Blood Neutrophil-lymphocyte Ratio Research Articles

Evaluation of primary markers of inflammation and the systemic inflammation index in specific learning disabilities.

Aim: Specific learning disorder (SLD) is a term that refers to reading, writing and arithmetic difficulties. The neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR) and systemic inflammation index (SII) are affordable and accessible inflammatory biomarkers. This research aims to evaluate the relationship between NLR, PLR, SII and SLD to determine whether inflammation contributes to pathogenesis.Methods: This study included 90 SLD-diagnosed patients and 90 age-, sex- and ethnicity-matched healthy controls. Blood cell counts and NLR, PLR and SII values were obtained from medical records and compared between the two groups.Results: The NLR, PLR and SII were significantly higher (p=0.029, p=0.033 and p=0.018 respectively) and lymphocyte counts were significantly lower (p=0.041) in the SLD group. WISC-R total scores decreased with age in the SLD group (-1.988 coefficient, Beta=-0.247ß, p=0.041). Multivariate logistic regression analysis revealed that the SII was the only parameter independently associated with the diagnosis of SLD (Beta=0.003, p=0.023).Conclusion: Inflammation might play a role in SLD etiopathogenesis. NLR, PLR and SII may be potential biomarkers for SLD in children. Further research may lead to early diagnosis and additional anti-inflammatory pharmacological therapies for SLDs.

Value of the red blood cell distribution width (RDW) and neutrophil lymphocyte ratio (NLR) in the prediction of functional recovery and 3-month mortality following endovascular treatment for acute anterior circulation ischemic stroke

ObjectivesThe red blood cell distribution width (RDW) and neutrophil to lymphocyte ratio (NLR) have been linked to poor prognosis in patients with ischaemic stroke. However, no study has yet evaluated the prognostic role of RDW and NLR, or their combined effect on reperfusion in patients with endovascularly-treated acute ischaemic stroke. This study therefore aimed to analyse the impact of RDW and NLR on poor functional outcomes and failed reperfusion following endovascular treatment in patients with acute anterior circulation ischaemic stroke. MethodsA total of 275 patients with acute anterior circulation ischaemic stroke treated endovascularly between 2015 and 2018 were enrolled in this study. The relationships between RDW, NLR, and poor outcomes were analysed using univariate and multivariate logistic regression models and receiver operating characteristic (ROC) curve analysis. The Youden Index was applied to determine the cut-off value. ResultsMultivariate logistic regression analysis identified RDW (p = 0.015) and NLR (p = 0.015) as independent predictors of mortality at the 3rd month. ROC curve analysis of RDW revealed a cutoff value of 14.25 (p = 0.009) for poor clinical outcomes (modified Rankin scale [mRS] 3–6). Similarly, a cutoff value of 14.25 was found for mortality prediction (p = 0.003). The cutoff value for poor clinical outcome (mRS 3–6) in the NLR was determined as 5.93 (p = 0.003), whereas the cutoff value for mortality was set at 5.17 (p = 0.028). RDW also predicted failed reperfusion, with a cutoff value of 17.75 (p = 0.048). ConclusionsHigh RDW and NLR upon admission were identified as independent indicators of mortality in endovascularly treated acute anterior circulation ischemic stroke patients. Furthermore, the RDW could potentially predict failed reperfusion.

NLR, MLR, and PLR are adverse prognostic variables for sleeve lobectomy within non-small cell lung cancer.

The goal of the research was to examine the value of peripheral blood indicators in forecasting survival and recurrence among people suffering central-type non-small cell lung cancer (NSCLC) undergoing sleeve lobectomy (SL). Clinical information was gathered from 146 individuals suffering from NSCLC who had SL at our facility between January 2014 and May 2023. Peripheral blood neutrophil lymphocyte ratio (NLR), monocyte lymphocyte ratio (MLR), and platelet lymphocyte ratio (PLR) levels were determined by receiver operating characteristic (ROC) curve to establish the threshold points. Kaplan-Meier survival analysis was employed to evaluate the prognostic value of different groupings, and both univariate and multivariate Cox proportional hazards model (referred to as COX) were performed. The disease-free survival (DFS) and overall survival (OS) cutoff values were carried out via ROC analysis. Kaplan-Meier survival analysis revealed notable differences in OS for NLR (≥2.196 vs. <2.196, p = 0.0009), MLR (≥0.2763 vs. <0.2763, p = 0.0018), and PLR (≥126.11 vs. <126.11, p = 0.0354). Similarly, significant differences in DFS were observed for NLR (≥3.010 vs. <3.010, p = 0.0005), MLR (≥0.2708 vs. <0.2708, p = 0.0046), and PLR (≥126.11 vs. <126.11, p = 0.0028). Univariate Cox analysis showed that NLR (hazard ratio [HR]: 2.469; 95% confidence interval [CI]: 1.416-4.306, p < 0.001), MLR (HR: 2.192, 95% CI: 1.319-3.643, p = 0.002) and PLR (HR: 1.696, 95% CI: 1.029-2.795, p = 0.038) were correlated alongside OS. Multivariate Cox analysis showed that NLR (HR: 2.036, 95% CI: 1.072-3.864, p = 0.030) was a separate OS risk variable. Additionally, the pN stage (HR: 3.163, 95% CI: 1.660-6.027, p < 0.001), NLR (HR: 2.530, 95% CI: 1.468-4.360, p < 0.001), MLR (HR: 2.229, 95% CI: 1.260-3.944, p = 0.006) and PLR (HR: 2.249, 95% CI: 1.300-3.889, p = 0.004) were connected to DFS. Multivariate Cox analysis showed that pN stage (HR: 3.098, 95% CI: 1.619-5.928, p < 0.001) was a separate DFS risk variable. The study demonstrates that NLR, MLR, and PLR play a convenient and cost-effective role in predicting survival and recurrence among individuals alongside central-type NSCLC having SL.

Assessment of Accuracy of Blood Neutrophil to Lymphocyte Ratio (NLR) in Diagnosis of Spontaneous Bacterial Peritonitis (SBP) in Cirrhotic Patients

Abstract Background This was across-sectional study conducted on 40 Egyptian patients with decompensated cirrhosis and ascites selected from Internal Medicine and Hepatology outpatient clinics and wards at Ain-Shams University Hospitals. Aim of the Work The aim of this study is to compare accuracy of blood neutrophil lymphocyte ratio (NLR) to ascitic fluid neutrophil lymphocyte ratio (NLR) in diagnosis of SBP. Patients and Methods Patients in this study were divided into 2 groups: Group 1 (case):20 cirrhotic patients diagnosed with (SBP) on the basis of clinical manifestations (fever, abdominal tenderness, and pre-hepatic coma) and laboratory diagnostic criteria: ascitic fluid PMNs greater than 250/mm 3 and culture positive. Group 2 (control): 20 cirrhotic patients with ascites and were admitted with no evidence of (SBP) by clinical and laboratory evaluation. Results According to our results, we found that there was no statistically significant difference found between two groups regarding Age, Sex and Child Classification. There was no statistically significant difference found between two groups regarding WBCs, Platelets, ALT, Creat, Albumin, INR, Bilirubin and Adenosine deaminase, and there was statistically significant difference found between two groups regarding AST and Urea, and there was highly statistically significant difference found between two groups regarding HB. Also there was highly statistically significant difference found between two groups regarding MELD score, SERUM PMNLs, Ascitic PMNLs, Serum NLR and Ascitic NLR. Conclusion Spontaneous bacterial peritonitis is a serious complication in patients with liver cirrhosis and is associated with a considerable risk of mortality. The present study could be of clinical utility in predicting SBP, a major cause of mortality in patients with cirrhosis. NLR is considered an easy test that can be used to diagnose SBP.

Association of Neutrophil-Lymphocyte Ratio and Red Blood Cell Distribution Width with Poor Outcome in Pediatric Cardiac Surgery - A Retrospective Observational Study.

Neutrophil-lymphocyte ratio (NLR) is a valuable indicator for evaluating inflammatory response and red blood cell distribution width (RBDW), a routinely available biomarker of likely erythropoietic dysfunction, which may be associated with adverse outcomes after cardiac surgery. This study aimed to investigate the association between these two readily available haematological parameters, with the poor outcomes in paediatric patients undergoing cardiac surgery. A comprehensive review of medical records for paediatric patients who underwent cardiac surgery at our tertiary care centre between April 2022 and June 2023 was carried out. RBDW and NLR values were collected from complete blood count reports obtained on admission to the ICU. Demographic data, surgical details, and postoperative complications were also recorded. A receiver operating characteristic (ROC) curve and multivariable logistic regression were applied to identify the prognosis performance of preoperative NLR and RBDW for poor outcomes. The study included 219 patients meeting the inclusion criteria of which a total of 90 (41%) children experienced at least one of the poor outcomes. Preoperative NLR (AUC=0.88, 95%CI 0.36-0.70, cut off- 4.2) and RBDW (AUC=0.88, 95%CI 0.39-0.73, cut off- 18.5%) showed prognostic significance in the perioperative period. This retrospective observational study highlights a significant association between elevated Red Blood Cell Distribution Width (RBDW) and Neutrophil Lymphocyte Ratio (NLR) values and poor outcomes in paediatric patients undergoing cardiac surgery. These readily available haematological parameters could serve as potential prognostic indicators for identifying patients at risk of poor outcomes.

Blood neutrophil to lymphocyte ratio is associated with 90-day mortality and 60-day readmission in Gram negative bacteremia: a multi-center cohort study

IntroductionThe Neutrophil-Lymphocyte Ratio (NLR) in blood has demonstrated its capability to predict bacteremia in emergency departments, and its association with mortality has been established in patients with sepsis in intensive care units. However, its potential concerning mortality and readmission in patients with Gram-negative bacteremia (GNB) is unexplored.MethodsThis retrospective cohort study included patients with GNB between 2018 and 2022 from six hospitals in the Capital Region of Denmark. Patients who were immunosuppressed or had missing NLR values on the day of blood culture were excluded. Logistic regression models were used to analyze the association between NLR levels and 90-day all-cause mortality, while the logit link interpretation of the cumulative incidence function was used to assess the association between NLR levels and 60-day readmission. Associations were quantified as odds ratios (OR) with corresponding 95% confidence intervals (CI).ResultsThe study included 1763 patients with a median age was 76.8 years and 51.3% were female. The median NLR was 17.3 and 15.8% of patients had a quick sequential organ failure assessment score of two or three. Urinary tract infection (UTI) was the most frequent focus and Escherichia coli the most frequent pathogen. Statistically significant differences in median NLR were found by age group and pathogen, and for patients with or without hypertension, liver disease, chronic obstructive pulmonary disease, dementia, and alcohol abuse. 378 patients (21.4%) died before 90 days. 526 (29.8%) patients were readmitted to the hospital within 60 days. For each doubling of the NLR, the OR for all-cause 90-day mortality was 1.15 (95% CI, 1.04–1.27) and 1.12 (95% CI, 1.02–1.24) for 60-day readmission. Analysis of subgroups did not show statistically significant differences between groups in relation to the association between NLR and mortality. The discriminatory ability of NLR for mortality was limited and comparable to blood neutrophil or lymphocyte count, producing receiver operating characteristic curves with an area under the curve of 0.59 (95% CI, 0.56–0.63), 0.60 (95% CI, 0.56–0.65) and 0.53 (95% CI, 0.49–0.56), respectively.ConclusionBlood neutrophil-lymphocyte ratio was associated with 90-day all-cause mortality and 60-day readmission in patients with GNB. However, the ratio has limited ability in predicting mortality or readmission.

Diagnostic Utility of the CAN Score and Proportionality Indices and Variations in Neutrophil—and Platelet—Lymphocyte Ratios in Fetal Malnutrition

Background: Nutritional status of neonates is best assessed using clinical assessment of nutrition (CAN) score and proportionality indices. The onset of malnutrition that begins in utero, termed fetal malnutrition (FM), can induce a state of inflammation. This study is aimed at estimating the prevalence of FM in different classes of births along with analysis of neutrophil lymphocyte ratio (NLR) and platelet lymphocyte ratio (PLR) in cord blood as markers of inflammation. Materials and Methods: It was a cross-sectional, descriptive study. The proportionality indices—body mass index (BMI), ponderal index (PI), and CAN score—were calculated. PI &lt;2.2, BMI&lt;11.2 kg/m2, and CAN score &lt;25 were indicators of FM. The Chi-square test was used to test the sensitivity and specificity of CAN score against PI and BMI. Results: A total of 100 term neonates were included, divided into 3 groups: small for gestational age (SGA), appropriate for gestational age (AGA), and large for gestational age (LGA). Fetal malnutrition was present in 16% of total neonates. The sensitivity and specificity of the CAN score was more than 85% with significant p-value {χ 2 = 33 (PI), χ 2 = 58.8 (BMI)}. Median NLR in FM was 1.63 ± 0.65, significantly ( P &lt; .001) higher than well-nourished neonates. Platelet lymphocyte ratio did not have a significant difference. Clinical assessment of nutrition score showed a positive correlation with maternal ( r = 0.806, P &lt; .001) and neonatal BMI ( r = 0.368, P &lt; .001). Conclusion: Proportionality indices and CAN score can be interchangeably used to diagnose FM. The presence of higher NLR values in neonates with FM suggesting an underlying inflammatory process requires closer follow-up.

Correlation of Neutrophil–Lymphocyte Ratio with Glycemic Control: An Analytical Cross-sectional Study

Abstract Background: Poorly controlled diabetes is one of the most common risk factors for cardiovascular disease. Neutrophil–Lymphocyte ratio (NLR) is a potential marker to predict inflammation. Many studies have shown it to be a predictor of adverse cardiovascular events in Type 2 diabetic patients. Our study was done to examine and establish a relationship between NLR and poor glycemic control and to examine whether a correlation exists between NLR and HbA1c. Materials and Methods: An analytical cross-sectional study was conducted with 104 randomly selected Type 2 diabetic patients (39 females and 65 males). They were randomly divided into three groups based on glycemic control according to the American Diabetes Association criteria. Patients with HbA1c &lt;7% as excellent control, HbA1c 7%–9% as poor control, and HbA1c &gt;9% as worst control were considered. Total leukocyte count, fasting blood sugar (FBS), low-density lipoprotein (LDL), and NLR were assessed. Results: Our study showed that the mean neutrophil count was significantly higher and the mean lymphocyte count was significantly lower in patients with the worst diabetic control. NLR was also significantly higher in patients with worse diabetic control. However, our study did not find any statistically significant correlation between total leukocyte count and glycemic control. Mean LDL and mean FBS were also significantly higher in patients with the worst diabetic control. Conclusions: Increased NLR was associated with high HbA1c and poor glycemic control. Thus, NLR can be used as a tool in follow-up of Type 2 diabetic patients and as a predictor of poor glycemic control and adverse cardiovascular events.

Relationship between neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) in peripheral blood and prognosis after castration therapy for prostate cancer

Abstract Background: The relationship between neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) in peripheral blood and prognosis after castration therapy for prostate cancer remains unclear. Methods: A total of 186 patients with prostate cancer treated between January 2018 and March 2021 were selected as the study subjects. All patients underwent castration therapy. Patient follow-up records for 2 years were examined to assess progression-free survival. NLR, PLR, and PSA levels were measured in the participants’ blood. Logistic regression analysis was used to identify factors affecting the occurrence of castration-resistant prostate cancer. Kaplan-Meier survival curves were plotted to analyze progression-free survival, and ROC curves were plotted to assess the predictive value of NLR and PLR for progression-free survival. Results: In the stable group, NLR, PLR, PSA levels, bone metastasis ratio, and Gleason score ≥8 were significantly lower than in the progression group. T3 stage, N0 stage, and M0 stage were significantly higher in the progression group, with statistical significance (P &lt; 0.05). NLR, PLR, and PSA levels were all significantly linearly correlated (P &lt; 0.05). High NLR, high PLR, high PSA, high bone metastasis, Gleason score &lt;8, T3 stage, and N0 stage were independent risk factors for poor prognosis after castration therapy for prostate cancer, with statistical significance (P &lt; 0.05). Patients with low NLR had significantly better progression-free survival than the high NLR group, and patients with low PLR had significantly better progression-free survival than the high PLR group, with statistical significance (P &lt; 0.05). The area under the curve for NLR and PLR in predicting progression-free survival after castration therapy for prostate cancer was both greater than 0.90, indicating high clinical utility. Conclusion: Peripheral blood NLR and PLR after castration therapy for prostate cancer are highly correlated with patient prognosis quality and can serve as important potential indicators for predicting patient prognosis quality.

Preoperative risk stratification for patients with ≤ 1cm papillary thyroid carcinomas based on preoperative blood inflammatory markers: construction of a dynamic predictive model.

The aim of this study was to investigate the relationships and predictive value of preoperative peripheral blood inflammatory markers as a means by which to assess risk for patients with ≤ 1cm papillary thyroid carcinomas (PTCs). In addition, a preoperative risk stratification predictive model was constructed and validated. Clinical and pathologic data, as well as preoperative blood specimens, were collected from patients who underwent initial thyroid cancer surgery at the Hangzhou First People's Hospital, from January 2014 to January 2023. Risk assessment was performed based on postoperative pathology according to the 2015 ATA guidelines for recurrence risk stratification. Using univariate analysis and multivariate logistic regression, we identified independent risk factors associated with risk stratification. A predictive model was established and its discriminative and calibration abilities were validated. An independent validation dataset was used to verify the model, and the model was deployed as an online calculator. A total of 1326 patients were included in the study, with 1047 cases (79.0%) classified as low risk and 279 cases (21.0%) classified as intermediate to high risk. The modeling group consisted of 981 cases, through univariate analysis and multivariate logistic regression analysis, preoperative blood Neutrophil/Lymphocyte Ratio (NLR), gender, tumor diameter, and multifocality were identified as independent risk factors that distinguished between low and intermediate to high risk patients with ≤ 1cm PTCs. The clinical predictive model exhibited an AUC of 0.785, specificity of 70.6%, and sensitivity of 75.8%. For the independent validation group of 345 patients, the AUC was 0.813, specificity was 83.8%, and sensitivity was 70.4%. The calibration curve and clinical decision curve indicate that the model demonstrates excellent calibration performance. A dynamic clinical predictive model based on preoperative blood NLR and clinical information for patients with ≤ 1cm PTCs was established. The model is useful for preoperative risk assessment of patients with ≤ 1cm PTCs.

Analysis of multi‐dimensional cognitive function of different sexes in the middle‐aged and elderly people at high altitude

AbstractBackgroundTo explore the overall and multi‐dimensional cognitive function of middle‐aged and elderly people and gender difference analysis of its influencing factors under hypoxia environment.MethodFrom January 2018 to December 2021, using cross‐sectional study design, all participants from Xining, Qinghai Province (with an average altitude of 2,500m) who have lived for more than 20 years were selected.General data questionnaire survey, laboratory collection, overall and multi‐dimensional cognitive function assessment were conducted.ResultA total of 500 middle‐aged and elderly people were included in this study, 299 males and 201 females, with an average age of 64.17 ± 10.58 years. Compared with women, there were more men working in civil service, earning more than 5000 months, smoking and drinking, accompanied by hypertension and diabetes (P&lt;0.01, P&lt;0.001), but Geriatric Depression Scale(GDS)and Pittsburgh sleep quality index (PSQI) scores were significantly lower (P&lt;0.01).Compared with women’s multiple cognitive domains, scores of Mini mental state examination(MMSE), Complex Figure Test Delay Recall(CFT‐DR), Digit Span Forward(DSF) and Digit Span Backward(DSB) in men were higher (P&lt;0.05, P&lt;0.01), while scores of Trail Making Test (TMT‐A and TMT‐B) were significantly lower (P&lt;0.01, P&lt;0.001).The neutrophil lymphocyte ratio (NLR) and homocysteine (HCY) in peripheral blood were higher than those in women (P&lt;0.05, P&lt;0.01). Covariance analysis showed after adjusting for education level that scores of MMSE and situational memory (CFT‐DR) of men in different age groups were higher than those of women, while scores of attention (TMT‐A) and executive ability (TMT‐B) were lower than those of women (P&lt;0.05, P&lt;0.01). After adjusting for age, scores of MMSE and CFT‐DR of men in primary school, middle school and high school were higher than those of women (P&lt;0.05, P&lt;0.01). With the influence of education level, men’s TMT‐A scores showed a trend of lower (P&lt;0.05, P&lt;0.01), while women’s TMT‐A scores changed little.TMT‐B score of men was lower than that of women in the four education stages (P&lt;0.05), but there was no trend for men and women to optimize with the increase of education level.ConclusionMiddle‐aged and elderly people of different sexes living in high altitude hypoxic environment may have different multidimensional cognitive decline.

Utilizing peripheral blood inflammatory biomarker (PBIB) to predict response to systemic therapy in patients with breast cancer.

Inflammation is a recognized factor in cancer progression and resistance to treatments. Several studies correlated inflammation-related peripheral blood inflammatory biomarkers (PBIB) to disease progression and poor survival in various cancer types and different populations. Nonetheless, inflammation is affected by the distinctive characteristics and environmental exposure of each population. There is no prior study addressing the association of pre-treatment inflammatory markers with outcomes in patients with breast cancer (BC) from Saudi Arabia. In this study, we evaluated the prognosis of locally advanced breast cancer (LABC) in relation to several PBIB. We retrospectively analyzed the data of female patients with LABC undergoing neoadjuvant chemotherapy (NACT). Demographics, body mass index (BMI), clinicopathologic characteristics and stage of the tumor, follow-up status, and response to treatment were collected. Outcomes were evaluated in relation to pre-treatment peripheral blood indices that were grouped based on the local laboratory cutoff values. Objective response rate (ORR) was predefined and assessed according to the post-NACT magnetic resonance imaging (MRI) breast and subcategorized into complete response (CR), partial response (PR), stable disease (SD), and progressive disease (PD). A total of 172 female patients with BC met the eligibility criteria from January 2014 to December 2019. The mean age at diagnosis was 53.4 ± 11, and BMI was 31.2 ± 6. Left BC accounted for 54.7%, and the majority was invasive ductal carcinoma (85.5%), moderately differentiated (51%), stage III (AJCC 8th edition) (73%), and estrogen receptor (ER)-positive tumor (79.1%). Human epidermal growth factor receptor 2 (HER2)-positive BC was reported in 32% and triple-negative breast cancer (TNBC) in 10%. Radiologic CR accounted for the majority of ORR (71.5%). Higher percentage of patients with normal red cell distribution width (RDW) of red blood cell (RBC) and low neutrophil-lymphocyte ratio (NLR) had CR with a significant P value of 0.003 and 0.014, respectively. Among several peripheral blood indices, RDW and NLR significantly influenced ORR. They can be explored further to potentially predict response after systemic therapy in patients with LABC. The great advantage of these biomarkers stems from their availability and affordability in routine clinical practice.

Blood-based biomarkers: diagnostic value in brain tumors (focus on gliomas).

Brain tumors, especially gliomas, are known for high lethality. It is currently understood that the correlations of tumors with coagulation and inflammation have been gradually revealed. This study aimed to explore the potential value of several reported peripheral blood parameters as comprehensively as possible, with preoperative diagnosis and identification of brain tumors (focus on gliomas). Patients with central nervous system tumors (craniopharyngioma, ependymoma, spinal meningioma, acoustic neuroma, brain metastases, meningioma, and glioma) or primary trigeminal neuralgia admitted to our hospital were retrospectively analyzed. The results of the routine coagulation factor test, serum albumin test, and blood cell test in peripheral blood were recorded for each group of patients on admission. Neutrophil-lymphocyte ratio (NLR), derived NLR (dNLR), platelet-lymphocyte ratio (PLR), lymphocyte-monocyte ratio (LMR), prognostic nutritional index (PNI), the systemic immune-inflammation index (SII), pan-immune-inflammation value (PIV), and their pairings were calculated. Their ability to identify brain tumors and their correlation with glioma grade were analyzed. A total of 698 patients were included in this retrospective case-control study. Glioma patients had higher NLR, SII, and PIV but lower LMR. The NLR in the brain metastasis group was lower than that in the control, meningioma, and acoustic neuroma groups, but the SII and PIV were higher than those in the ependymoma group. Fibrinogen, white blood cell count, neutrophil count, NLR, SII, and PIV in the GBM group were higher than those in the control group. In all comparisons, NLR and NLR + dNLR showed the greatest accuracy, with areas under the curve (AUCs) of 0.7490 (0.6482-0.8498) and 0.7481 (0.6457-0.8505), respectively. PIV, dNLR + PIV, and LMR + PIV ranked second, with AUCs of 0.7200 (0.6551-0.7849), 0.7200 (0.6526-0.7874), 0.7204 (0.6530-0.7878) and 0.7206 (0.6536-0.7875), respectively. NLR, PIV, and their combinations show high sensitivity and specificity in the diagnosis of brain tumors, especially gliomas. Overall, our results provide evidence for these convenient and reliable peripheral blood markers.

Systematic review and metanalysis of neutrophil to lymphocyte ratio and prognosis in patients with nasopharyngeal carcinoma.

Hematological parameters have been associated with prognosis in patients with nasopharyngeal carcinoma (NPC). The present meta-analysis investigated the utility of neutrophil-lymphocyte ratio (NLR) in the prognosis of patients with NPC. Multiple electronic databases, including PubMed, Embase, the Cochrane Library, and the Web of Science, were systematically searched for studies assessing the association between NLR and NPC from 2011 to 2021. The primary outcomes were overall survival (OS) and progression-free survival (PFS). Pooled hazard ratios (HRs) and 95% confidence intervals (CIs) were utilized to estimate effect size. Use of a fixed effect or random effect model was based on heterogeneity stability was tested by sensitivity analysis, and the risk of bias was assessed by funnel plots. Random effects models were used based on the actual results. Because the NLR grouping criteria for the included studies differed, subgroup analyses were performed. A search of the electronic databases identified 14 studies, encompassing 6693 patients, that met the selection criteria. NLR higher than the cutoff value was significantly associated with poorer OS [HR 1.760, 95% CI 1.470-2.120, p <0.00001] and PFS [HR 1.850, 95% CI 1.430-2.390, p = .006]. Sensitivity analysis showed that the results of the meta-analysis were relatively stable, and funnel plots were used to exclude the risk of bias. Elevated pretreatment NLR in peripheral blood is predictive of poorer OS and PFS in patients with NPC. NLR is an easily measured and important prognostic factor in patients with NPC.

The relationship between neutrophil to lymphocyte ratio and diastolic dysfunction in patients with essential hypertension

Aim: Diastolic dysfunction (DD), which often accompanies essential hypertension (HT), can progress to heart failure with preserved ejection fraction. Recent studies have shown an association between chronic inflammation and HT. In this study, we aimed to investigate the neutrophil lymphocyte ratio (NLR) in hypertensive patients with and without DD and the relationship between NLR and DD development. Methods: The study included 50 patients with DD and 50 patients without DD. Left ventricular systolic and diastolic functions were evaluated by echocardiography in all patients. A complete blood count, C-reactive protein (CRP), and NLR were analyzed in blood samples obtained from the patients. Results: There was no significant difference in demographic characteristics and biochemical values between the two groups. White blood cell count and NLR were significantly higher in the group with DD (p&lt;0.001). There was a strong correlation between the presence of DD and NLR in hypertensive patients (r=0.814, p&lt;0.001). Although CRP was between reference values in both groups, it was significantly higher in the group with DD compared to the group without DD (4.40±1.60 vs. 3.70±0.90, p=0.020). Conclusion: NLR can be used to detect DD in patients with hypertension and is an easily accessible and inexpensive inflammatory marker.

Frontal QRS-T Angle in COVID-19 Patients with reduced left ventricular ejection fraction

Aim: Diastolic dysfunction (DD), which often accompanies essential hypertension (HT), can progress to heart failure with preserved ejection fraction. Recent studies have shown an association between chronic inflammation and HT. In this study, we aimed to investigate the neutrophil lymphocyte ratio (NLR) in hypertensive patients with and without DD and the relationship between NLR and DD development. Methods: The study included 50 patients with DD and 50 patients without DD. Left ventricular systolic and diastolic functions were evaluated by echocardiography in all patients. A complete blood count, C-reactive protein (CRP), and NLR were analyzed in blood samples obtained from the patients. Results: There was no significant difference in demographic characteristics and biochemical values between the two groups. White blood cell count and NLR were significantly higher in the group with DD (p&lt;0.001). There was a strong correlation between the presence of DD and NLR in hypertensive patients (r=0.814, p&lt;0.001). Although CRP was between reference values in both groups, it was significantly higher in the group with DD compared to the group without DD (4.40±1.60 vs. 3.70±0.90, p=0.020). Conclusion: NLR can be used to detect DD in patients with hypertension and is an easily accessible and inexpensive inflammatory marker.

Effects of peripheral blood neutrophil/lymphocyte ratio levels and their changes on the prognosis of patients with early cervical cancer.

Although some studies have reported on the levels and clinical significance of peripheral blood neutrophil/lymphocyte ratio (NLR) in cervical cancer, the role of NLR levels and their changes preoperatively and postoperatively in early cervical cancer remain unclear. Our analyses explored the preoperative and postoperative NLR in 203 patients with stage I-IIA cervical cancer and evaluated the relationship between NLR changes, clinicopathological characteristics, and patient prognosis. The cut-off preoperative and postoperative NLR values were determined using receiver operating characteristic curve analysis. Preoperative NLR correlated with age, menopausal status, tumor size, and vascular infiltration, whereas postoperative NLR correlated with tumor differentiation. Patients with cervical cancer with a high preoperative NLR had significantly shorter overall survival (OS) and progression-free survival (PFS) than other patients, whereas PFS was significantly lower in the high postoperative NLR group. When comparing postoperative and preoperative NLR values, we observed a significantly higher rate of increase in postmenopausal patients and those without vascular infiltration than that among premenopausal patients and those with vascular infiltration. However, no clear difference in prognosis was observed between the groups with increased and decreased NLR. Therefore, a high peripheral blood NLR may predict a poor prognosis in patients with early cervical cancer. The effect of NLR changes on the prognosis of patients with cervical cancer requires further verification in multicenter studies.

Tertiary lymphoid structure and neutrophil-lymphocyte ratio coordinately predict outcome of pembrolizumab.

Emerging evidence suggests that the presence of tertiary lymphoid structures (TLS) and neutrophil-lymphocyte ratio (NLR) in peripheral blood is associated with the treatment response to checkpoint inhibitors (CPIs), whereas there is limited knowledge regarding whether these factors reciprocally impact the treatment outcomes of CPIs in metastatic urothelial carcinoma (mUC). Herein, we investigated treatment outcomes of platinum-refractory mUC patients (50 cases with whole-exome and transcriptome sequencing) treated with pembrolizumab. The pathological review identified 24% of cases of TLS in the specimens. There was no significant difference in the NLR between the TLS- and TLS+ groups (p = 0.153). In the lower NLR group, both overall survival and progression-free survival were significantly longer in patients with TLS than in those without TLS, whereas the favorable outcomes associated with TLS were not observed in patients in the higher NLR group. We explored transcriptomic differences in UC with TLS. The TLS was comparably observed between luminal (20%) and basal (25%) tumor subtypes (p = 0.736). Exploring putative immune-checkpoint genes revealed that ICOSLG (B7-H2) was significantly increased in tumors with lower NLR. KRT expression levels exhibited higher basal cell markers (KRT5 and KRT17) in the higher NLR group and lower differentiated cell markers (KRT8 and KRT18) in patients with TLS. In conclusion, the improved outcomes of pembrolizumab treatment in mUC are restricted to patients with lower NLR. Our findings begin to elucidate a distinct molecular pattern for the presence of TLS according to the NLR in peripheral blood.

The Effectiveness of Meloxicam Adjuvant Therapy against Negative Symptoms and Neutrophil Lymphocyte Ratio (NLR) in Schizophrenic Patients

Highlights:1. The NLR value can show the role of neuroinflammation in schizophrenic patients.2. Meloxicam as adjuvant therapy can improve negative symptoms and changes in the NLR in schizophrenic patients. AbstractIntroduction: Neutrophil-lymphocyte ratio is a simple and affordable marker of inflammation that has recently been widely used to assess systemic inflammation in psychiatric patients. This study aimed to determine and analyze the effectiveness of meloxicam as adjuvant therapy to improve negative symptoms and changes in the neutrophil-lymphocyte ratio (NLR) in schizophrenic patients. Methods: This was a quasi-experimental study using a single-blind, pretest–post-test design. Subjects were determined using a purposive sampling technique based on inclusion criteria. This study examined 34 samples and divided them into two groups. The treatment group consisted of 17 subjects who received adjuvant therapy with meloxicam 15 mg/day for 4 weeks and 17 subjects in the control group. Data collection was obtained from medical records, interviews, field notes, positive scale, negative scale, and general psychopathology scale (PANSS) assessment sheets, and blood NLR examinations. Data analysis used SPSS 25.0.Results: The negative subscale PANSS score in the treatment group decreased lower than in the control group, with p-value = 0.640. However, the decrease in NLR values was more significant in the treatment group than in the control group, with p-value = 0.094. There was a decrease in the negative subscale PANSS scores and clinical NLR scores, but it was not statistically significant.Conclusion: Adjuvant therapy with Meloxicam, given once a day for four weeks, had an effect on decreasing the negative subscale PANSS score and NLR scores for schizophrenic patients at Dr. Arif Zainudin Regional Mental Hospital (RSJD), Surakarta, clinically, but it was not statistically significant.

Effectiveness of Adjuvant Treatment of N-Acetylcysteine on Negative Symptoms and Neutrophil-Lymphocyte Ratio (NLR) in Schizophrenic Patients

Highlights:1. The essence of schizophrenia is the negative symptoms.2. Adding meloxicam can improve the negative symptoms and changes in the NLR in schizophrenic patients. AbstractIntroduction: Schizophrenia is a mental disorder that has a negative symptom domain. Negative symptoms are commonly referred to as the essence of schizophrenia. Treatment of negative symptoms is still considered less than optimal. The ratio of neutrophils and lymphocytes is one of the markers of inflammation. This study aimed to analyze the effectiveness of N-acetylcysteine as adjuvant therapy for improving negative symptoms and changes in the neutrophil-lymphocyte ratio (NLR) in schizophrenic patients. Methods: This was a quasi-experimental study using a single-blind, pretest–post-test design. The subjects were 34 schizophrenic patients who were inpatients at Dr. Arif Zainuddin Regional Mental Hospital (RSJD), Surakarta, from May to July 2020. The subjects were assigned using a purposive sampling technique based on inclusion criteria and received adjuvant N-acetylcysteine therapy at 400 mg/day for 4 weeks. Data collection was obtained from medical records, interviews, field notes, positive scale, negative scale, and general psychopathology scale (PANSS) assessment sheets, and blood NLR examinations. Data analysis used SPSS 25.0.Results: There was a significant difference between the treatment and control groups in reducing negative PANSS subscale measurement after adjuvant N-acetylcysteine treatment. However, there was no significant difference between the control and treatment groups after N-acetylcysteine administration for NLR.Conclusion: The dose of adjuvant therapy N-acetylcysteine given to patients in this study had an effect on decreasing the negative subscale PANSS score.