Baseline Platelet-to-lymphocyte Ratio Research Articles

Predictive value of platelet to lymphocyte ratio for early virological response in patients with genotype C hepatitis B virus infection who were treated with Entecavir

Objective To investigate the prognostic value of platelet to lymphocyte ratio (PLR) for early virological response in Entecavir (ETV)-treated chronic hepatitis B (CHB) patients with genotype C infection. Methods Ninety-one genotype C CHB patients with HBV DNA≥1×105 copies/mL were treated with ETV (0.5 mg/d) for 10—13 days. The correlation between PLR and viral load decline was evaluated by Pearson or Spearman′s rank correlation coefficient. Stepwise linear regression analysis was used to establish the prediction model of virological response. Receiver operating characteristic (ROC) curves were used to evaluate the predictive value of PLR for early virological response in ETV-treated patients with genotype C hepatitis B virus (HBV) infection. Results After 10—13 days of ETV treatment, HBV DNA decreased ≥1×lg copies/mL from baseline in 89 cases of the 91 patients, while HBV DNA declined ≥2×lg copies/mL in 65 patients and 4 patients achieved HBV DNA<500 copies/mL. HBV DNA decline was positively correlated with baseline PLR levels (r=0.235 09, P<0.05). After adjustment for age, gender, Hepatitis B e Antigen (HBeAg), and treatment days, HBV DNA decline was still positively correlated with baseline PLR levels (r=0.220 26, P<0.05). Area under curve (AUC) of prediction model including age , baseline aspartate transaminase (AST) and HBV DNA was 0.759 (95% CI : 0.660—0.859, P<0.01). After adding PLR to the prediction model, the AUC was 0.780 (95% CI: 0.685—0.875, P<0.01). Conclusions PLR is predictive to early virological response in ETV-treated CHB patients with genotype C infection. Higher baseline PLR level indicates a better virological response. PLR monitoring should be recommended in CHB patients with antiviral treatment in clinical practice. Key words: Hepatitis B, chronic; HBV DNA; Entecavir; Forecasting; PLR

The Role of Baseline Inflammatory Response Biomarkers in Predictingthe Prognosis in No Metastatic Gastric Cancer Patients Treated with Preoperative Chemoradiation

Purpose: To evaluate the prognostic potential of inflammatory response biomarkers neutrophil to lymphocyte ratio (NLR), derived neutrophil to lymphocyte ratio (dNLR), platelet to lymphocyte ratio (PLR) and lymphocyte to monocyte ratio (LMR) in predicting the outcome of gastric cancer patients undergoing neoadjuvant chemoradiation prior to surgical resection. Methods: Patients with localized, gastric adenocarcinoma received two cycles of induction chemotherapy of fluorouracil, docetaxel, and cisplatin (TPF) followed by 45 Gy of radiation and concurrent fluorouracil plus docetaxel then surgery for non-metastatic patients. Baseline NLR, dNLR, PLR and LMR calculated from peripheral blood cell count taken at pre-operation were compared with clinicopathological parameters. The prognostic value of baseline NLR, dNLR, PLR and LMR for disease free survival (DFS) and overall survival (OS) were assessed using Log rank and Cox regression. Results: The final analysis included 80 patient who had resection after neoadjuvant chemoradiation. The receiver operating curve (ROC) cut off values of baseline NLR, dNLR, LMR and PLR in predicting outcome were 2.4, 1.7, 5.1 and 130 respectively. Elevated NLR, dNLR, PLR, LMR, age of patients (≥ 50 years), stage III, grade 3 tumors, R1 resection and partial response to preoperative chemoradiation course with >10% residual tumor were significantly associated with decreased OS, and DFS. Multivariate analysis revealed that elevated NLR and dNLR were independent factors for worse OS and DFS hazard ratio (HR) 2.04 (95% CI=2.41-8.24), 6.63 (95% CI, 1.61- 10.32) and DSF with (HR) 1.84 (95% CI=3.27-7.36), 4.63 (95% CI=3.61-12.12) respectively. Conclusion: The baseline NLR, dNLR, LMR and PLR showed a significant association with different clinicopathological prognostic factors in gastric cancer patients receiving preoperative chemoradiation. Additionally, NLR, dNLR may be considered as potential independent prognostic indicators of clinical outcomes in this group of patients.

The Pre-treatment Systemic Inflammatory Response Biomarkers are Important Determinant of Prognosis for Patients Undergoing Neoadjuvant Therapy for Rectal Cancer

Purpose: To evaluate the prognostic potential of inflammatory response biomarkers neutrophil to lymphocyte ratio (NLR), derived neutrophil to lymphocyte ratio (dNLR), platelet to lymphocyte ratio (PLR) and lymphocyte to monocyte ratio (LMR) in predicting the outcome of rectal cancer patients undergoing neoadjuvant chemoradiation prior to surgery. Methods: Retrospective review of T3/T4, or N+ rectal cancer treated with neoadjuvant chemoradiation 50.4 Gy concurrently with either 5 FU (1 g/m2/d) or Capecitabine 825 mg/m2 twice daily. Four additional cycles of 5-FU chemotherapy (500 mg/m2/d, i.v. bolus) or capecitabine (2500 mg/m2 days 1-14, repeated day 22), were applied post-operatively. Pre-treatment NLR, dNLR, PLR and LMR calculated from peripheral blood cell were compared with clinicopathological parameters. The prognostic value of baseline NLR, dNLR, PLR and LMR for disease free survival (DFS) and overall survival (OS) were assessed using Log rank and Cox regression. Results: The final analysis included 80 patients, the receiver operating curve (ROC) calculated cut off values of baseline NLR, dNLR, LMR and PLR in predicting outcome were 3, 2.1, 4.9 and 169 respectively. Elevated NLR, dNLR, PLR, LMR, age of patients (≥50 years), depth of invasion ≥T3, lymph node N1-N2, stage III, grade 3 tumors, and partial response to preoperative chemoradiation were significantly associated with decreased OS, and DFS. Multivariate analysis revealed that elevated NLR and dNLR were independent Powered by Editorial Manager® and ProduXion Manager® from Aries Systems Corporation factors for worse OS and DFS hazard ratio (HR) 2.34 (95% CI=3.41-7.24), 4.53 (95% CI, 2.61-8.32) and DSF with (HR) 1.84 (95% CI=2.27-5.36), 4.23 (95% CI=3.49-9.52) respectively. Conclusion: The baseline NLR, dNLR, LMR and PLR showed a significant association with different clinicopathological prognostic factors in rectal cancer patients receiving preoperative chemoradiation. Additionally, NLR, dNLR may be considered as potential independent prognostic indicators of clinical outcomes.

Comparison of the Prognostic Impact of Neutrophil/Lymphocyte Ratio, Platelet/Lymphocyte Ratio, and Glasgow Prognostic Score in Diffuse Large B-Cell Lymphoma

Background: Given the role of inflammation in tumor progression, as well as in diffuse large B-cell lymphoma (DLBCL), researchers are trying to identify easily applicable, easy accessible prognostic markers for individual risk assessment. The most frequently used inflammatory prognostic markers are the neutrophil-to-lymphocyte ratio (NLR), the platelet-to-lymphocyte ratio (PLR),andthe Glasgow prognostic score (GPS). Objectives: To determine and compare the prognostic value of the baseline inflammatory biomarkers NLR, PLR, and GPS in patients with DLBCL. Methods: We retrospectively analyzed data from 103 DLBCL patients treated with R-CHOP or R-CHOP-like regimens. We evaluated the significance of NLR, PLR, and GPS as a predictor of response to treatment, overall survival (OS), and event-free survival (EFS). Results: Higher NLR levels were found in patients with a poorer response to therapy (median [range] 2.87 [0.56 - 26.33] vs. 4 [0.62 - 29.66], P = 0.026). Patients with NLR values of > 2.63 (cutoff value calculated by receiver-operating characteristic) had significantly worse two-year OS (65.1% vs. 87.2%, P = 0.002) and two-year EFS (59.8% vs. 87.1%, P = 0.001). PLR values were not significant for survival. The two-year OS rates for patients with GPS = 0, GPS = 1, and GPS = 2 were 93.3%, 63.9%, and 33.3%, respectively (P 2.63 were an independent prognostic factor for OS (hazard ratio [HR] = 2.857; 95% confidence interval [CI] 1.022 - 8.699; P = 0.048] and EFS (HR = 4.06; 95% CI 1.357 - 12.151; P = 0.012). Conclusions: Our research confirmed NLR as useful independent prognostic marker for survival. PLR and GPS did not show independent prognostic value, although they were also associated with the patients’ clinical features. The easy availability and inexpensiveness of inflammatory biomarkers should encourage their use in clinical practice.

Changes in neutrophil/lymphocyte and platelet/lymphocyte ratios after chemotherapy correlate with chemotherapy response and prediction of prognosis in patients with unresectable gastric cancer.

The aim of the study was to investigate the application value of neutrophil to lymphocyte ratio (NLR) and the platelet to lymphocyte ratio (PLR) in the prediction of chemotherapy response and prognosis in patients with advanced gastric cancer. In total, 120 patients with unresectable gastric cancer were included and separated into two groups according to the median values of NLR or PLR (NLR low: <4.62 or NLR high: ≥4.62 and PLR low: <235 or PLR high: ≥235, respectively). Low baseline NLR level correlated with improved clinicopathological characteristics, including smaller tumor size, well differentiation and less metastasis. Low baseline PLR level also associated with less metastasis. Patients with a low baseline level of NLR or PLR had an improved response to chemotherapy. Patients with a higher baseline NLR and PLR had decreased progression-free survival (PFS) and overall survival (OS) ratios. Alterations in the NLR and PLR levels were associated with therapeutic efficacy and prognosis. The patients who remained in or switched to the low NLR level subgroup subsequent to first-line chemotherapy had an improved response and improved OS ratios, compared to the patients remaining in or switching to the high NLR level group. Similar results were observed when the PLR level was investigated. In conclusion, baseline NLR and PLR measurements, as well as changes of NLR and PLR following chemotherapy can predict the prognostic results in patients with unresectable gastric cancer.

The platelet-to-lymphocyte ratio predicts poor survival in patients with huge hepatocellular carcinoma that received transarterial chemoembolization.

Inflammation is particularly strong in huge hepatocellular carcinoma (HCC). However, it is unclear whether the platelet-to-lymphocyte ratio (PLR), as an inflammatory-related marker, can predict survival of patients with huge HCC. In this study, we enrolled 291 patients with huge HCC (diameter over 10 cm) who were undergoing repeated transarterial chemoembolization (TACE) at our institute. The baseline PLR was calculated from complete serum blood counts before the first chemoembolization. We found that a baseline PLR cutoff value over 150 best predicted huge HCC survival. The 12, 24, and 36 months survival rates in the high PLR group (22.6, 8.1, and 4.1 %, respectively) were significantly lower than in the low PLR group (35.6, 22.4, and 14 %, respectively). Thus, a significant difference was found in overall survival (log-rank test, p < 0.0001). Univariate analyses indicated a high PLR (p < 0.0001) was predictor of poor survival, and multivariate Cox analyses further showed that a high PLR (p = 0.002) was an independent factor that predicted worse survival. In conclusion, for patients with huge HCC, a high baseline PLR is a useful predictor of poor survival in patients undergoing chemoembolization. Additional anti-inflammatory or anti-platelet treatments, in combination with TACE, may improve survival in HCC patients with high PLR.

Association between Platelet-to-Lymphocyte Ratio and Contrast-Induced Nephropathy in Patients Undergoing Percutaneous Coronary Intervention for Acute Coronary Syndrome

Objective: Contrast-induced nephropathy (CIN) is associated with significantly increased morbidity and mortality after percutaneous coronary intervention (PCI). Patients with acute coronary syndrome (ACS) are at higher risk of CIN. The platelet-to-lymphocyte ratio (PLR) is closely linked to inflammatory conditions. We hypothesized that PLR levels on admission can predict the development of CIN after PCI for ACS. Subjects and Methods: A total of 426 patients (mean age 63.17 ± 13.01 years, 61.2% males) with ACS undergoing PCI were enrolled in this study. Admission PLR levels were measured before PCI. Serum creatinine values were measured before and within 72 h after the administration of contrast agents. Patients were divided into 2 groups: the CIN group and the no-CIN group. CIN was defined as an increase in serum creatinine level of ≥0.5 mg/dl or 25% above baseline within 72 h after contrast administration. Results: CIN developed in 53 patients (15.9%). Baseline PLR was significantly higher in patients who developed CIN compared to those who did not (160.8 ± 29.7 and 135.1 ± 26.1, respectively; p < 0.001). Multivariate analyses found that PLR [odds ratio (OR) 3.453, 95% confidence interval (CI) 1.453-8.543; p = 0.004] and admission creatinine (OR 6.511, 95% CI 1.759-11.095; p = 0.002) were independent predictors of CIN. Conclusions: The admission PLR level is an independent predictor of the development of CIN after PCI in ACS.