Lymphocyte Ratio In Patients Research Articles

The role of neutrophil to lymphocyte ratio in patients with pTa non-muscle invasive bladder cancer

Abstract Introduction: The peritumoral inflammatory reaction has a substantial importance in the oncologic outcome of bladder cancer (BC). One biomarker proven to be practical and accessible is the NLR (neutrophil-to-lymphocyte ratio) for high risk non-muscle invasive bladder cancer (NMIBC). The aim of the study was to investigate the role of NLR as a prognostic biomarker for disease recurrence, progression and survival of p Ta (pathological assesment of the primary tumor) NMIBC. Material and Methods: In our retrospective study we included 54 patients with pTa NMIBC from a total of 235 patients who underwent transurethral resection of bladder tumor (TURBT) during two consecutive years: January 2007 - December 2008 [median follow-up 106 months (interquartile range-IQR 68-116)]. Criteria for inclusion were: primary tumor, low-grade, with NLR available at 2 weeks prior to TURBT. NLR was considered altered if higher than 3. Results: The median age of the patients included was 63 years (IQR 55 - 72). Most of the patients had NLR---lt---3 (37 patients). Median EORTC (European Organization of Research and Treatment of Cancer) Recurrence Score was 4 (IQR 1-6), while EORTC Progression Score was 3 (IQR 0-6), respectively. Recurrence occurred in 8 out of 54 (14.81 %) patients and progression was identified in 2 out of 54 (3.70 %) patients with muscle-invasive BC during follow-up. NLR---gt---3 was not associated with clinical and pathological factors. In multivariable Cox regression analyses NLR as a continuous variable was an independent predictive factor for recurrence. Recurrence-free survival (RFS) Kaplan-Meier analysis did not show a statistical significance between NLR groups: 82.67% vs. 64.12%, p=0.26. Kaplan-Meier analysis showed a lower Progression-free survival (PFS) in the NLR---gt---3 group: 94.12% vs. 100%, p=0.04. During follow-up (106 months) 18 patients deceased with no impact of NLR as a prognostic factor in multivariable analyses. Kaplan-Meier overall survival (OS) analysis showed a 10-year OS of 70.27% in the low NLR group compared with 58.82% in the high NLR group, p=0.45. Conclusion: In this cohort, high NLR was associated with high recurrence rate in patients with Ta NMIBC. In low-risk NMIBC NLR could represent a valid biomarker for clinical usage regarding the intensity of follow-up schedule.

Relationship between Wilkins echocardiographic score and neutrophil to lymphocyte ratio in patients with rheumatic mitral stenosis

OBJECTIVE: Wilkins echocardiography score (WS) is commonly used for patients with rheumatic mitral stenosis (RMS) to evaluate their eligibility for percutaneous mitral balloon valvuloplasty (PMBV) treatment. Patients with WS of higher than 11 are not eligible for PMBV treatment. Previous studies demonstrated that inflammation might play a role in RMS progression. The purpose of this study was to investigate the role of neutrophil/lymphocyte ratio (N/L ratio), which is an indicator of inflammation in predicting high WS. MATERIALS and METHODS: In this retrospective study, we investigated 115 patients (93 females, 22 males) with moderate to severe RMS. Transthoracic and transesophageal echocardiography reports were analysed. Patients were divided into two groups according to their Wilkins scores. Patients with a WS ≤ 11 were included in Group 1 and those with a WS >11 were included in Group 2. The echocardiographic and haematological parameters of the groups were compared. RESULTS: Group 1 consisted of 72 patients (mean age 43.7±12.0) and group 2 consisted of 43 patients (mean age 52.7±11.3). In Group 1, the mean WS was 7.4±2.0 while it was 12.4±0.7 in Group 2. The N/L ratio was 3.8±0.5 in Group 2 and it was significantly higher than that of Group 1, which was 2.6±0.9 (p 11 in patients with RMS.

Neutrophil and platelet to lymphocyte ratio in patients with hypothyroid Hashimoto's thyroiditis.

Aim:Chronic lymphocytic thyroiditis is among the most common causes of hypothyroidism along with HT (Hashimoto’s thyroiditis) goitre, which is also named as autoimmune thyroiditis. Our study aims to determine the usefulness of PLR (platelet to lymphocyte ratio) and NLR (neutrophil to lymphocyte ratio), which can be obtained with a hemogram, at the clinical course or the severity of the disease in patients with Hashimoto’s thyroiditis.Materials and Methods:Our study is a retrospective cross-sectional study that included 121 hypothyroid or subclinical hypothyroid Hashimoto’s thyroiditis patients and a healthy control group comprised of 100 individuals. Thyroid-stimulating hormone (TSH), free triiodothyronine (FT3), free thyroxine (FT4), anti-thyroid peroxidase (anti-TPO), complete blood count (CBC), and C-reactive protein (CRP) results were obtained from patient files for both HT patients and the control group, and we computed PLR and NLR for both groups.Results:PLR was lower in patients diagnosed with HT compared to the healthy control group, with statistical significance (respectively, 130.8±50.5 versus 145.3±58.5; p<0,05). NLR was higher in patients diagnosed with HT compared to the control group and a statistically significant relationship was determined (respectively, 2.43±0.94 versus 2,11±0,81; p<0,05). In addition to the present findings, we determined that PLR and NLR were correlated with anti-TPO, TSH, and FT4, although without statistical significance.Conclusion:As values that can be measured with an inexpensive and easily accessible routine hemogram, PLR and NLR can serve as practical and valuable markers at the clinical course or the severity of the disease and other diseases that are autoimmune and progress with chronic inflammation. (www.actabiomedica.it)

Prognostic significance of neutrophil lymphocyte ratio in patients of carcinoma cervix treated with radiotherapy

Background: The elevated neutrophil-to-lymphocyte ratio (NLR) has been identified as a poor prognostic indicator in various malignancies. The progression of malignancies is manifested as alteration in blood counts which can be used as the prognostic markers. Aim: The aim of the present study is to analyze the effect of pretreatment NLR and other hematological variables on progression-free survival (PFS) and overall survival (OS) among cervical cancers patients. Materials and Methods: The present retrospective study enrolled 303 cervical cancer (Stage IIB–IVA) patients treated by radical radiotherapy from January 2016 to December 2018. The pretreatment values of NLR, absolute neutrophil count, and absolute lymphocyte count (ALC) were recorded for each patient and their associations with the clinicopathologic variables, PFS, and OS were analyzed. Results: The optimal cutoff value of NLR was 3.0. The median follow-up period was 19 months. On univariate analysis, PFS rates during the follow-up period were significantly lower in NLR-high versus NLR-low group (P = 0.042) and in low-ALC versus high-ALC group (P = 0.018). Multivariate Cox-proportional hazards model identified NLR and ALC as the strongest prognostic factors for PFS. On univariate analysis, OS was better for patients with the International Federation of Gynecology and Obstetrics Stage IIB versus III–IVA (P = 0.046) and ALC >2000/c.mm versus ≤2000/c.mm (P = 0.050), respectively. None of the hematological variables remained significant for OS on the multivariate analysis. Conclusion: High-NLR is associated with worse survival outcomes in cervical cancer patients. NLR and ALC are the independent prognostic factors for PFS in cervical cancer patients.

The relationship between exercise capacity and neutrophil//lymphocyte ratio in patients taken to cardiopulmonary rehabilitation program.

The aim of the present study was to evaluate the relationship between exercise capacity and n/lymphocyte ratio (NLR) in patients enrolled in a cardiopulmonary rehabilitation program. NLR has recently been used as a potential marker to determine inflammation in cardiac and non-cardiac diseases. In this retrospective study, an exercise test and six-minute walking test (6MWT) were carried out in 23 patients with coronary artery disease and 28 patients with pulmonary disease before cardiopulmonary rehabilitation program, and routine hemogram test results were evaluated. The result of 6MWT test distance was 333.43 ± 86.58 m in the cardiac rehabilitation group and 348.46 ± 81.37 m in the pulmonary rehabilitation group. There was a negative correlation between 6MWT and NLR in the cardiac rehabilitation group (p < 0.05). As NLR increased, the MET value and duration of exercise decreased in the pulmonary rehabilitation group (p < 0.05). NLR could be used as a predictor to evaluate the exercise capacity in patients to be enrolled in cardiopulmonary rehabilitation program (Tab. 3, Ref. 30) Keywords: exercise capacity, neutrophil/lymphocyte ratio, rehabilitation.

Study of neutrophil lymphocyte ratio in patients with type 2 diabetes mellitus and its correlation with glycemic control

Background: Neutrophil lymphocyte ratio (NLR) is an indicator of subclinical inflammation. Subclinical inflammation may be associated with increased cardiovascular risk. Raised NLR is associated with metabolic syndrome and is found to be a predictor of cardiovascular disorders. There are only few studies assessing the correlation between NLR and glycemic control. The aim of the present study is to investigate the relationship between NLR and glycemic control in type 2 diabetes patients.Methods: This observational study was conducted in Department of Medicine, Bangalore medical college. 100 patients diagnosed to have type 2 diabetes mellitus were assessed. They were divided into three groups based upon HbA1c levels: Group 1, HbA1c ≤7%; group 2, HbA1c 7-9%, and group 3, HbA1c&gt;9%. Complete blood count and other relevant investigations were performed. SPSS software was used for statistical analysis. T test was used for continuous variables and chi square test for categorical variables. ANOVA test was used to compare three groups. A p value of &lt;0.05 was considered statistically significant.Results: Out of 100 patients, the white blood cell count (WBC count) was higher in group 3 as compared to group 1 and group 2(p 0.008). Similarly, the absolute neutrophil count was higher in group 3 as compared to group 1 and group 2(p.017). The neutrophil lymphocyte ratio (NLR) was significantly higher in group 3 as compared with group 1 and group 2(p.009). NLR had a positive correlation with HbA1c and was found to be an independent predictor of poor glycemic control in patients with type 2 diabetes mellitusConclusions: Our study found a significant positive correlation between NLR and glycemic control. Increased NLR is associated with elevated HbA1c and poor glycemic control. Type 2 diabetes mellitus patients with raised NLR should be evaluated for cardiovascular, renal and ocular complications of diabetes.

Evaluation of red blood cell distribution width,neutrophil to lymphocyte ratio and platelet to lymphocyte ratio in patients with fibromyalgia

Objective: In the present study we investigate the level of subclinical inflammatory markers neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR) and red blood cell distribution width (RDW) in FMS Method: Included in the study were 98 patients who had been newly diagnosed with FMS according to the 2010 American College of Rheumatology (ACR) criteria and 38 healthy controls. The age, Body Mass Index (BMI), White Blood Cell (WBC), neutrophil, lymphocyte, platelet, high-sensitivity C-reactive protein (hsCRP) and Erythrocyte Sedimentation Rate (ESR) values of the participants in both groups were recorded, and also the Visual Analogue Scale (VAS) and Fibromyalgia Impact Questionnaire (FIQ) scores of the patients Results : There was no statistically significant difference between Groups 1 and 2 with respect to NLR, PLR and RDW values (p>0.05). Conclusions: Blood NLR, PLR and RDW values in patients with FMS have no significance in an investigation of subclinical inflammation.

Clinical Analysis of B-CLPD with Cytopemia as the Predominant Characteristic

To investigate the clinical characteristics and therapeutic responte of patients with B-CLPD mainly manifested as cytopenia, so as to deeply understand this disease. The clinical data of 13 B-CLPD patients with hematocytopenia as main manifestation, and the absolute count of lymphocytes＜5×109/L, absence of hepatosplenic lymph-nodes and extramedullary invasion tin our department fron 2003 to 2018 were analyzed retrospectively. The clinical characteristics, therapeutic efficacy and adverse reactions of 3 patients were summarized. The median age of patients was 59 (43-76) years old, the median of lymphocyte was 1.86 (0.69-4.8) ×109/L, the levels of LDH and β2-microglubulin were normal in most patients, the monolineage and multilencage hematopoietic failure of different degrees existed in most all patients. The lymphocyte ratio in patients was 18.5%-94.0%, CD20 was positive in all patients, and yet the CD5-positive and CD-negative existed in 7 and 6 cases respectively. There was no significant difference in ratio of lymphocyte invasion among different immunophemtype. The FISH detection showed that there were no high risk genetic types. 92.3% of patients received rituximab treatment, most of them received chemotherapy of rituximab combined with C0P/CHOP like regimen, only 2 patients received fludarabine for comparatively short course. The analysis indicated that 8 out of 13 patients showed a certain theropeutic efficacy, however the drug-related hematopoietic suppression occurred in both 2 patients treated with fludarabin. The B-CLPD accompanied with hematocytopenia often displays bone marrow hypohematopoiesis of different degree and easily confuses with the congenital and acquired hemotopoietic faiture diseases. The rituximab treatment may be more appropreate for these patients, but for patients received chemotherapy containing fludarabin, the persistant hematopoietic failure must be especially watched out.

Prognostic significance of peripheral blood absolute lymphocyte count and derived neutrophil to lymphocyte ratio in patients with newly diagnosed extranodal natural killer/T-cell lymphoma.

Background: Accumulating evidence suggested that tumor microenvironment and host immune system played important roles in determining the clinical course and outcome of human malignancies. The derived neutrophil to lymphocyte ratio (dNLR) and absolute lymphocyte count (ALC) were demonstrated to act as a prognostic factor in several malignancies. Nevertheless, the prognostic significance of them in extranodal natural killer/T-cell lymphoma (ENKTL) patients has never been explored.Patients and methods: A total of 33 newly diagnosed patients with ENKTL were included in this study. Clinicopathological characteristics were collected and prognostic significance of dNLR and ALC were evaluated.Results: Elevated dNLR and low ALC were both associated with poor survival rates. Patients with dNLR ≥3.6 revealed significantly shorter overall survival (OS) (P=0.001) and progression-free survival (PFS) (P=0.008) than those with dNLR <3.6. Patients with ALC <0.8×109/L had worse OS (P=0.008) and PFS (P<0.001) than those with ALC ≥0.8×109/L. An independent significant association between low ALC and poor clinical outcome in multivariate analysis for OS (HR, 36.023; 95% CI, 2.438–532.243; P=0.009) as well as PFS (HR, 7.698; 95%CI, 1.573–37.679; P=0.012) was identified.Conclusion: In this study, we validated for the first time the prognostic value of dNLR and ALC in ENKTL patients. Elevated dNLR and low ALC were both associated with aggressive tumor process and poor survival.ALC value at diagnosis represented an independent favorable prognostic factor for the clinical outcome of ENKTL patients.

Increased neutrophil lymphocyte ratio and platelet lymphocyte ratio in malignant parotid tumors

IntroductionRecently it has been reported that a high preoperative neutrophil–lymphocyte ratio and platelet–lymphocyte ratio may be related to increased recurrence risk, tumor aggressiveness, and worsened prognosis in various malignancies. ObjectiveThe objective of this research is to explore whether neutrophil–lymphocyte ratio and platelet–lymphocyte ratio in parotid tumors may or may not be used as a cancer marker. MethodsThis retrospective research has been conducted on a total of 228 patients consisting of 83 healthy persons and 145 patients with a mass in the parotid gland, who applied to a tertiary referral center and underwent surgery. Patients have been divided into two groups by their histopathological findings as malignant or benign parotid tumor. A third group consisting of healthy people has been defined as the control group. Also the malignant parotid tumor group has been divided into two subgroups as early stage and advanced stage. The groups have been compared in terms of neutrophil–lymphocyte ratio, platelet–lymphocyte ratio and other laboratory data. ResultsThe average neutrophil–lymphocyte ratio values of malignant parotid tumor, benign parotid tumor, healthy control groups were 2.51, 2.01, 1.79 respectively and the difference was statistically significant (p<0.001). There was no significant difference between advanced stage and early stage parotid tumor groups in terms of average neutrophil–lymphocyte ratio value (p=0.782). In dual comparisons, the platelet–lymphocyte ratio value of patients in the malignant group was found out to be statistically significantly higher than that of benign and control groups (p<0.001 and p=0.001 respectively). ConclusionTo the best of our knowledge our research is the first in the medical literature comparing neutrophil–lymphocyte ratio and platelet–lymphocyte ratio in patients with parotid tumor. neutrophil–lymphocyte ratio and platelet–lymphocyte ratio can serve as cost-effective, repeatable, easily accessible, and helpful inflammatory markers in order to distinguish patients with malignant parotid tumor from healthy people.

Neutrophil lymphocyte ratio in patients with ankylosing spondylitis: A systematic review and meta-analysis

Objective: The aim of this meta-analysis was to investigate the association of neutrophil lymphocyte ratio (NLR) with AS (ankylosing spondylitis) patients.Methods: PubMed, Web of Science, Cochrane Library, Elsevier Science Direct and Google Scholar databases (up to 30 September 2018) were searched to collect all pertinent articles. The pooled standard mean difference (SMD) with 95% confidence interval (CI) was calculated by the random effects model.Results: Totally 10 studies contained 765 AS patients and 701 healthy controls were included in our meta-analysis. The results indicated that there were significant statistical differences between AS patients and healthy controls in NLR (SMD = 0.418, 95%CI = 0.239–0.598, p < .001). Meanwhile, the results of subgroup analysis showed, in the subgroup of C-reactive protein (CRP) ≥10 and the two subgroups of BASDAI (the Bath AS Disease Activity Index), NLR levels in AS were significantly higher than in control (all p < .001). The results of subgroup analysis and meta-regression suggested that BASDAI and CRP were likely associated with NLR in AS patients.Conclusion: The current meta-analysis provides evidence that NLR is a reasonable measure to detect systemic inflammation in AS patients. Besides, NLR may be able to indicate disease activity in patients with AS.

Clinical, Demographical Features, Accompanying Diseases and Neutrophil to Lymphocyte Ratio- Platelet to Lymphocyte Ratio in Patients with Bullous Pemphigoid in Bolu

Objective: Bullous pemphigoid (BP) is a rare autoimmune blistering disorder that affects the elderly population. In this study, we retrospectively evaluated the clinical, demographic characteristics and comorbid diseases in patients with BP. Mean platelet volume (MPV), neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) are known to be the indicators of inflammation. We also investigated MPV, NLR, and PLR values in patients with BP and a control group. To our knowledge, there is no previous study in the literature researching NLR, PLR and MPV together in patients with BP. Method: A total of fourteen patients with BP and fourteen control subjects were included in the study. Medical reports of the patients who received clinical and histopathological diagnosis of BP between 2008 and 2018 were reviewed. MPV, NLR, and PLR values were recorded in BP patients and the control group. Results: Of the 14 patients, 9 were female and 5 male. The most frequent comorbid chronic disease was hypertension, which was detected in 7 (50%) patients. Four of the 7 patients with hypertension had coronary artery disease (28,5%) at the same time. The NLR of patients with BP was significantly higher than that of the control group (p = 0.01). There was no difference in PLR and MPV between the groups. Conclusions: The most common comorbidity in patients with BP in our study was cardiovascular diseases. More studies are needed to investigate the association between BP and cardiovascular disorders. In addition, NLR may be an inexpensive and simple parameter of inflammation in patients with BP and needs to be developed further.

Thyroid autoimmunity and increased neutrophil lymphocyte ratio in patients with chronic urticaria

Amaç: Kronik ürtikerin (KÜ) etyopatogenezi henüz net değildir. Ancak otoimmünitenin ve inflamasyonun rol oynadığı yapılan çalışmalarda gösterilmiştir. Bu çalışmamızda KÜ’li hastalarda tiroid otoimmünitesinin saptanması, hastalık şiddetiyle ilişkisinin araştırılması ve inflamatuar belirteçler olan nötrofil lenfosit oranı (NLO), eosinofil lenfosit oranı (ELO) ve monosit lenfosit oranlarının (MLO) kontrol grup ile karşılaştırılması amaçlanmıştır. Gereç ve Yöntemler: Erişkin allerji-immünoloji polikliniğinde KÜ nedeniyle takip edilen hastaların kayıtları geriye dönük olarak incelendi. Çalışmaya 100 KÜ’li hasta ve kontrol grubu olarak 100 sağlıklı birey alındı. KÜ’li hastaların demografik verileri, yedi günlük ürtikeryal aktivite skorları (UAS 7), kullandığı ilaçlar, laboratuar verilerinden anti-tiroglobülin (anti-Tg) ve anti-tiroid peroksidaz (anti-Tpo), antinükleer antikor (ANA) sonuçları ve kan sayımı parametreleri kayıt edildi. Kontrol grubu olarak yaş ve cinsiyet uyumlu sağlıklı bireylerin kan sayımı parametreleri kayıt edildi.Bulgular: KÜ hastalarda anti-Tpo % 19 hastada pozitif iken, anti-Tg % 8, ANA % 17 hastada pozitif idi. KÜ hastalar UAS 7’ye göre hafif, orta ve şiddetli olarak, gruplara ayrılarak değerlendirildiğinde, gruplar arası anti-Tpo, anti-Tg ve ANA sonuçları açısından fark saptanmadı (p&amp;gt;0,05). KÜ hastalar ve kontrol grupları arasında NLO, MLO ve ELO kıyaslandığında, NLO ve MLO istatistiksel olarak anlamlı yüksek tespit edilirken (p=0,028, p=0,001, sırasıyla) ELO açısından istatistiksel olarak anlamlı fark yoktu (p=0,094). KÜ’li hastalarda NLO, MLO ve ELO değerleri anti-Tpo, anti-Tg ve ANA pozitif ve negatif olan gruplar arasında kıyaslandığında anlamlı fark saptanmadı (p&amp;gt;0,05). Sonuç: KÜ’de otoimmünitenin ve inflamasyonun önemi yapılan çalışmalarda gösterilmişti. Ek olarak bu çalışmada hastalık aktivitesi ile tiroid otoimmünitesi arasında ilişki saptanmazken inflamatuar bir belirteç olan NLO’ya ek olarak MLO da yüksek olarak tespit edildi.

Elevated neutrophil to lymphocyte and platelet to lymphocyte ratios predict high grade and advanced stage renal cell carcinoma.

Renal cell carcinoma is the most common malignancy of the kidney, which accounts 85% of all renal tumors. In recent years, the incidence of renal cell carcinoma was increased due to the widespread use of imaging techniques. The aim of this study is to investigate the clinical significance of pretreatment neutrophil to lymphocyte and platelet to lymphocyte ratios in patients with renal cell carcinomas. The patients who underwent nephrectomy for renal tumor between 2010 and 2018 in two centers were reviewed retrospectively. The age, sex, complete blood test, and pathological results were recorded. The patients who were diagnosed with other carcinomas, benign renal tumors, and missing data of age, complete blood test, and pathological results, were excluded. The patients were divided into two groups according to the T stage and Fuhrman grade, T1-2 and T3-4, G1-2 and G3-4. There were 271 patients in the current study. The male to female ratio was 1.97 and the mean age of the patients was 59.37±11.62 years. Clear cell renal cell carcinoma was the most common subtype in 72.7% of the patients. Both the neutrophil to lymphocyte ratio and the platelet to lymphocyte ratio were significantly higher in patients with high-grade and advanced-stage disease than in the others. The receiver operating characteristic curve showed no significant difference between platelet to lymphocyte ratio and neutrophil to lymphocyte ratio to diagnose the high grade and stage of renal cell carcinoma. The neutrophil to lymphocyte and platelet to lymphocyte ratios are easily accessible biomarkers which are used for the prognosis of malignancy. The current study found that these biomarkers may predict the pathological results during the preoperative period.

Neutrophil exosomes enhance the skin autoinflammation in generalized pustular psoriasis via activating keratinocytes.

Generalized pustular psoriasis (GPP) is a rare and severe inflammatory skin disease that can be life-threatening. Gene mutations are found in some cases, but its immune pathogenesis is largely unknown. Here, we observed that the neutrophil:lymphocyte ratio in patients with GPP was higher than that in healthy controls and decreased after effective treatment. Neutrophils isolated from patients with GPP induced higher expressions of inflammatory genes including IL-1β, IL-36G, IL-18, TNF-α, and C-X-C motif chemokine ligands in keratinocytes than normal neutrophils did. Moreover, neutrophils from patients with GPP secreted more exosomes than controls, which were then rapidly internalized by keratinocytes, increasing the expression of these inflammatory molecules via activating NF-κB and MAPK signaling pathways. The proteomic profiles in neutrophil exosomes further characterized functional proteins and identified olfactomedin 4 as the critical differentially expressed protein that mediates the autoimmune inflammatory responses of GPP. These results demonstrate that neutrophil exosomes have an immune-regulatory effect on keratinocytes, which modulates immune cell migration and autoinflammation in GPP.-Shao, S., Fang, H., Zhang, J., Jiang, M., Xue, K., Ma, J., Zhang, J., Lei, J., Zhang, Y., Li, B., Yuan, X., Dang, E., Wang, G. Neutrophil exosomes enhance the skin autoinflammation in generalized pustular psoriasis via activating keratinocytes.

Prognostic value of platelet to lymphocyte ratio in patients with non-small cell lung cancer

Background: The prognostic value of Platelet-to-lymphocyte ratio (PLR) in patients with non-small-cell lung cancer (NSCLC) is still indistinct. We conducted this study to assess the prognostic significance of pretreatment PLR in patients with unresectable NSCLC.Aim of the Work: To assess the prognostic significance of pre-treatment PLR in patients with NSCLC.Material and Methods: We retrospectively reviewed 130 patients treated for NSCLC with definitive/palliative chemotherapy and/or radiotherapy in Ain-Shams Universit hospital, Clinical Oncology department between January 2014 and December 2016. Pre-treatment CBC was available for the 130 patients to calculate PLR by dividing the absolute platelet count by the absolute lymphocytic count.Results: Out of 130 patients with available pre-treatment complete blood picture, population age ranged from 23 to 87 years. Male to female ratio was 4.8:1. Adenocarcinoma presents 51% of cases. Unresectable stage II and stage III present 2% and 27% respectively, while Stage IV presents 69%. Using a cut-off value of 150, a statistically significant correlation between baseline PLR &gt; 150 and presence of distant metastases was found (p = .043); with a trend towards less advanced stage disease among group of patients with baseline PLR &lt; 150 (p = .064). High PLR &gt; 150 was significantly associated with poor overall survival (OS) (median OS: 10.33 months; 95% CI: 6.23-14.42, compared to patients with PLR &lt; 150; (median OS: 24.63 months, 95% CI:11.5-37.76, p = .008), but not PFS. In multivariate analysis, PLR &lt; 150 was an independent good prognostic factor for OS; (HR = 0.549; 95% CI: 0.314-0.958; p = .035).Conclusion: High PLR is associated with poor OS in patients with unresectable NSCLC.

Assessment of neutrophil to lymphocyte and platelet to lymphocyte ratios in patients with temporal lobe epilepsy

Assessment of neutrophil to lymphocyte and platelet to lymphocyte ratios in patients with temporal lobe epilepsy

The Clinical Significance of Neutrophil Lymphocyte ratio, Monocyte Lymphocyte ratio and Platelet Lymphocyte ratio in Patients with Guillain-Barré Syndrome

The Clinical Significance of Neutrophil Lymphocyte ratio, Monocyte Lymphocyte ratio and Platelet Lymphocyte ratio in Patients with Guillain-Barré Syndrome

Significance of Neutrophil to Lymphocyte Ratio in Patients Undergoing Appendectomy

Significance of Neutrophil to Lymphocyte Ratio in Patients Undergoing Appendectomy

Predictive value of neutrophil to lymphocyte ratio in patients with acute exacerbation of chronic obstructive pulmonary disease.

ObjectiveThis study aimed to determine the predictive value of the neutrophil to lymphocyte ratio (NLR) in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD).MethodsA retrospective study was conducted from March 2012 to May 2016 in Fuxing Hospital, Capital University of Medical Science. We collected 906 cases (525 males, 381 females, mean age 81.86±9.75 years) diagnosed with AECOPD. The NLR was calculated from their white blood cell (WBC), neutrophil (NEU), and lymphocyte (LYM) counts, which were obtained at laboratory examination.ResultAfter treatment, 698 patients with AECOPD improved. The NLR was higher at admission (6.89±6.82) than after treatment (4.19±5.11) (P = 0.000). The area under the receiver operating characteristic curve (AUC) of the NLR for predicting the 28-day mortality rate was 0.737. Using 8.130 as the critical NLR value, the sensitivity was 60.5%, and the specificity was 74.8%. The AUC of the NLR for predicting the frequency of the need for invasive mechanical ventilation was 0.732. Using 10.345 as the critical NLR value, the sensitivity was 54.3%, and the specificity was 84.8%. The AUC of WBC, NEU and LYM for predicting 28-day mortality and the need for invasive mechanical ventilation in these patients were all less than 0.7. An increased NLR was an independent risk factor for 28-day mortality (OR = 1.067, 95% CI = 1.039 to 1.095, P = 0.000), intensive care unit occupancy (OR = 1.046, 95% CI = 1.023 to 1.068, P = 0.000), and the need for invasive mechanical ventilation (OR = 1.042, 95% CI = 1.019 to 1.066, P = 0.000). Compared with those patients without comorbidities, patients with renal dysfunction or upper gastrointestinal bleeding had an increased risk of death within 28 days (OR = 3.102, 95% CI = 1.525 to 6.312; OR = 4.598, 95% CI = 1.825 to 11.583, respectively), ICU admission (OR = 2.228, 95% CI = 1.286 to 3.860; OR = 3.103, 95% CI = 1.402 to 6.866, respectively), and the need for invasive mechanical ventilation (OR = 3.572, 95% CI = 1.822 to 7.000; OR = 4.279, 95% CI = 1.823 to 10.045, respectively).ConclusionIn patients with AECOPD, the accuracy of the NLR for predicting the 28-day mortality rate and frequency of the need for mechanical ventilation was significantly higher than the accuracy of WBC, NEU and LYM counts. AECOPD patients with an NLR≥8.130 had higher 28-day mortality rate, while those with an NLR ≥10.345 were more likely to need invasive mechanical ventilation.