the records of 189 patients who underwent LT for HBV-related HCC. The receiver operating characteristic (ROC) curve was used to determine the optimal SII, PLR and NLR cut-off value. Overall survival (OS) and recurrence-free survival (RFS) following LT were calculated. The Kaplan–Meier method and the Cox proportional hazards model were used to evaluate the prognostic value of SII, PLR and NLR.ResultsThe 1-, 3-, and 5-year OS rates were significantly lower in the high SII group (74.1%, 34.2%, and 32.3%, respectively) than in the low SII group (78.5%, 66.9%, and 59.9%, respectively; p = 0.000). The 1-, 3-, and 5-year RFS rates were, respectively, 75.9%, 59.7%, and 49.4% in the high SII group and 93.3%, 80.2%, and 73.7% in the low SII group (p = 0.000). Finally, OS curves were plotted by the Kaplan–Meier method and compared using the Log rank test. High PLR and NLR scores were also associated with poor OS (p = 0.000 and p = 0.003) and poor RFS (p = 0.000 and p = 0.000). The multivariate analysis demonstrated that AFP ≥400 ng/mL, high MELD score, largest tumor size ≥5cm, SII ≥449.61, NLR ≥5.29, and PLR ≥98.52 were independent prognostic factors for OS.ConclusionHigh SII, PLR and NLR are significantly poor prognostic factors for overall survival and recurrence-free survival in patients with HBV-related hepatocellular carcinoma after liver transplantation.

Introduction: HER2 gene amplificationis associated with shorter disease-free and overall survival in breast cancer.The prognostic value of the NLR, PLR, LMR or MLR has been also reported for many types of cancer. The aim of the present study was to assess the blood the neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR) and monocyte-lymphocyte ratio (MLR) as a prognostic factors in breast cancer patients (BC) according to HER2 overexpression. Material and Methods: A the retrospective analysis of 529 BC patients who were treated at COI (Gliwice, Poland) between January 2005 and June 2018 was performed. The prognostic value (OS) of the pre-treatment PLR, NLR and MLR was assessed by univariate and multivariate analysis. The cut-off values were determined using receiver operating characteristic curves. Based on the cut-off values determined, the NLR was considered as ‘elevated’ at &amp;gt;1.68, the MLR value was ‘elevated’ at &amp;gt;0.23 and the PLR was considered ‘elevated’ at&amp;gt;119.0. Result: The 5-year OS rates in HER2 positive and HER2 negative BC were 86.5 and 90.4%, respectively.The 5-year OS in the NLR &amp;gt;1.68 subgroup with HER2 (83.0 vs. 93.0%; P=0.579) and without HER2 overexpression (88.7 vs. 92.9%; P=0.159) were lower compared with a patients with NLR &amp;lt;1.68. Similarly, 5-year OS was lower in patients with a PLR of &amp;gt;119.0 with HER2 (85.9vs. 87.8%; P=0.782) and without HER2 overexpression (88.1 vs. 94.0%; P=0.060) compared with that in patients with a PLR of ≤119.0. The 5-year OS was similar in patients with a MLR of &amp;gt;0.23 with HER2 overexpression compared with that in patients with a MLR of ≤119.0 (86.1 vs. 86.7%; P=0.745). In group with a MLR of &amp;gt;0.23 without HER2 overexpression OS was lower compared with that in patients with a MLR of ≤0.23 (89.5 vs. 91.7%; P=0.185). Univariate Cox regression analyses of OS showed that in subgroup with HER2 overexpression factors such as tumor size (T3-4 vs. T1-2, HR=2.47; P=0.008), the presence of lymph node metastases (N+ vs.N0, HR=3.15; P=0.006) and estrogen receptor status (ER(+) vs. ER(-), HR=0.50; P=0.039) were statistically significant. Factors such as NLR, PLR and MLR were not statistically significant.Multivariate analysis revealed that in group breast cancer patients with HER2 overexpression negative prognostic factors were: tumor size and lymph node metastases. In contrary, positive prognostic factor was positive steroid receptor status (ER+).Univariate Cox regression analyses of OS showed that in subgroup without HER2 overexpression factors such as tumor size (T3-4 vs. T1-2, HR=3.89; P=0.0001), the presence of lymph node metastases (N+ vs.N0, HR=3.16; P=0.001), tumor grade (G3 vs. G1-2, HR=2.59; P=0.005), estrogen receptor status (ER(+) vs. ER(-), HR=0.43; P=0.012), progesterone receptor status (PR(+) vs. PR(-), HR=0.31; P=0.001), leukocytes &amp;gt;6.22 (HR=2.11; P=0.041), monocytes &amp;gt;0.52 (HR=2.24; P=0.018) and PLT&amp;gt;291 (HR=2.24; P=0.024) were statistically significant. Factors such as NLR (HR=1.66; P=0.166), PLR (HR=2.03; P=0.067) and MLR (HR=1.61; P=0.192) were not statistically significant. Multivariate analysis revealed that significant negative prognostic factors in without HER2 overexpression breast cancer patients were: tumor size, lymph node metastases and leukocyte number. In contrary, positive prognostic factor were positive steroid receptor status (PR+) and lymphocytes number. Conclusion: Elevated PLR, NLR and MLR worsens insignificantly prognosis in group of patients with tumors without HER2 overexpression. The presence of elevated MLR, PLR, NLR did not influence overall survival (prognosis) in group with HER2 overexpression. In both subgroups (HER2 positive and HER2 negative) common negative prognostic factors were tumor size and lymph node metastases. Citation Format: Joanna Huszno, Zofia Kolosza, Jolanta Mrochem Kwarciak, Aleksander Zajusz. Prognostic value of the neutrophil-lymphocyte, platelet-lymphocyte and monocyte-lymphocyte ratio breast cancer patients according to HER2 overexpression [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr P3-08-67.

Background Early-onset sepsis (EOS) remains a common and serious problem in neonates. The neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) are easily accessible biomarkers that have been reported to have meaningful correlations with inflammatory markers. Objectives We aimed to evaluate the NLR, PLR and systemic immune-inflammation (SII) as a diagnostic tests for early detection of EOS. Patients and Methods This study was carried out on 100 preterm infants at the Neonatal Intensive Care Unit (NICU) of Ain Shams University Children’s Hospital. They were divided into two groups: Group A (patient group) which included 45 preterm, suffering from EOS and group B (controls group) which included 55 healthy preterm. History-taking, complete clinical examination, blood culture, complete blood count (CBC), C-reactive protein (CRP), NLR, PLR and SII were done. Results Patients group (high CRP, Rodwell Score positive, positive blood cultures) had significantly higher NLR, PLR, and SII at first and third day of life compared with the controls group(negative CRP, Rodwell Score non sepsis and negative blood cultures). NLR of 1.9 was determined as the predictive cutoff value of EOS (sensitivity 91.11%; specificity 92.73%). A PLR of 53.79 was determined as the predictive cutoff value of neonatal EOS (sensitivity 93.33%; specificity 43.64%). A SII of 333.97 was determined as the predictive cutoff value of neonatal EOS (sensitivity 97.98%; specificity 90.91%). Conclusion NLR, PLR and SII had high sensitivity and specificity as diagnostic markers for earlyonset neonatal sepsis.

e15575 Background: Increasing study indicates that inflammatory biomarkers play a important role in predicting prognosis and therapeutic effect in esophageal squamous cell carcinoma. This research is designed to evaluate prognostic value of inflammatory biomarkers at baseline including neutrophil to lymphocyte ratio (NLR), derived neutrophil to lymphocyte ratio (dNLR), monocyte to lymphocyte ratio (MLR), platelet to lymphocyte ratio (PLR), prognostic nutritional index (PNI) and fibrinogen to Albumin ratio (FAR) and the association between inflammatory biomarkers at baseline and symptomatic radiation pneumonitis in patients with esophageal squamous cell carcinoma (ESCC) treated with definitive chemoradiotherapy. Methods: Patients with ESCC treated with definitive chemoradiotherapy from 2011 to 2015 were enrolled retrospectively. The operating characteristic analysis was used to determine optimal cut-off values of NLR, dNLR, MLR and PLR. The Kaplan-Meier method with a log-rank test and Cox regression model were used to evaluate the prognostic role of these biomarkers and the logistic regression was performed to investigate the association berween NLR and radiation pneumonitis. Results: 311 patients were included with a median follow-up of 24 months. The three-year survival rate is 24.12%. The optimal cut-of values of NLR, dNLR, MLR, PLR were 2.77, 1.70, 0.5 and 168.35, respectively. Univariate analysis revealed that tumor length, smoking and drinking status, performance status, tumor stage, tumor location, albumin level, NLR, dNLR, MLR, PLR, PNI, and FAR were significantly associated with progression-free survival (PFS) and overall survival (OS) (p &lt; 0.05), but only tumor length, smoking status, performance status, tumor stage, dNLR and PLR were independent predictors of PFS and OS in multivariate model. Compared with separate marker, the prognostic predictive value of combined dNLR and PLR (coPLR-dNLR) was increased, and it was also a prognostic indicator when patients were stratified into early and advanced TNM stage. None of inflammatory biomarkers was significantly associated with symptomatic radiation pneumonitis in univariate and multivariate analysis. Conclusions: dNLR and PLR were powerful biomarker to predict prognosis in patients with esophageal squamous cell carcinoma treated with definitive chemoradiotherapy, however inflammatory biomarkers could not predict the occurrence of symptomatic radiation pneumonitis.

Introduction Heart failure (HF) is one of the most common causes of hospitalization worldwide. The neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), NPAR (neutrophil-percentage-to-albumin-ratio) are markers of body inflammatory response that have been associated with worse outcomes in HF patients. Purpose Primary aim of this study was to investigate predictive value of admission NLR, PLR and NPAR in decompensated heart failure patients with reduced ejection fraction (HFrEF) for 30-days cardiovascular mortality and heart failure rehospitalization. Methods The study enrolled 137 patients consecutively admitted with HFrEF at Cardiology Department of our Clinical Hospital between January 2023 and December 2023. The admission NLR, PLR and NPAR were obtained from the electronic health system and correlated with comorbidities, echocardiographic, and laboratory parameters, and 30-days cardiovascular rehospitalization and mortality. Exclusion criteria: age &amp;lt; 18 years old, pregnancy, active malignancy, platelet count &amp;lt;100 x 109/L, decompensated cirrhosis, and sepsis. Multivariable Cox regression model with time-varying coefficients was used to examine changes in the association between admission NLR, PLR and NPAR and cardiovascular rehospitalization and mortality 30 days after discharge, and Pearson correlation test to predict the relationship between length of stay (LOS), NT-proBNP and presence of iron deficiency anemia with admission values of NLR, PLR and NPAR. Results Study included 95 men and 42 women (median age: 69 years; range: 35–89 years). The median values of NLR, PLR, and NPAR were as follows: 4 (1.0–29.0), 173.0 (25.0–987.0), 1.9 (0.9–3.2), 15.1 (12.3-30.1). After 30 days of follow-up, 22 patients (16.05%) died and 12(8.7%) were rehospitalized. In Cox regression models with adjustment for sex, NYHA class, and left ventricular end-diastolic diameter (mm), higher values of NLR, PLR and NPAR were independently associated with cardiovascular mortality and rehospitalization in all NYHA classes (p&amp;lt;0001) (Table 1). The most significant results were recorded for NLR and NPAR. The NLR and the NPAR value were higher in the following group of patients with NYHA III–IV (median: 6.0 vs. 2.0; p &amp;lt; 0.001; median: 4.7 vs. 2.2; p &amp;lt; 0.001). There was a negative correlation between LOS in the hospital, increased levels of NT-proBNP and present iron deficiency anemia and admission value of NLR (r=-0.1, -0.3, -0.5, P&amp;lt;0.05). Conclusions NLR and NPAR are independent predictors of 30-days mortality in HFrEF patients. Only NLR value correlated with LOS in the hospital, increased levels of NT-proBNP and present iron deficiency anemia. This finding demonstrates the value of inflammatory markers in predicting prognosis of HFrEF patients, but more prospective studies need to be done which will include more patients and parameters.

Background & AimsTumor-associated chronic inflammation has been determined to play a crucial role in tumor progression, angiogenesis and immunosuppression. The objective of this study was to assess the prognostic value of the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) in perihilar cholangiocarcinoma (pCCA) patients following curative resection.MethodsConsecutive pCCA patients following curative resection at 3 Chinese hospitals between 2014 and 2018 were included. The NLR was defined as the ratio of neutrophil count to lymphocyte count. PLR was defined as the ratio of platelet count to lymphocyte count. The optimal cutoff values of preoperative NLR and PLR were determined according to receiver operating characteristic (ROC) curves for the prediction of 1-year overall survival (OS), and all patients were divided into high- and low-risk groups. Kaplan-Meier curves and Cox regression models were used to investigate the relationship between values of NLR and PLR and values of OS and recurrence-free survival (RFS) in pCCA patients. The usefulness of NLR and PLR in predicting OS and RFS was evaluated by time-dependent ROC curves.ResultsA total of 333 patients were included. According to the ROC curve for the prediction of 1-year OS, the optimal cutoff values of preoperative NLR and PLR were 1.68 and 113.1, respectively, and all patients were divided into high- and low-risk groups. The 5-year survival rates in the low-NLR (<1.68) and low-PLR groups (<113.1) were 30.1% and 29.4%, respectively, which were significantly higher than the rates of 14.9% and 3.3% in the high-NLR group (≥1.68) and high-PLR group (≥113.1), respectively. In multivariate analysis, high NLR and high PLR were independently associated with poor OS and RFS for pCCA patients. The time-dependent ROC curve revealed that both NLR and PLR were ideally useful in predicting OS and RFS for pCCA patients.ConclusionsThis study found that both NLR and PLR could be used to effectively predict long-term survival in patients with pCCA who underwent curative resection.

Recent studies suggest that elevated neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) are poor prognostic factors in sudden sensorineural hearing loss (SSNHL). We aimed to investigate the accuracy of this hypothesis by taking into account the effect of cardiovascular risk (CVR) factors. Medical records of 122 patients with SSNHL were reviewed retrospectively and grouped into 2 as; patients without CVR (group 1; n = 68) and patients having CVR (group 2; n = 54). Moreover, 60 control cases who did not have SSNHL were also included and grouped into 2 as; group 3 (n = 30) with CVR and group 4 (n = 30) healthy controls without having SSNHL or CVRs. Neutrophil (N), lymphocyte (L), platelet (Plt), NLR, and PLR between the groups and their relationship with the severity of hearing loss, recovery rates, and audiogram configurations were analyzed. The highest N and NLR values were in group 1 and were significantly higher than the values of group 4 (P < .05, P < .01). There was no significant relationship between the groups in terms of L, Plt, or PLR values. The highest NLR and PLR values were determined in SSNHL patients with mild hearing loss, complete recovery, and up-sloping audiogram configuration (P > .05). Elevated levels of N and NLR may be considered as strong laboratory findings showing an inflammatory response in the diagnosis of SSNHL, but the presence of CVR factors does not seem to increase the inflammatory response in SSNHL as expected. In patients with SSNHL, NLR and PLR elevation may indicate better prognosis.