Monocyte/lymphocyte Ratio Values Research Articles

Effect of adalimumab treatment on inflammatory and hematological parameters in patients with Hidradenitis suppurativa

Objective Hidradenitis suppurativa (HS), a chronic inflammatory disease that typically manifests after puberty, is characterised by painful nodules, abscesses, draining sinus tracts, and scars in areas rich in apocrine glands such as the axillary and inguinal regions. In recent years, blood-based biomarkers such as the Neutrophil/Lymphocyte Ratio (NLR), Platelet/Lymphocyte Ratio (PLR), Monocyte/Lymphocyte Ratio (MLR), Mean Platelet Volume (MPV), Systemic Immune-Inflammation Index (SII) and Pan-Immune-Inflammation Value (PIV) have been used as significant indicators of systemic inflammation. While there are few studies evaluating these biomarkers in HS, the response of these markers to treatment has only been assessed in one study to date. Our study aims to investigate the effect of adalimumab treatment on blood-based systemic inflammation biomarkers in HS, where inflammation plays a significant role. Methods The study included 42 adult patients who received adalimumab treatment at our dermatology and venereology clinic between January 2020 and January 2023. Medical records for complete blood count results of the patients were retrospectively reviewed. All systemic inflammation-based biomarkers were calculated from the absolute values of the complete blood count. The SII was calculated with the following formula: (neutrophil count × platelet count/lymphocyte count). The PIV was calculated as follows: (neutrophil count × platelet count × monocyte count/lymphocyte count). Values before the treatment and at the 12th week of treatment were compared. Results When the changes in the inflammatory parameters of the patients were examined, it was found that NLR (2.13 ± 0.87 vs 2.26 ± 1.12), PLR (111.01 ± 39.89 vs 99.43 ± 35.34), MLR (0.27 ± 0.11 vs 0.28 ± 0.12), MPV (9.59 ± 0.71 vs 9.70 ± 0.79), SII (680.79 ± 330.18 vs 687.89 ± 442.66), and PIV (552.02 ± 330.71 vs 605.05 ± 415.96) values did not change statistically significantly after treatment (p > 0.05). While there was a significant decrease in platelet count compared to before treatment, no statistically significant difference was found in the other evaluated blood cells. Conclusion Adalimumab treatment has not had a significant effect on systemic inflammation markers in HS, an inflammatory disease. More studies are needed to evaluate the effect of adalimumab on these markers in HS.

Evaluation of inflammatory markers obtained from complete blood count in different stages of schizophrenia

Objective Systemic inflammatory biomarkers recently studied in schizophrenia include neutrophil/lymphocyte ratio (NLR), monocyte/lymphocyte ratio (MLR), platelet/lymphocyte ratio (PLR), systemic immune inflammation index (SII), and systemic inflammation response index (SIRI). SIRI, a novel inflammatory marker, has not been studied in different stages of schizophrenia. We aimed to compare NLR, MLR, PLR, SII, and SIRI values between psychotic exacerbation and remission values of the same patients with schizophrenia and a healthy control group. Method In this study, 86 patients with schizophrenia who were hospitalized due to psychotic relapse, the same patient group who were in remission after treatment, and 86 age-sex-matched healthy control subjects were analyzed. Inflammatory marker values of the patient group in both the psychotic exacerbation (PE) and the remission (R) period were analyzed and compared with healthy controls (HC). Results NLR, MLR, PLR, SII, and SIRI values were significantly higher in the schizophrenia-PE group than in the HC group. NLR, MLR, SII, and SIRI values were significantly higher in the schizophrenia-PE group than in the schizophrenia-R group. MLR values were significantly higher in the schizophrenia-R group than in the HC group. Conclusion These findings may be interpreted as NLR, SII, and SIRI, which may be considered as state biomarkers, and MLR may be a trait marker for schizophrenia.

SENSITIVITY OF PLATELET-LYMPHOCYTE RATIO, MONOCYTE-LYMPHOCYTE RATIO, NEUTROPHIL-LYMPHOCYTE RATIO, RED BLOOD CELL DISTRIBUTION WIDTH AND SYSTEMIC IMMUNE INFLAMMATORY INDEX IN MULTIPLE SCLEROSIS PATIENTS: RELATIONSHIP WITH DISEASE SUBTYPES AND DISABILITY

OBJECTIVE: Multiple sclerosis (MS) is a chronic inflammatory autoimmune disease of the central nervous system (CNS). Although it is not clear how autoimmune responses occur, it is known that peripheral blood cells may promote the initiation and exacerbation of the inflammatory response in MS. The aim of this study was to evaluate the sensitivity and specificity of neutrophil-lymphocyte ratio (NLR), monocyte-lymphocyte ratio (MLR), platelet-lymphocyte ratio (PLR), erythrocyte distribution width (RDW) and systemic immune inflammation index (SIII) in MS and to determine their relationship with disability. MATERIAL AND METHODS: In this single-center, retrospective case-control study, 104 patients with MS and 65 healthy individuals were included. Disability was assessed with the Expanded Disability Status Scale (EDSS) score, and patients were classified as mild (EDSS<3), moderate (3.5 ≤ EDSS ≥4.5), and severe (EDSS≥5) disabilities. NLR, MLR, PLR, RDW and SIII values were calculated according to the complete blood counts of the patients and the control group. Inflammation markers between the control group and MS patients, MS subtypes, and relapsing-remitting MS (RRMS) attack and remission periods were compared. the relationship between these markers and duration of illness, number of attacks and disability was examined. RESULTS: MLR and RDW were higher in MS than the controls. There was no significant difference in these values between MS subtypes. It was observed that RDW increased as the disease duration, number of attacks and EDSS increased. CONCLUSIONS: In our study, in evaluating inflammation it was seen that MLR and RDW were more determinative than PLR, NLR and SIII. The fact that RDW is higher in MS patients and is affected by disease disability indicates that RDW may have an important role in the follow-up of MS patients and in evaluating the degree of disability.

Evaluation of hematological inflammatory parameters in patients with palmoplantar pustulosis.

Palmoplantar pustulosis (PPP) is a chronic inflammatory disease of ill-defined etiopathology. Recent studies have proposed complete blood count-based hematological parameters, such as neutrophil/lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR), as biomarkers to monitor disease status in many inflammatory diseases. This study aimed to analyze for the first time the clinical significance of hematological parameters, including NLR, monocyte/lymphocyte ratio (MLR), PLR, mean platelet volume (MPV), plateletcrit (PCT), and pan-immune-inflammation value (PIV) in PPP patients. We retrospectively investigated the clinical and laboratory data of 237 patients with PPP and 250 sex-age-matched healthy controls (HCs). Hematological parameters were compared between patients with PPP and HCs. The correlations between these parameters and disease severity, as well as treatment response, were analyzed. NLR, MLR, MPV, PCT, and PIV values were significantly higher in PPP patients than in HCs. But in receiver-operating characteristic analyses, only monocyte count (Youden Index = 0.53), PCT (Youden Index = 0.65), and PIV (Youden Index = 0.52) performed relatively accurate distinguishment between moderate-to-severe cases and mild cases. PCT and PIV values were significantly correlated with disease severity. After treatment, both PIV and PCT values decreased significantly in the responder group but not in the non-responder group. Hematological parameters altered significantly in PPP patients. PCT and PIV can be used as simple and inexpensive biomarkers for systemic inflammation in PPP patients.

Comparison of diagnostic values of monocyte-lymphocyte ratio, neutrophil-lymphocyte ratio, red cell distribution width-lymphocyte ratio, and systemic inflammatory index in predicting patients with non-dipper hypertension

Objective: Hypertension (HTN) is related to myocardial ischemia, malignant arrhythmias, and cardiovascular mortality. However, inflammatory biomarkers are an important predictor of cardiovascular events. This study aimed to examine the diagnostic utility of inflammatory biomarkers in determining non-dipper hypertensive individuals and the relative superiority of the biomarkers. Methods: The research was carried out as a retrospective observational study. Patients diagnosed with HTN were included in this study. Blood pressure (BP) measurements were obtained from Holter records. The patients were classified into two groups: non-dipper (n=54) and dipper (n=143) based on Holter monitoring. The cut-off value of MLR (monocyte/lymphocyte ratio), NLR (neutrophil/lymphocyte ratio), SII (systemic inflammatory index), and RLR (red cell distribution width/lymphocyte ratio) for predicting non-dipper hypertension was determined using a receiver operating characteristic (ROC) analysis. Results: A total of 197 patients, comprising 84 females (42.6%) and, 113 males (57.4%) with a median age of 62 (54-69) years, participated in the research. Age, FPG, CRP, WBC, NEU, LYM, MONO, RDW, NLR, MLR, RLR, and SII were higher in the non-dipper group (p0.05). When the odds ratios of putative variables were evaluated, it was found that increasing MLR (OR: 7.22; 95%CI: 3.52-14.78; p

Evaluation of Relationship of Neutrophil/Lymphocyte, Platelet/Lymphocyte, Monocyte/Lymphocyte Monocyte/HDL Ratios and Systemic Immune Inflammatory Index Value with Antipsychotic Treatments in Schizophrenic Patients

IntroductionThere are studies showing that the systemic inflammation response in patients diagnosed with schizophrenia is different from healty controls. Neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (TLR), monocyte-lymphocyte ratio (MLR), monocyte-HDL ratio (MHO) and systemic immune inflammation index (SII) have recently been used as inflammation indicators.ObjectivesNLR, TLR, MLR, MHO and SII have been evaluated in many studies in schizophrenia patients. The aim of our study is to evaluate the relationship between NLR, TLR, MLR, MHO, SII values and antipsychotic treatments of patients diagnosed with schizophrenia.Methods203 individuals diagnosed with schizophrenia who were followed up in the psychotic disorders outpatient clinic of Selçuk University Faculty of Medicine were included in the study. Neutrophil, lymphocyte, platelet and monocyte counts and HDL values were obtained retrospectively from blood tests. NLR, TLR, MLO, MHO and SII were calculated. The study approved by the ethics committee of Selçuk University Faculty of Medicine.Results45.3% of the patients were female (n = 92); the mean age was 45.8±14.0. The average number of hospitalizations was 3.0±2.7 years; the mean disease duration was 17.0±9.6 years. 56.7% (n=115) use long-acting antipsychotic treatment, 21% (n=43) use monthly paliperidone long-acting (PP1M) treatment, and 14.8% (n=30) use 3-month paliperidone long-acting (PP3M) treatment. No significant difference was observed in NLR, TLR, MLR, MHO and SII values between individuals using and not using long-acting antipsychotics. However, a significant difference in NLR value was observed between PP1M and PP3M treatment (p = 0.039). Oral antipsychotic use was 71% (n=137), 19% (n=38) used clozapine monotherapy, and 25% (n=51) used non-clozapine oral monotherapy. No significant difference was detected in inflammatory markers between clozapine monotherapy and other oral monotherapies.ConclusionsAccording to our findings, NLR levels in patients diagnosed with schizophrenia were found to be significantly higher in those using PP1M treatment compared to those using PP3M. This finding can be interpreted in favor of the fact that PP3M contributes to the reduction of inflammation due to its longer duration of action compared to PP1M. It is thought that schizophrenia progresses through inflammatory processes and antipsychotic treatments play a role in anti-inflammation. It is envisaged that future studies may be helpful in evaluating the onset, exacerbation and remission periods of the disease, including treatment doses and durations, and revealing the relationship between inflammatory markers and schizophrenia disease and the effects of antipsychotic treatments on inflammatory markers such as NLR, TLR, MLR, MHO and SII.Disclosure of InterestNone Declared

The Predictive Role of Inflammatory Biomarkers in Patients With Larynx Cancer Undergoing Definitive Radiotherapy.

Inflammation plays an important role in the process of cancer development. The number of studies evaluating the ability of inflammatory biomarkers to predict survival has increased in recent years. This study aimed to comprehensively evaluate the predictive role of inflammatory biomarkers in patients with larynx cancer undergoing definitive radiotherapy. A total of 101 patients who underwent definitive radiotherapy for larynx cancer at our center were retrospectively examined. Blood samples were taken from the patients before radiotherapy to obtain biomarkers such as C-reactive protein (CRP), neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), monocyte-lymphocyte ratio (MLR), systemic immune-inflammation index (SII), pan-immune inflammatory value (PIV), hemo-eosinophil inflammation index (HEI), albumin, and Lactate dehydrogenase (LDH). The study examined the predictive value of parameters for progression-free survival (PFS), local recurrence-free survival (LRFS), and overall survival (OS) using both univariate and multivariate Cox regression analysis. In the univariate analysis, the biomarkers that predicted PFS were SII, PIV, CRP, and Eastern Cooperative Oncology Group Performance Status (ECOG PS). According to the multivariate analysis, only CRP was found to be a significant predictor of PFS. In the univariate analysis, the following biomarkers were found to predict OS: NLR, PLR, MLR, SII, PIV, CRP, HEI, stage, and ECOG PS. In the multivariate analysis, NLR and ECOG PS were found to be predictors of OS. A significant difference was found in MLR, PIV, and CRP values based on the presence of lymphatic metastasis. The current study is the first to comprehensively examine the relationship between larynx cancer and several inflammatory biomarkers. Many of these biomarkers have been shown to predict both PFS and OS in patients with larynx cancer undergoing definitive radiotherapy. It has been shown that PIV and CRP may predict the presence of lymphatic metastases in addition to PFS and OS.

Neutrophil-Lymphocyte Ratio, Monocyte-Lymphocyte Ratio and Platelet-Lymphocyte Ratio in Manic Episode Patients with Bipolar Disorder

Objective: Inflammation is one of several etiopathological mechanisms contributing to bipolar disorder. Neutrophil-lymphocyte ratio (NLR), monocyte-lymphocyte ratio (MLR), and platelet-lymphocyte ratio (PLR) are relatively cheap hematological parameters recommended to measure the level of inflammation. In this study, the NLR, MLR, and PLR values of the same patients during manic and euthymic periods were compared to a healthy control group. Methods: This retrospective study was conducted on inpatients with bipolar disorder manic episodes at the University Faculty of Medicine psychiatry clinic. Ninety-nine patients with manic episodes of bipolar disorder and age and gender-matched 101 volunteers without prior psychiatric illness were included in the study. Neutrophil, lymphocyte, monocyte, and platelet counts during the disease period were recorded, and NLR, MLR, and PLR values were calculated from these values. Similar hematological parameters of the same patients in the euthymic period after discharge were compared. Results: Patients with manic episodes were shown to have significantly higher neutrophil, platelet, NLR, MLR, and PLR levels than the control group (p<0.001). Monocyte count was significantly lower in manic episode patients compared to controls (p<0.001). Neutrophil and monocyte counts were significantly lower during the euthymic period compared to the control group, while NLR, MLR, and PLR levels were higher (p<0.001). Conclusions: The fact that NLR, MLR, and PLR are higher in BD patients compared to the healthy control group in both manic and euthymic periods indicates that they can be used as trait biomarkers.

Can the Systemic Immune Inflammation Index Predict the Treatment of Ectopic Pregnancy?

Objective: The aim of this study was to predict the selection of treatment for ectopic pregnancy (EP) using the values of platelet/lymphocyte ratio (PLR), neutrophil/lymphocyte ratio (NLR), monocyte/lymphocyte ratio (MLR) and systemic immune inflammation index (SII) obtained from hematological parameters routinely used in clinical practice. Design: Retrospective observational study. Place & duration of study: This retrospective, cross-sectional study was conducted in the Department of Obstetrics and Gynecology of Konya City Hospital, between August 2020 and August 2022. Methodology: The study included 140 patients who were diagnosed with EP in our hospital. The patients were separated as those who received medical treatment with methotrexate (MTX) (Group I) and those who underwent surgical procedures (Group II). The two groups were compared with respect to demographic characteristics and pre-treatment laboratory parameters. Results: Of the 140 patients diagnosed with EP, 75 were in Group I, treated with MTX, and 65 were in Group II, treated with surgery. No significant difference was determined between the groups with respect to age, body mass index, and gravida-parity of the patients (p>0.05). The incidence of extrauterine mass, presence of yolk sac, and fetal heartbeat on ultrasonography was significantly higher in Group II than in Group I (p<0.05). NLR and MLR values in Group II were significantly lower than in Group I (p<0.05). The PLR value did not differ significantly between the groups (p>0.05). The SII value was significantly higher in Group II than in Group I (p<0.05). Conclusion: NLR and MLR were found to be lower, and the SII was significantly higher in the patients who underwent surgery. Hematological parameters, especially SII, are potential markers that can be used in EP treatment selection.

The predictive value of hematological markers in renal cell carcinoma.

621 Background: Renal cell carcinoma (RCC), which accounts for about 3% of adult malignancies, is regarded as a major cause of morbidity and mortality. The neutrophil-lymphocyte ratio (NLR) is a simple, reliable, and cost-effective biomarker of systemic inflammation that has been linked to oncologic outcomes in a variety of malignancies. The objective of this study is to determine whether NLR, along with other hematological parameters such as absolute neutrophil count (ANC), absolute lymphocyte count (ALC), absolute eosinophil count (AEC), absolute monocyte count (AMC), monocyte-lymphocyte ratio (MLR), platelet-lymphocyte ratio (PLR), and the Systemic Immune-Inflammation Index (SII; defined as neutrophils counts X platelets counts divided by lymphocyte count), are related to baseline distant metastases and overall survival (OS) in RCC patients. Methods: Clinical data from 203 RCC patients treated at King Hussein Cancer Center (Amman, Jordan) were retrospectively reviewed. We examined the relationship between age, sex, ANC, AMC, ALC, AEC, NLR, MLR, PLR, and SII with baseline distant metastasis and patients’ OS. Results: Of the 203 patients, 97 patients (48.5%) were stage 4 at the time of diagnosis. Univariate analysis showed that patients with high baseline ANC (>5400), AMC (>600), AEC (>120), NLR (>4.36), MLR (>0.33), PLR (>140.44), WBC count (>8.2), SII (>757.7) and low baseline ALC (≤1900) had more baseline metastasis. (p-value: <0.001, 0.007, 0.020, <0.001, <0.001, <0.001, 0.006, <0.001, and 0.004, respectively). On multivariate analysis, patients who had elevated NLR (>4.36) were more likely to have distant metastasis at the time of diagnosis (p-value = 0.0076, odds ratio (OR): 4.45, CI: 1.49–13.33). Moreover, univariate and multivariate analysis showed that patients with elevated NLR (>4.36) were associated with poorer OS (p-value: <0.0001 and 0.0065, respectively). In addition, patients with elevated baseline ANC, AMC, MLR, PLR, SII, WBC count, and low ALC values were associated with poorer OS (p-value: <0.0001, 0.0234, <0.0001, <0.0001, <0.0001, 0.0290, and <0.0001, respectively). Conclusions: The results of this study indicate a substantial correlation between several hematological parameters, including NLR, with the presence of distant metastases at the time of diagnosis and OS. Further research is required to uncover whether these hematological markers may be used to identify patients who are more likely to develop metastases and predict treatment response.

Obez ve obez olmayan çocuklarda inflamatuar hematolojik parametrelerin karşılaştırılması

Introduction: Obesity is an increasing health problem in the whole world, and it has an important inflammatory component related to the insulin resistance (IR), hypertension, atherosclerosis and some cancers. This study aims to evaluate the inflammatory hematological parameters in childhood obesity.Methods: Sixty-four obese and 50 normal weight cases were included in the study. The physical examination features and laboratory data of the patients were evaluated retrospectively from the patient’s files. Laboratory tests, hematological parameters, gender were compared between the groups. Correlations between Homeostasis model evaluation for insulin resistance (HOMA-IR) and other laboratory parameters in the obese group were examined.Results: The leukocyte, neutrophile, monocyte, lymphocyte, thrombocyte and MPV values of the obese group were found to be statistically higher than the control group (p: 0.006, p:0.015, p:0.014, p:0.001, p<0.001). There was no statistically significant difference between the two groups for Neutrophile/Lymphocyte ratio (NLR), Monocyte/Lymphocyte ratio (MLR) and Platelet/Lymphocyte ratio (PLR) (p:0.642, p:0.989, 0.982). Also, there was no statistically significant correlation between Homa IR and age, BMI, Neutrophil, Lymphocyte, Monocyte, Thrombocyte, Neutrophil/Lymphocyte, Monocyte/Lymphocyte and Thrombocyte/Lymphocyte values.Conclusion: The current study showed that there was no significant difference between obese and controls in terms of NLR, PLR, and MLR values. However, the leukocyte, neutrophile, monocyte, lymphocyte, thrombocyte and MPV values were statistically higher in obese group than controls. Nevertheless, these findings can point relation between obesity and inflammation.Keywords: obesity, children, inflammation, hematological parameters

Predictive Role of Biomarkers in COVID-19 Mortality.

Background The coronavirus disease 2019 (COVID-19) pandemic has resulted in high mortality among patients in critical intensive care units. Hence, identifying mortality markers in the follow-up and treatment of these patients is essential. This study aimed to evaluate the relationships between mortality rates in patients with COVID-19 and the neutrophil/lymphocyte ratio (NLR), derived NLR (dNLR), platelet/lymphocyte ratio (PLR), monocyte/lymphocyte ratio (MLR), systemic inflammation response index (SII), and systemic inflammatory response index (SIRI). Methodology In this study, we assessed 466 critically ill patients diagnosed with COVID-19 in the adult intensive care unit of Kastamonu Training and Research Hospital. Age, gender, and comorbidities were recorded at the time of admission along with NLR, dNLR, MLR, PLR, SII, and SIRI values from hemogram data. Acute Physiology and Chronic Health Evaluation II (APACHE II) scores and mortality rates over 28 days were recorded. Patients were divided into survival (n = 128) and non-survival (n = 338) groups according to 28-day mortality. Results A statistically significant difference was found between leukocyte, neutrophil, dNLR, APACHE II, and SIRI parameters between the surviving and non-surviving groups. A logistic regression analysis of independent variables of 28-day mortality identified significant associations between dNLR (p = 0.002) and APACHE II score (p < 0.001) and 28-day mortality. Conclusions Inflammatory biomarkers and APACHE II score appear to be good predictive values for mortality in COVID-19 infection. The dNLR value was more effective than other biomarkers in estimating mortality due to COVID-19. In our study, the cut-off value for dNLR was 3.64.

Subclinical inflammation markers in Abortus Imminens and their relation with obstetric outcomes. A case-control study

Background: In recent years, studies reveal that subclinical inflammatory markers can be used as an indicator of the inflammatory process in many diseases. Few studies have evaluated indicators of inflammation and postpartum outcomes in abortion immune patients. Objectives: The aim of the study is to investigate the relationship of subclinical inflammatory factors (Platelet crit (PCT), Neutrophil-lymphocyte ratio(NLR), Monocyte-lymphocyte ratio(MLR), Platelet-lymphocyte ratio(PLR)) obtained from complete blood count(CBC) with Abortion Immunes(AI) and obstetric results.. Material method: The study was conducted between January 2020 and January 2021. A total of 429 pregnant women, 203 of whom were pregnant with AI and 226 were healthy, were included in the study. Results: PCT, NLR, and MLR values were significantly higher and PLR values were low in the AI group (p&lt;0.05). PCT &gt; 0.22, NLR &gt; 2.29, and MLR &gt; 0.20 were significantly associated with increased risk of AI (P&lt;0.05). PLR value above 135.5 was associated with the normal group. There was a significant difference between the group whose pregnancy was terminated by abortion and the group who gave birth in terms of PCT, NLR, MLR, and PLR values. PCT, NLR, and MLR values were high in the abortion group, and PLR values were low (p&lt;0.05). Premature birth was developed in 11.3% (n=15) of AI patients. There was a significant difference between the preterm and term pregnancy in terms of PCT, NLR, MLR, and PLR levels (p&lt;0.005). PCT, NLR, and MLR values were high and PLR levels were low in pregnant women who gave birth prematurely. Conclusion: We think that close follow-up of abortion imminence patients with high levels of these inflammatory factors is appropriate.

316. The Value of Monocyte-Lymphocyte Ratio, Neutrophil-Lymphocyte Ratio and Platelet-Lymphocyte Ratio in Predicting COVID-19 Mortality: A Single-Center Retrospective Study

Abstract Background The quest for an easy yet effective and affordable tool in predicting mortality among COVID 19 patients is one of the major health concerns that should be addressed. In this study, we investigated the role of these hemogram derived ratios- Monocyte-Lymphocyte Ratio, Neutrophil-Lymphocyte Ratio and Platelet-LymphocyteRatio in predicting in-hospital COVID 19 Mortality. Objectives of this study aimed to determine the optimal cut-off value of each ratio and compare the values of each ratio in predicting mortality. Methods A cross sectional retrospective study utilizing chart review of adult, COVID 19 confirmed patients admitted at Dr. Paulino J. Garcia Memorial Research and Medical Center from July 2020 to July 2021 were analyzed. Complete blood count taken within 24 hours of admission were recorded. The primary outcome was in-hospital mortality. The NLR, MLR and PLR values were computed and were stratified into two groups after determining the optimal cut-off from the receiver operating characteristic curve (ROC) curve. Results A total of 226 adult Filipinos with confirmed COVID 19 infection were included. Patients who died had significantly higher mean age (p=0.004), lower mean hospital days (p=&amp;lt; 0.001) and significantly had a higher proportion of diabetes (p=&amp;lt; 0.027) as a co-morbidity. Significantly higher neutrophils (p=&amp;lt; 0.001), lower lymphocytes (p=&amp;lt; 0.001), higher NLR (p=&amp;lt; 0.001), higher MLR (p=0.002) and higher PLR (p=&amp;lt; 0.001) among non-survivors than survivors group. The optimal cutoff value of NLR to predict in-hospital mortality is ≥5.846 with 66.37% sensitivity and 60.18% specificity (AuROC curve of 0.695). The optimal cut off value of MLR is ≥0.4444 and PLR of ≥190. Conclusion NLR, MLR and PLR were noted to be consistently high among non-survivors of COVID 19 Infection. These are useful markers in predicting in-hospital mortality. NLR appears to be the best predictor of COVID-19 mortality of the three markers. However, its overall diagnostic accuracy is only considered acceptable at best. Disclosures All Authors: No reported disclosures.

Elevated levels of monocyte-lymphocyte ratio and platelet-lymphocyte ratio in adolescents with non-suicidal self-injury

BackgroundNeutrophil–lymphocyte ratio (NLR), monocyte-lymphocyte ratio (MLR), and platelet-lymphocyte ratio (PLR) are blood indicators of systemic inflammation. This study aims to compare the levels of inflammatory indicators derived from blood routine tests between adolescents with non-suicidal self-injury (NSSI) and those with non-NSSI.MethodsA total of 201 adolescents with mood or emotional disorders were enrolled in this study, among which 106 had engaged in NSSI and 95 had never engaged in NSSI. NLR, MLR, and PLR were calculated based on the complete blood cell count.ResultsThere was no significant difference in demographic data between the two groups. The NSSI group exhibited significantly higher MLR (P = 0.001) and PLR (P = 0.007) than the non-NSSI group. Multivariate logistic regression analysis revealed that MLR (OR 1.545, 95%CI [1.087–2.281], P = 0.021) and PLR (OR 1.327, 95%CI [1.215–1.450], P < 0.001) were independently associated with NSSI. Receiver operating characteristic (ROC) curve analyses demonstrated that for differentiating NSSI from non-NSSI, the optimal cut-off value of MLR was 0.135 and the area under curve was 0.638 ([0.561- 0.715], P < 0.001), with a sensitivity of 90.60% and a specificity of 33.70%; the optimal cut-off value of PLR was 127.505 and the area under curve was of 0.611 ([0.533–0.689], P < 0.001), with a sensitivity of 39.60% and a specificity of 81.10%.ConclusionsSystemic inflammation, as indicated by elevated MLR and PLR, was found to be strongly associated with NSSI among adolescents.

Predictive Value of Monocyte Lymphocyte Ratio in Peritonitis Risk in Peritoneal Dialysis Patients and Its Body Mass Index: A Case-Control

The aim of our study was to determine the predictive value of monocyte to lymphocyte ratio in peritonitis risk in PD patients with and without chronic inflammation and its relationship with body mass index.

EVALUATION OF PERIPHERAL INFLAMMATION PARAMETERS IN ADOLESCENTS WITH SUICIDE ATTEMPTS

OBJECTIVE: Haematological parameters are peripheral inflammation markers that can be used to demonstrate the relationship between psychopathology and inflammation. In this study, we aimed to compare adolescents who attempted suicide with healthy adolescents in terms of haematological parameters.MATERIAL AND METHODS: The haemogram records of 765 adolescents admitted to the Paediatric Emergency Service between October 2018 and March 2020 were retrospectively evaluated. The control group was created from the haemogram records of adolescents who had similar age and sex characteristics, who had been examined in paediatric outpatient clinics during the above-mentioned period and who did not have any organic or psychopathological disorder. After implementation of the exclusion criteria, 95 adolescents with suicide attempts and 95 healthy adolescents were included in the study. The case and control groups were statistically compared in terms of neutrophil/lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte/lymphocyte ratio (MLR), mean platelet volume (MPV) and red cell distribution width (RDW) parameters.RESULTS: It was found that in adolescents with suicide attempts, NLR and MLR values were significantly higher than in the control group. There was no significant difference between the groups in terms of other parameters. In terms of NLR and MLR parameters, there was no statistical difference among the three subgroups of the case group separated according to the psychiatric diagnoses. However, NLR was found to be significantly higher in comparison with the control group of these three subgroups.CONCLUSIONS: The NLR and MLR parameters of adolescents who attempted suicide were higher than those of the control group. There is a need for more comprehensive studies on the evaluation of inflammatory parameters in adolescents who have attempted suicide.

Can preoperative inflammatory markers predict the success of varicocelectomy?

The aim of this study was to evaluate the effect of inflammation on the success of varicocelectomy by using some inflammatory markers. Adult male patients aged ≥18 years who were evaluated for infertility, had abnormal parameters in at least two preoperative semen analyses and underwent subinguinal microscopic varicocelectomy were retrospectively evaluated. The patients were divided into two groups; those showing improvement in semen parameters were determined as Group A and those without improvement as Group B and compared with each other. A total of 102 patients were included in this study. Group A contained 32 (31.4%) patients while Group B had 70 (68.6%) patients. Monocyte/lymphocyte ratio (MLR) and neutrophil/lymphocyte ratio (NLR) were found to be statistically significantly higher in Group B (p=0.014 and p=0.028 respectively). Although preoperative sperm concentration and total motile sperm count were higher in Group B, postoperative all semen parameters were significantly higher in Group A. The cutoff points that were determined using the Youden test were <2.02 for NLR (AUC=0.636, CI=0.519-0.754; p=0.028) and <0.22 for MLR (AUC=0.652, CI=0.531-0.773; p=0.014). Pre-varicocelectomy low NLR and MLR values were found to be significant parameters in predicting the success of the surgery.

Are Neutrophil-Lymphocyte, Platelet-Lymphocyte, and Monocyte-Lymphocyte Ratios Prognostic Indicators in Patients With Chronic Obstructive Pulmonary Disease in Intensive Care Units?

Background and objectiveChronic obstructive pulmonary disease (COPD) is a condition in which the expiratory airflow is restricted and is characterized by inflammation. Recently, inflammation-related biomarkers such as neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and monocyte-lymphocyte ratio (MLR) have been used to predict the prognosis in COPD. The aim of this study was to evaluate the role of biomarkers such as NLR, PLR, and MLR in COPD patients in intensive care and to examine the ability of these markers to predict the prognosis [length of stay in hospital (LOSH), duration of mechanical ventilation (MV), length of stay in ICU (LOS ICU), and mortality].MethodsA total of 562 patients who were treated in the ICU between 2018 and 2019 were retrospectively reviewed. Among them, 369 were patients with COPD. We evaluated clinical data including patient demographics, Charlson Comorbidity Index (CCI), Acute Physiology and Chronic Health Evaluation II (APACHE II) score, Sequential Organ Failure Assessment (SOFA) score, LOS ICU, LOSH, duration of MV, as well as NLR, PLR, and MLR values. Data on patient deaths (30-day mortality) was obtained from the Death Notification System.ResultsAge, LOSH, CCI, and SOFA were found to predict mortality in COPD patients. In cases with mortality, age, inotropic use, MV duration, LOS ICU, APACHE II, CCI, SOFA, lymphocyte count, neutrophil count, platelet count, monocyte count, NLR, PLR, and MLR levels were statistically significantly higher than those in cases without mortality. There was a positive and low statistically significant relationship of NLR, PLR, and MLR with prognostic factors like MV duration, APACHE II scores, and SOFA scores.ConclusionThe NLR, PLR, and MLR values may be used as prognostic indicators in COPD patients in intensive care. Although there are many studies endorsing the use of biomarkers such as NLR, PLR, and MLR as prognostic indicators, further comparative studies on this subject are still required to gain deeper insights into the topic.

The Clinicopathological and Prognostic Value of NLR, PLR and MLR in Non-Muscular Invasive Bladder Cancer.

The clinicopathological and prognostic relevance of neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), and monocyte/lymphocyte ratio (MLR) in non-muscular invasive bladder cancer (NMIBC) was investigated. All patients who underwent transurethral resection of bladder tumor (TURBT) and postoperative intravesical chemotherapy had their peripheral blood levels of NLR, PLR, and MLR quantified. The preoperative peripheral blood levels of NLR, PLR, and MLR were analyzed in patients with G1, G2, and G3 NMIBC. A total of 208 patients was divided into poor prognosis (PP, with recurrence, n=51) and good prognosis (GP, no recurrence, n=157) groups, according to whether the recurrence of NMIBC was observed at 1-year follow-up after treatment. Univariate and multivariate logistic regression analyses were performed to evaluate the prognostic factors in NMIBC. In addition, receiver operating characteristic (ROC) curves were used to analyze the prognostic performance of NLR, PLR, and MLR in NMIBC. The preoperative peripheral blood level of PLR was significantly increased in patients with G3 NMIBC compared with that in patients with G1 (p < 0.05) and G2 NMIBC (p < 0.05). The results of univariate and multivariate logistic regression analyses showed that the tumor diameter, differentiation grade, and preoperative peripheral blood levels of NLR, PLR, and MLR were independent prognostic factors for NMIBC recurrence (p < 0.05). Compared with the NMIBC patients without recurrence, 3.490%, 177.575% and 3.175% were determined as the optimum prognostic cutoffs for NLR, PLR, and MLR, respectively. ROC curve was used to evaluate the sensitivity, specificity, and area under the curve (AUC) of NLR, PLR, MLR, and combinations. In contrast to NLR, PLR, or MLR, the combination of NLR, PLR, and MLR (AUC 0.758, sensitivity 66.70%, specificity 89.80%,Youden index 0.565) improved the prognostic performance in the discrimination of NMIBC patients with recurrence from thosewithout recurrence. The preoperative peripheral blood levels of NLR, PLR, and MLR, which were closely related to the grade and recurrence of NMIBC, were easy to detect and inexpensive. Moreover, these three factors showed the potential for auxiliary prognostic evaluation of NMIBC, wherein the combination than individual values exhibited better prognostic performance.