Neutrophil-monocyte Ratio Research Articles

Association between Hematological Parameters and Severity of COVID-19 disease

Background This study aimed to determine the relationships between hematological parameters- hemoglobin, Total Leucocyte Counts (TLC), platelet counts, Absolute Neutrophil Counts (ANC), Absolute Lymphocyte Counts (ALC), Neutrophil Lymphocyte Ratio (NLR), Systemic Immune Inflammatory Index (SII), Neutrophil Monocyte Ratio (NMR), Platelet Lymphocyte Ratio (PLR) and the severity of COVID-19 disease and their use in predicting severity of COVID-19 disease. Methods and Material This was a prospective, observational, single-center study of 573 symptomatic adult inpatients of COVID 19 admitted to our tertiary care center. Statistical analysis used The above-mentioned hematological parameter levels were noted and compared between the two categories of COVID-19 disease, namely non-severe and severe COVID-19 using logistic regression methods. Their cut-off values were detected using the ROC curve. Results The median TLC, ANC, NLR, SII, NMR, PLR were notably higher in patients with severe COVID-19 than in those with non-severe COVID-19. Logistic regression analysis showed that NMR (OR=1.029, p=0.006) and ALC (OR=0.999, p=0.002) were statistically significant independent predictors of COVID-19 severity. Conclusions The hematological parameters mentioned, can be used for predicting severe COVID-19 disease at admission. ALC and NMR levels could be used as hematological markers to predict severity of COVID-19 in adult patients with their cut off values being < 1105 cells/cubic millimeter and > 10.434 respectively.

Differential White Blood Cell Count and COVID-19 Hospital Length of Stay: A Post-hoc Analysis

Objective: To explore the association between differential white blood cell count and hospital length of stay (LOS) in COVID-19 patients.Methods: This study is a post-hoc analysis of two prospective cohort studies involving hospitalized COVID-19 patients who received standard therapy, including antiviral and supportive treatments at Persahabatan Hospital, Jakarta, Indonesia, during the Delta and Omicron dominant pandemic periods. Baseline differential white blood cell count before initiation of therapy were documented. LOS was categorized as ≤10 days and >10 days.Result: Data from 463 subjects were included with most subjects were males (62.2%) with a median age of 54 (14–93) years. The average LOS for subjects was 12.7 (12.1–13.4) days. Bivariate tests showed that lymphocytes, neutrophils, monocytes, neutrophil-lymphocyte ratio (NLR), and neutrophil-monocyte ratio (NMR) had significant association (p <0.05) to LOS. Logistic regression showed that higher monocyte counts were associated with shorter LOS (adjusted OR 0.89; 95% CI 0.840 - 0.943; p < 0.001). ROC curve showed that higher monocyte counts (>8.35 × 10^3/µL) at admission may predict shorter hospitalization (<10 days).Conclusion: Monocyte count may serve as a potential marker for length of stay in COVID-19 patients, offering key insights for optimizing patient management and resource allocation.

Association between Hematological Parameters and Severity of COVID-19 disease.

This study aimed to determine the relationships between hematological parameters- hemoglobin, Total Leucocyte Counts (TLC), platelet counts, Absolute Neutrophil Counts (ANC), Absolute Lymphocyte Counts (ALC), Neutrophil Lymphocyte Ratio (NLR), Systemic Immune Inflammatory Index (SII), Neutrophil Monocyte Ratio (NMR), Platelet Lymphocyte Ratio (PLR) and the severity of COVID-19 disease and their use in predicting severity of COVID-19 disease. This was a prospective, observational, single-center study of 573 symptomatic adult inpatients of COVID 19 admitted to our tertiary care center. The above-mentioned hematological parameter levels were noted and compared between the two categories of COVID-19 disease, namely non-severe and severe COVID-19 using logistic regression methods. Their cut-off values were detected using the ROC curve. The median TLC, ANC, NLR, SII, NMR, PLR were notably higher in patients with severe COVID-19 than in those with non-severe COVID-19. Logistic regression analysis showed that NMR (OR=1.029, p=0.006) and ALC (OR=0.999, p=0.002) were statistically significant independent predictors of COVID-19 severity. The hematological parameters mentioned, can be used for predicting severe COVID-19 disease at admission. ALC and NMR levels could be used as hematological markers to predict severity of COVID-19 in adult patients with their cut off values being < 1105 cells/cubic millimeter and > 10.434 respectively.

Prediction of in-hospital mortality in patients with myocardial infarction and type 2 diabetes: the role of cellular indices of systemic inflammation

Aim. To assess the value of cellular indices of systemic inflammation in the prognosis of in-hospital mortality in patients with ST-segment elevation myocardial infarction (MI) in combination with type 2 diabetes (T2D).Material and methods. The retrospective case-control study included 125 patients with myocardial infarction and T2D, 25 of whom died during the index hospitalization. The cellular composition of the blood and the level of high-sensitivity C-reactive protein (hsCRP) were determined on the first and third days of hospitalization. In the groups of deceased and surviving patients, cellular indices of systemic inflammation were calculated and compared (neutrophil-lymphocyte ratio (NLR), neutrophil-monocyte ratio (NMR), monocyte-lymphocyte ratio (MLR), platelet-lymphocyte ratio (PLR), systemic inflammation index (SII), systemic inflammation response index (SIRI)) and average hsCRP levels). The prognostic role of the studied parameters was assessed using univariate and multivariate logistic regression.Results. Deceased patients, compared with survived ones, had higher Killip class, body mass index, number of stents implanted, higher hsCRP levels, and lower left ventricular ejection fraction. Inhospital mortality was associated with hsCRP (odds ratio of 1,03 with 95% confidence interval of 1,003-1,05, p=0,029), NLR (2,56 [1,73-9,78], p&lt;0,001), NMR (1,16 [1,001-1,35], p=0,04), MLR (23,7 [3,1-182,6], p=0,002), SII (1,001 [1,0-1,001], p=0,028), SIRI (1,29 [1,09-1,52], p=0,003) 48 hours after admission, as well as with the degree of hsCRP change (1,03 [1,003-1,05], p=0,025), NLR (1,58 [1,21-2,06], p=0,001), SII (1,001 [1,0-1,001], p=0,028) during the first three days. Adjusted multivariate regression analysis identified a set of independent predictors with greatest accuracy in assessing the death probability: NLR, SII and SIRI 48 hours after admission, the degree of hsCRP change, body mass index and the num ber of implanted stents.Conclusion. The work demonstrated the significance of cellular indices of systemic inflammation (NLR, SII and SIRI) in assessing the prognosis of in-hospital mortality in patients with MI combined with T2D.

Association between Hematological Parameters and Severity of Covid-19 Infections

Background This study aimed to determine the relationships between hematological parameters- hemoglobin, Total Leucocyte Counts (TLC), platelet counts, Absolute Neutrophil Counts (ANC), Absolute Lymphocyte Counts (ALC), Neutrophil Lymphocyte Ratio (NLR), Systemic Immune Inflammatory Index (SII), Neutrophil Monocyte Ratio (NMR), Platelet Lymphocyte Ratio (PLR) and the severity of COVID 19 infections and their use in predicting severity of COVID-19 infections. Methods and Material This was a prospective, observational, single-center study of 573 symptomatic adult inpatients of COVID 19 admitted to our tertiary care center. Statistical analysis used The above-mentioned hematological parameter levels were noted and compared between the two categories of COVID-19 infection, namely non-severe and severe COVID-19 using logistic regression methods. Their cut-off values were detected using the ROC curve. Results The median TLC, ANC, NLR, SII, NMR, PLR were notably higher in patients with severe COVID-19 than in those with non-severe COVID-19. Logistic regression analysis showed that NMR (OR=1.029, p=0.006) and ALC (OR=0.999, p=0.002) were statistically significant independent predictors of COVID-19 severity Conclusions The hematological parameters mentioned, can be used for predicting severe COVID-19 infections at admission. ALC and NMR levels could be used as hematological markers to predict severity of COVID-19 in adult patients with their cut off values being &lt; 1105 cells/cubic millimeter and &gt; 10.434 respectively.

White Blood Cell Parameters in Patients Diagnosed with COVID-19

Aim: The SARS-CoV-2 virus has been a major health concern in recent times, causing a large number of deaths globally. It primarily effects the respiratory and immune system. The present study aimed at analysing the effect of this virus on the white blood cell (WBC) parameters. Study Design: Retrospective record-based study. Place and duration of study: The study was conducted at Lok Nayak Hospital, Delhi. It was one of the largest COVID designated hospitals in India during the COVID pandemic. A total of 200 patients admitted to Lok Nayak Hospital during the COVID wave in April-May 2021 and the COVID wave in January-February 2022 were randomly included in the study. Methodology: The cases were grouped into intensive care unit (ICU) patients and non-ICU patients to compare the association of severity of disease with the WBC parameters. Results: Patients infected with COVID-19 requiring hospital admission showed leucocytosis in the present study. It was noted that the patients requiring critical care had a significantly higher total leucocyte count (TLC), absolute neutrophil count (ANC), neutrophil lymphocyte ratio (NLR) and neutrophil monocyte ratio (NMR). Though no statistically significant association was noted between absolute lymphocyte count (ALC) and the severity of infection, the ALC was markedly reduced in ICU patients as compared to non-ICU patients (p-value= 0.057). Conclusion: WBC parameters TLC, ANC, NLR and NMR show significant correlation with severity of COVID-19 infection. These basic haematological parameters can be used to assess severity of COVID-19 infection and treatment response in resource limited conditions.

Prognostic value of the geriatric nutritional risk index and other hematological markers on long-term survival in the geriatric population.

The prognostic value of hematological markers has not been extensively explored in the geriatric population, particularly in the presence of the frailty phenotype among hospitalized individuals. Therefore, our study aimed to assess the influence of the frailty phenotype in hospitalized geriatric individuals on hematological markers and their impact on short- and long-term outcomes. This is a secondary analysis of a prospective cohort study. This study involved hospitalized individuals who were followed during their hospitalization and for nearly 2 years after discharge. At baseline, Fried's frailty phenotype was assessed, as well as hematological markers, including neutrophil-lymphocyte ratio, monocyte-lymphocyte ratio, neutrophil-monocyte ratio, platelet-lymphocyte ratio, systemic inflammation index, prognostic nutritional index, geriatric nutritional risk index (GNRI), and C-reactive protein-albumin ratio. The phase angle derived from bioelectrical impedance analysis was likewise considered a prognostic biomarker. Our main outcomes were hospital length of stay and mortality during follow-up. Frailty occurred in 43.2% of the population. Individuals with the frailty phenotype exhibited worse hematological markers and lower phase angle values. Low GNRI and elevated C-reactive protein-albumin ratio values were independently associated with mortality (hazard ratio = 6.88, 95% confidence interval 2.0-23.6; hazard ratio = 2.2, 95% confidence interval 1.1-4.4). Only higher values of the systemic inflammation index were independently associated with prolonged hospital stays. Hematological markers may serve as a feasible tool for prognostic assessment. Individuals with the frailty phenotype and low GNRI represented a worst-case scenario. Geriatr Gerontol Int 2024; 24: 312-318.

Prediction of the risk of mortality in older patients with coronavirus disease 2019 using blood markers and machine learning.

The mortality rate among older people infected with severe acute respiratory syndrome coronavirus 2 is alarmingly high. This study aimed to explore the predictive value of a novel model for assessing the risk of death in this vulnerable cohort. We enrolled 199 older patients with coronavirus disease 2019 (COVID-19) from Zhejiang Provincial Hospital of Chinese Medicine (Hubin) between 16 December 2022 and 17 January 2023. Additionally, 90 patients from two other centers (Qiantang and Xixi) formed an external independent testing cohort. Univariate and multivariate analyses were used to identify the risk factors for mortality. Least absolute shrinkage and selection operator (LASSO) regression analysis was used to select variables associated with COVID-19 mortality. Nine machine-learning algorithms were used to predict mortality risk in older patients, and their performance was assessed using receiver operating characteristic curves, area under the curve (AUC), calibration curve analysis, and decision curve analysis. Neutrophil-monocyte ratio, neutrophil-lymphocyte ratio, C- reactive protein, interleukin 6, and D-dimer were considered to be relevant factors associated with the death risk of COVID-19-related death by LASSO regression. The Gaussian naive Bayes model was the best-performing model. In the validation cohort, the model had an AUC of 0.901, whereas in the testing cohort, the model had an AUC of 0.952. The calibration curve showed a good correlation between the actual and predicted probabilities, and the decision curve indicated a strong clinical benefit. Furthermore, the model had an AUC of 0.873 in an external independent testing cohort. In this study, a predictive machine-learning model was developed with an online prediction tool designed to assist clinicians in evaluating mortality risk factors and devising targeted and effective treatments for older patients with COVID-19, potentially reducing the mortality rates.

The Impact of Hematological Indices on the Occurrence of Delayed Graft Function (DGF) of Transplanted Kidney.

to analyse the effect of haematological indices on the occurrence of Delayed Graft Function (DGF) in patients undergoing kidney transplantation and on the function of the transplanted kidney on the 7th postoperative day. 365 recipients who underwent kidney transplantation from a donor with known brain death between 2010 and 2017 were included in this retrospective study. Information from patient medical records, donor medical records, and donation and transplantation protocols was used for analysis. Statistica 13 was used for statistical analysis. In the study group, DGF occurred in 144 recipients (39.45%), and Non-Graft Function (NGF) occurred in 12 recipients (3.29%). Recipients who developed DGF had a significantly higher Neutrophil/Monocyte Ratio (NMR) before renal transplantation (p = 0.048), a lower NMR value on postoperative day 1 (p < 0.001), and a difference between the values on day 1 and before surgery (p < 0.001). In addition, they had a significantly lower Lymphocyte/Monocyte Ratio (LMR) on postoperative day 1 LMR 1 (p < 0.001). It was shown that the value of the indices based on the ROC curve-NMR1 > 29.29, NMR1-0 > 22.71, and LMR1 > 1.74 (respectively: AUC = 0.624; 95% CI 0.566-0.682; and p < 0.001/AUC = 0.622; 95% CI 0.563-0.680; and p < 0.001/AUC = 0.610; 95% CI 0.550-0.670; and p < 0.001)-can be used to identify recipients with a significant probability of DGF. the NMR and LMR parameters on the first postoperative day and the difference between the NMR values on the first post-transplant day and the first pre-transplant day are predictive factors associated with the risk of DGF.

Development and validation of a peripheral cell ratio and lactate score for differentiating status epilepticus from prolonged psychogenic nonepileptic seizures.

Differentiating status epilepticus (SE) from prolonged psychogenic nonepileptic seizures (pPNES) can be difficult clinically. We aimed to define the utility of peripheral cell counts, cell ratios, and lactate levels in distinguishing SE from pPNES. Retrospective two-center study investigating the sensitivity and specificity of acute (≤12 h of event offset) peripheral cell counts, cell ratios (neutrophil-lymphocyte ratio, neutrophil-monocyte ratio, monocyte-lymphocyte ratio, platelet-lymphocyte ratio, systemic immune-inflammatory index [SII], systemic inflammatory response index [SIRI]), and lactate levels in differentiating SE from pPNES. Patients were identified from two tertiary hospitals, with one forming the development cohort and the other the validation cohort. Using generalized additive models to generate biomarker vs time curves, optimal blood collection times were defined for set parameters. Three diagnostic scores combining neutrophil count, SII, or SIRI with lactate levels were developed and validated in separate cohorts. For the development cohort, 1262 seizure-like events were reviewed and 79 SE and 44 pPNES events were included. For the validation cohort, 241 events were reviewed and 20 SE and 11 pPNES events were included. Individually, the biomarkers generally had low sensitivity and reasonable specificity for differentiating SE from pPNES, with the neutrophil count, SIRI, and SII performing best with sensitivities of 0.65-0.84, specificities of 0.64-0.89, and ROC AUCs of 0.78-0.79. Lactate levels peaked at 60 min, while cell counts and ratios peaked after 240 min. Combining early peaking lactate levels and later peaking neutrophil count, SIRI or SII resulted in three scores that improved predictive potential with sensitivities of between 0.75 and 0.79, specificities between 0.93 and 1.00, and ROC AUCs of 0.89-0.91. Lactate levels peak early post-SE, whereas cell counts and ratios do so later. The differing post-event time profiles of lactate levels vs neutrophil count, SIRI, and SII allow incorporation into three separate scores which can assist in differentiating SE from pPNES.

Unveiling the role of neutrophils in chronic spontaneous urticaria: Beyond mast cells.

Mast cells and eosinophils are considered pivotal contributors to the pathogenesis of chronic spontaneous urticaria (CSU). However, emerging evidence suggests that neutrophils also play a central role. Cutaneous mast cells and macrophages orchestrate the recruitment of neutrophils through the regulation and activation of diverse processes, including heightened local vascular permeability and chemokine release. Studies have demonstrated increased activation and elevated levels of neutrophil-related cytokines in CSU patients. Moreover, neutrophils have been proposed as antigen-presenting cells during the late-phase reaction of immunoglobulin E-mediated allergy and have been associated with the expression of calcitonin gene-related protein and vascular endothelial growth factor in CSU. Histopathological analysis of lesional skin in CSU patients revealed significantly higher eosinophil and neutrophil counts than unaffected skin. However, the extent of neutrophil infiltration in the skin does not appear to correlate with the number of neutrophils in peripheral blood. The utility of the neutrophil-lymphocyte ratio as a marker for disease activity or remission in CSU remains inconclusive. Neutrophil-targeted therapy may confer benefits for CSU patients who exhibit resistance to antihistamines. Omalizumab has demonstrated its ability to reduce neutrophil counts, the neutrophil-lymphocyte ratio, and the neutrophil-monocyte ratio in peripheral blood. While dapsone and colchicine are recommended as alternative treatment options for CSU, their evidential support from published studies remains limited. Inhibitors targeting interleukin-1 and neutrophil-related cytokines have been proposed as potential therapeutic interventions for patients exhibiting neutrophil predominance. Further research is warranted to gain deeper insights into the involvement of neutrophils in CSU and to explore potential therapeutic interventions.

Inflammatory biomarkers derived from whole blood cell count in atrial fibrillation patients.

Aim This study aimed to evaluate the potential relationships between atrial fibrillation (AF) and hematological indices, such as neutrophil / lymphocyte ratio (NLR), mean platelet volume (MPV), platelet / lymphocyte ratio (PLR), mean platelet volume / platelet (MPV / PLT), neutrophil / monocyte ratio (NMR), lymphocyte / monocyte ratio (LMR), systemic immune inflammation index (SII, platelet x neutrophil / lymphocytes), and monocyte / high-density lipoprotein ratio (MHR), that can be obtained from the complete blood count (CBC test).Material and method This retrospective study included 150 patients aged 40-80 yrs who were diagnosed with AF, and 91 age- and gender-matched controls. Hematological indices and inflammation markers were evaluated.Results In the AF group, NLR, PLR, SII, MHR, and MPV / PLT were elevated, and LMR was low. Multivariate regression analysis showed that hematological indices NLR, SII, and MHR were significant, independent, predictive factors for AF. ROC curves revealed the following significant sensitivity and specificity values: NLR 75 %, 52.3 %; LMR 61.3 %, 67.3 %; SII 67.4 %, 64.6 %; MHR 100 %, 56 %.Conclusion NLR, PLR, LMR, SII, MPV / PLT, and MHR may be useful in the early prediction of AF development. It is strongly emphasized that among these variables, MHR, may be the best independent variable that can be used to predict AF.

Neutrophil-to-monocyte ratio is the better new inflammatory marker associated with rheumatoid arthritis activity.

Rheumatoid arthritis (RA) is a systemic autoimmune disease that chronically affects patients with episodes of inflammation. New inflammatory hematological markers were investigated for follow-up, such as the neutrophil-monocyte ratio (NMR), lymphocyte monocyte ratio (LMR), and neutrophil-lymphocyte ratio (NLR). This study was conducted to determine the most useful marker based on studies of association with RA disease activity and correlation with the classical markers C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and rheumatoid factor (RF). This case-control study included 62 chronic RA patients who had previously been diagnosed and experienced episodes of symptoms while attending a variety of public and private rheumatology clinics in Ibb City, Republic of Yemen, for the period of September 1 to November 30, 2021. Twenty healthy volunteers were included in this study. Complete blood count, CRP, ESR, and RF levels were measured in all participants. The total leukocyte count, neutrophil count, platelet count, NMR, LMR, and NLR were positively correlated with CRP and ESR, but the monocyte count was reversed. The area under the curve (AUC = 0.861, 95% confidence interval [CI] = 0.769-0.948) for the NMR cutoff value of 4.7 was equal to that of CRP and close to that of ESR. This NMR cutoff value had 87% sensitivity and 80% specificity. LMR and NLR cutoff values of 4.35 and 1.35, respectively, resulted in AUCs of (AUC = 0.807, 95% CI, 0.708-0.905) and (AUC = 0.699, 95% CI, 0.571-0.819); their sensitivity and specificity were 62.3%, 90%, 57.4%, and 80%, respectively. As a convenient and low-cost inflammatory marker of RA activity, NMR outperformed LMR and NLR.

Leucocytal indexes in apparently healthy cats

Leukocyte indices are ratios that are used to assess the state of the patient's blood and immune system. The use of leukocyte indices in the diagnosis of feline diseases is currently limited, which is mainly due to the lack of norms in wide publication, as well as studies of patterns characteristic of specific groups of diseases, as well as the nature of the course of pathological processes. The purpose of the presented study was to assess the indicators of leukocyte indices in clinically healthy cats. The analysis of morphological parameters of the blood of 11 mongrel clinically healthy cats with the obligatory absence of a stress leukogram was carried out. The number of leukocytes and leukogram in the blood were determined according to generally accepted methods, followed by the calculation of leukocyte indices: Krebs index (KI), leukocyte intoxication index (LII), G.D. Dashtayants nuclear index (NI), leukocyte shift index (LSI), leukocyte index (LI), neutrophilmonocyte ratio index (NMRI), the index of the ratio of lymphocytes to monocytes (IRLM). The obtained data are expected to further expand the diagnostic and prognostic capabilities of cat diseases. In the future, the study is planned to be expanded with the capture and analysis of individual nosological units and breed characteristics, as well as the features of the diet, the ratio to the severity of the condition, the analysis of life expectancy and survival. It should be noted that in order to more accurately determine the diagnostic significance and the possibility of determining forecasts, it is necessary to increase the number of animal samples with an assessment of indicators in dynamics.

Helikobakter Pilori Enfeksiyonu ile Nötrofil-Lenfosit Oranı, Trombosit-Lenfosit Oranı Ve Nötrofil-Monosit Oranları Arasındaki İlişki

Aim: In our study, we aimed to show the relationship between neutrophil-lymphocyte ratio, platelet-lymphocyte ratio, neutrophil-monocyte ratio and mean platelet volume, and Helicobacter pylori positivity and severity. Material and Methods: In this study, we included 596 patients without active and/or chronic disease who underwent upper gastrointestinal system endoscopy due to dyspeptic complaints in a state hospital between July 2021 and July 2022. Demographic and laboratory data were obtained retrospectively from electronic patient records. The patients were divided into two groups as positive and negative for Helicobacter pylori according to the pathology report. Helicobacter pylori presence was defined as none, mild, moderate and severe. Hemogram parameters were compared between the groups. Results: Mean age of the patients (n=596) was 41.8±13.57 years, 374 (62.8%) were female, and 331 (55.5%) were Helicobacter pylori positive. There was no statistically significant difference between Helicobacter pylori positive and negative patient groups in terms of age, gender, leukocytes, lymphocytes, monocytes, platelets, hemoglobin, neutrophil-lymphocyte ratio, platelet-lymphocyte ratio, neutrophil-monocyte ratio and mean platelet volume values. When the hemogram parameters were evaluated according to the severity of Helicobacter pylori, a statistically significant difference was found between the groups only in terms of lymphocyte levels (p=0.028). However, this difference was not considered clinically significant. Conclusion: Neutrophil-lymphocyte ratio, platelet-lymphocyte ratio, neutrophil-monocyte ratio and mean platelet volume are thought to be popular recently and easy, accessible and inexpensive parameters for diagnosis and degree of inflammation in many systemic diseases, but in our study, no statistically significant relationship was found between Helicobacter pylori positivity and severity and hemogram parameters. Prospective studies with larger numbers of cases are needed to accept these parameters as predictors for Helicobacter pylori infection.

Lymphocyte to monocyte ratio predicts survival and is epigenetically linked to miR-222-3p and miR-26b-5p in diffuse large B cell lymphoma

Diffuse large B-cell lymphoma (DLBCL) is the most common type of non-Hodgkin lymphoma. 10–20% of the patients present with bone marrow (BM) involvement which predicts a worse survival. This study aimed to determine the prognostic significance of serum miR-222-3p, miR-26b-5p, EBV-miR-BHRF1-2-5p, and EBV-miR-BHRF1-2-3p and correlate their levels to clinical and haematological markers in DLBCL with special emphasis on the lymphocyte-monocyte ratio (LMR) and neutrophil-monocyte ratio. We also studied the role of BM BMI1 and PIM2 proteins in predicting BM infiltration. Serum miRNAs were studied on 40 DLBCL and 18 normal individuals using qRT-PCR. BMI1 and PIM2 proteins were studied on BM biopsies by immunohistochemistry. The results were correlated with clinical and follow-up data. All the studied miRNAs were dysregulated in DLBCL serum samples. BMI1 and PIM2 were expressed in 67% and 77.5% of BM samples, respectively. LMR was significantly associated with disease-free survival (DFS) (P = 0.022), miR-222-3P (P = 0.043), and miR-26b-5p (P = 0.043). EBV-miR-BHRF1-2-3p was significantly correlated to haemoglobin level (P = 0.027). MiR-222-3p, miR-26b-5p, and EBV-miR-BHRF1-2-5p expressions were significantly correlated to each other (P = 0.001). There was no significant correlation between the studied markers and follow-up data. LMR is a simple method for predicting survival in DLBCL. MiR-222-3p and miR-26b-5p may be implicated in an immunological mechanism affecting patients’ immunity and accordingly influence LMR. The correlation between miR-222-3p, miR-26b-5p, and EBV-miR-BHRF1-2-5p may indicate a common mechanism among the 3 miRNAs that may explain DLBCL pathogenesis.

Predictive value of neutrophil-to-lymphocyte ratio and neutrophil-to-monocyte ratio in severe traumatic brain injury: a retrospective cohort.

The neutrophil-lymphocyte ratio (NLR), the platelet-lymphocyte ratio (PLR), the lymphocyte-monocyte ratio (LMR), the neutrophil-monocyte ratio (NMR) and the systemic immune inflammation index (SII) are associated with clinical outcomes in oncological diseases, cardiovascular diseases, infectious / inflammatory diseases, endocrinological, pulmonary and brain injuries. Here, we investigate its association with hospital mortality in patients with severe traumatic brain injury. We retrospectively reviewed clinical data from patients with severe traumatic brain injury (sTBI) who were treated in our department between January 2015 and December 2020. NLR, PLR, NMR, LMR and SII data were collected between admission and day 3, as well as other indicators related. The relationship between hematological ratios and in-hospital mortality were analyzed. A total of 96 patients were included in study, hospital mortality was 40.6% (N.=39). The levels of NLR on admission (D0), NLR day 1 (D1), NLR day 2 (D2), NLR day 3 (D3), NMR day 1 (D1) and NMR day (2) remained significantly higher in patients with death intra-hospital (P=0.030; P=0.038; P=0.016; P=0.048; P=0.046 and P=0.001, respectively). Multivariate logistic analysis showed that higher NLR values at admission and day 2 NMR were associated with in-hospital mortality (OR=1.120, P=0.037; and OR=1.307, P=0.004, respectively). Analysis of the recipient operating characteristic (ROC) curve showed that the NLR on admission had a sensitivity of 59.0% and a specificity of 66.7% (area under the curve 0.630, P=0.031, Youden's Index 0.26) and the NMR of day 2 had a sensitivity of 67.7% and a specificity of 70.4% (area under the curve 0.719, P=0.001, Youden's index 0.38) to predict mortality intra-hospital based on the best threshold. Our analysis indicates that higher NLR levels on admission and day 2 NMR are independent predictors of in-hospital mortality in patients with sTBI.

Association between preoperative hematologic markers and aggressive behavior in meningiomas

IntroductionMeningiomas have varying degrees of aggressive behavior. Some systemic hematologic makers are associated with malignancy, but their value in predicting aggressive meningioma behavior is not fully understood. ObjectiveTo evaluate the association between preoperative markers such as neutrophil-lymphocyte ratio (NLR), neutrophil-monocyte ratio (NMR), monocyte-lymphocyte ratio (MLR), platelet-lymphocyte ratio (PLR), and prognostic nutritional index (PNI), and diagnostic and prognostic factors including WHO grade, proliferation index, presence of edema on preoperative MRI, and tumor recurrence. MethodsA retrospective review of patients treated between 2000 and 2019 with a preoperative complete blood count (CBC) differential lab draw before intracranial meningioma resection was conducted. All preoperative steroid dosages were converted to dexamethasone equivalents. Primary outcomes included presence/absence of perilesional edema, WHO grade, Ki-67/MIB-index, and recurrence. Univariate and multivariable regression analyses were conducted. ResultsA total of 209 meningioma patients were included. Of these, 143 (68 %) were WHO grade I, 61 (29 %) grade II and 5 (2 %) were grade III. Recurrence was reported in 19 (9.1 %) tumors. No hematologic markers were associated with recurrence. In separate multivariable logistic analyses, no biomarkers were associated with perilesional edema or WHO grade. MLR was associated with higher MIB-index (p = 0.018, OR 6.57, 95 % CI 1.37–30.91). ConclusionMost hematologic markers were not associated with meningioma invasiveness, grade, proliferative index, or aggressiveness. Preoperative MLR was associated with high proliferation index in patients undergoing surgery for intracranial meningioma. Higher MLR could be a surrogate for meningioma proliferation and has potential to be used as an adjunct for risk-stratifying meningiomas.

FEATURES OF CHANGES IN INTEGRATIVE INDICATORS OF ENDOGENOUS INTOXICATION, REACTIVITY, INFLAMMATION ACTIVITY IN PATIENTS WITH CHRONIC VIRAL HEPATITIS AND CHRONIC RENAL FAILURE

The aim: to study the peculiarities of changes in integrative indicators of endogenous intoxication, reactivity and activity of inflammation in patients with chronic viral hepatitis B and C, and with chronic renal failure undergoing hemodialysis. Materials and methods. 19 patients with chronic viral hepatitis B (HBV) and chronic viral hepatitis C (HCV) with chronic renal failure and patients with chronic kidney disease (KD) were examined. Comparison group included 40 healthy blood donors. Epidemiological, clinical and laboratory examination was performed. Indicators of endogenous intoxication, nonspecific reactivity and inflammatory activity were calculated and analyzed using statistical criteria (M±m, Student's test and Mann–Whitney test). Results: an increase in the integrative indicators of endogenous intoxication in patients with the combined pathology of chronic KD and chronic viral hepatitis (VH) is a consequence of the activation of tissue disintegration, cytolysis of hepatocytes and a significant impairment of liver function. A change in the indices of non-specific inflammation indicate expressed activity of the inflammatory process and immunological disorder of reactivity. These changes also suggest decompensated endotoxicosis, as a possible consequence of a chronic infectious process and decompensated endogenous intoxication. Indicators of leukocyte intoxication index (LII), leukocyte shift index (ISL), hematological intoxication index (HII), intoxication index severity (IIS), immunoreactivity index (IR), neutrophil-monocyte ratio (NMR) are increased in all patients with chronic KD, which may be related to the actual cause of development – glomerulonephritis, chronic pyelonephritis, concomitant pathology. More pronounced deviations were found in men of both groups than in women, which may be related to greater adherence to diet, water load between hemodialysis procedures in the latter. Conclusions. Patients receiving invasive manipulations, including hemodialysis, belong to the risk group and are more susceptible, taking into account immunodeficiency, to infection with hepatitis viruses than the general population. CVH is one of the most common types of lesions in them. The obtained changes, namely, a more pronounced increase in the integrative indicators of endogenous intoxication, in patients with the combined pathology of CKD and CVH indicate the activation of the processes of tissue decay, cytolysis of hepatocytes and significant liver function impairment. At the same time, a change in indices of non-specific inflammation indicates a pronounced activity of the inflammatory process and an immunological disorder of reactivity. A clear systemic reaction to inflammatory processes in the body of patients is determined, the probable development of decompensated endogenous intoxication, which is possible consequence of a chronic infectious process. A simultaneous increase in ISL and a decrease in ILG was established, which is associated with the development of endogenous intoxication and a violation of immunological reactivity due to autointoxication of the body. A decrease in Ilymph indicates an active adaptive reaction of white blood cells and a cell-type immunodeficiency, in particular, a decrease in non-specific anti-infective protection. Indicators of LII, ISL, HII, IIS, IR, NMR are increased in all patients with CKD, which may be related to the actual cause of development – glomerulonephritis, chronic pyelonephritis, etc. The difference of integrative indicators between men and women was established, more pronounced deviations from normal were found in men of both groups than in women, which may be associated with greater adherence to diet, water load between hemodialysis procedures in the latter.

Are inflammatory parameters an independent predictor of hip osteoarthritis severity? A prospective cross-sectional study.

This study aimed to investigate the relationship between the presence of hip osteoarthritis and the neutrophil-lymphocyte ratio, platelet-lymphocyte ratio, monocyte-lymphocyte ratio, and neutrophil-monocyte ratio. Participants with hip osteoarthritis and healthy controls aged 45-75 years were recruited in the study. The participants with hip osteoarthritis were divided into two groups: mild/moderate hip osteoarthritis and severe hip osteoarthritis. Complete blood parameters of the participants were recorded, and neutrophil-lymphocyte ratio, neutrophil-monocyte ratio, monocyte-lymphocyte ratio, and platelet-lymphocyte ratio were calculated. Pain severity was evaluated using a visual analog scale. A total of 76 participants with hip osteoarthritis and 59 healthy controls were included in the study. The mean age of the participants was 57.6±6.11 years. Mean neutrophil-lymphocyte ratio and neutrophil-monocyte ratio values were statistically significantly different between the hip osteoarthritis group and healthy control group (p<0.05). Platelet-lymphocyte ratio, monocyte-lymphocyte ratio, erythrocyte sedimentation rate, and C-reactive protein values were not significantly different between the groups. Also, there was no difference between all inflammatory parameters and hip osteoarthritis severity (p>0.05). Neutrophil-lymphocyte ratio and neutrophil-monocyte ratio values were higher in patients with hip osteoarthritis than in healthy controls. Mean platelet-lymphocyte ratio, monocyte-lymphocyte ratio, erythrocyte sedimentation rate, and C-reactive protein values did not change according to the presence of hip osteoarthritis. Not all hematological indices give valuable information regarding the severity of hip osteoarthritis.