Neutrophil-lymphocyte Ratio Values Research Articles

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.

Neutrophil-to-lymphocyte ratio trend at admission predicts adverse outcome in hospitalized respiratory syncytial virus patients

Background and aimsSevere cases of respiratory syncytial virus (RSV) infection are relatively rare but may lead to serious clinical outcomes, including respiratory failure and death. These infections were shown to be accompanied by immune dysregulation. We aimed to test whether the admission neutrophil-to-leukocyte ratio, a marker of an aberrant immune response, can predict adverse outcome. MethodsWe retrospectively analyzed a cohort of RSV patients admitted to the Tel Aviv Medical Center from January 2010 to October 2020d. Laboratory, demographic and clinical parameters were collected. Two-way analysis of variance was used to test the association between neutrophil-lymphocyte ratio (NLR) values and poor outcomes. Receiver operating characteristic (ROC) curve analysis was applied to test the discrimination ability of NLR. ResultsIn total, 482 RSV patients (median age 79 years, 248 [51%] females) were enrolled. There was a significant interaction between a poor clinical outcome and a sequential rise in NLR levels (positive delta NLR). The ROC curve analysis revealed an area under curve (AUC) of poor outcomes for delta NLR of (0.58). Using a cut-off of delta = 0 (the second NLR is equal to the first NLR value), multivariate logistic regression identified a rise in NLR (delta NLR>0) as being a prognostic factor for poor clinical outcome, after adjusting for age, sex and Charlson comorbidity score, with an odds ratio of 1.914 (P = 0.014) and a total AUC of 0.63. ConclusionsA rise in NLR levels within the first 48 h of hospital admission can serve as a prognostic marker for adverse outcome.

Relation of NLR Value and Mortality Rate in Neonatal Sepsis

<p><strong>Introduction</strong>: Neonatal sepsis is a significant issue for newborns everywhere and causes a large amount of morbidity and mortality. Various indicators of newborn sepsis are expensive and occasionally unavailable in peripheral hospitals. The neutrophil-lymphocyte ratio (NLR), which is affordable, is a component of complete blood counts and does not call for further testing. This study intended to investigate the neutrophil-to-lymphocyte ratio (NLR) as a predictor of neonatal mortality rate in the local hospital in rural locations.</p><p><strong>Methods</strong>: This study sampled newborns with sepsis in the perinatal room of dr. Soebandi Hospital Jember for this cross-sectional study, from January 2021 to June 2022. NLR is calculated by manually dividing the number of neutrophils by the actual number of lymphocytes. Our neutrophil and lymphocyte data were obtained from the patient's lab results. This study analyzed neonatal sepsis NLR data using Spearman analysis to find the relation between NLR value and mortality rate of neonatal sepsis.</p><p><strong>Results</strong>: This study obtained 43 data on neonatal sepsis in the perinatology ward during this period. The data found to show that 37 neonatal sepsis survived and 6 died. The collected data analysis found that the lowest NLR neonatal sepsis is 0.4, the highest NLR neonatal sepsis is 25.6 and the mean value for NLR neonatal sepsis in perinatology was 3.88. This study found no correlation between the NLR value of the sepsis neonate and the neonatal mortality rate Sig. (2-tailed) 0.662.<strong></strong></p><p><strong>Conclusion</strong>: In this study demonstrated no correlation between the NLR value of the sepsis neonates and the neonatal mortality rate.</p>

Association between neutrophil-lymphocyte ratio, platelet-lymphocyte ratio, and survival in undifferentiated pleomorphic sarcoma (NLR, PLR, and overall survival in UPS)

Background and objectivesCancer-related inflammation has been shown to be a driver of tumor growth and progression, and there has been a recent focus on identifying markers of the inflammatory tumor microenvironment. Neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) are inflammatory indices that have been identified as prognostic biomarkers in various malignancies. However, there is limited and conflicting data regarding their prognostic value in soft tissue sarcoma (STS) and specifically in undifferentiated pleomorphic sarcoma (UPS). MethodsThis was a retrospective review of patients who underwent surgical treatment for primary UPS from 1993 to 2021. Cutoff values for NLR and PLR were determined by receiver operating curve analysis. Cox proportional hazards regression was used to determine prognostic factors on univariate and multivariate analysis. ResultsEighty-six patients were included. The optimal cutoff value was 3.3 for NLR and 190 for PLR. Both high NLR (HR 2.44; 95% CI 1.29–4.63; p = 0.005) and high PLR (HR 1.99; 95% CI 1.08–3.67, p = 0.02) were associated with worse OS on univariate analysis. On multivariate analysis, metastasis at presentation and radiotherapy were independently predictive of OS, but high NLR (HR 1.30; 95% CI 0.64–2.98; p = 0.41) and high PLR (HR 1.63; 95% CI 0.82–3.25; p = 0.17) were not predictive of survival. ConclusionsHigh pre-treatment NLR and PLR were associated with decreased overall survival but were not independent predictors of survival in patients undergoing resection for UPS. Until additional prospective studies can be done, survival outcomes are best predicted using previously established patient- and tumor-specific factors.

Neutrophil/Lymphocyte and Platelet/Lymphocyte Ratio in Preterm Premature Rupture of Membranes.

This study aimed to investigate maternal hematological laboratory parameters of pregnancies complicated with preterm premature rupture of membranes (PPROM) compared to mothers of healthy-term infants (control group). This case-controlstudy included 158 mothers who were divided into PPROM (n=67) and control (n=91) groups, respectively. Laboratory parameters of platelet, lymphocyte, and neutrophil counts, neutrophil/lymphocyte ratio (NLR), and platelet/lymphocyte ratio (PLR) were recorded at the time of diagnosis for the PPROM group and at the time of hospital admission for birth for the control group. NLR was significantly higher in the PPROM group than in the control group (p=0.001). The cutoff value of NLR to predict PPROM was 6.73 (AUC=0.671, 95% confidence interval=0.58-0.75,p=0.000). A cheap and routine NLR blood test can be used to predict PPROM before labor.

Effectiveness of Zingiber officinale to reduce inflammation markers and the length of stay of patients with community-acquired pneumonia: An open-label clinical trial.

Examination of the interleukin 6 (IL-6) and procalcitonin levels, and neutrophil-lymphocyte ratio (NLR) might could help to diagnosis and predict the duration of therapy and prognosis of pneumonia cases. Zingiber officinale var rubrum could be used as an adjunct therapy in infectious diseases as it has anti-inflammatory activity. The aim of study was to assess the effect of Z. officinale on levels of IL-6 dan procalcitonin, NLR, and the length of hospitalization of patients with community-acquired pneumonia (CAP). An open-label clinical trial was conducted among CAP cases regardless of the etiology at Dr Moewardi Hospital and Universitas Sebelas Maret Hospital, Surakarta, Indonesia from July to September 2022. A total of 30 inpatient CAP cases were recruited and were randomly divided into two groups: (1) received Z. officinale capsule 300 mg daily for five days in addition to CAP standard therapy; and (2) received CAP standard therapy only, as control group. The data were compared using a paired Student t-test, Chi-squared test, Mann-Whitney test and Wilcoxon signed-rank test as appropriate. In Z. officinale group, the mean difference between post-and pre-treatment as follow: IL-6 level was 9.93 pg/mL, procalcitonin level -471.31 ng/mL, and NLR value -4.01. In control group, the difference was 18.94 pg/mL for IL-6, 339.39 ng/mL for procalcitonin, and 1.56 for NLR. The change of IL-6 was not statistically significant between treatment and control groups with p=0.917. The changes of procalcitonin level and NLR were significant between treatment and control group with p=0.024 and p=0.007, respectively, of which the treatment had better improvement. In addition, our data indicated that the length of stay was not statistically significant between the treatment and control groups (4.13 vs 4.47 days, p=0.361). In conclusion, Z. officinale could reduce serum inflammatory markers such as procalcitonin and NLR but it has little impact in reducing IL-16 level and the length of hospitalization of CAP patients.

Is early prediction of postpartum wound infection possible? A retrospective cohort study.

Objective: This study investigated whether delta-neutrophil index(DNI) and neutrophil/lymphocyte ratio (NLR) values have prognostic significance in wound infections after cesarean section.
 Material and Methods: In this retrospective study, one hundred and ten patients who developed wound infection and were rehospitalized after cesarean section in a tertiary health center between 2015 and 2019 formed the study group. The same number of patients were in the control group; laboratory tests including DNI, leukocyte count, and percentage of neutrophils were measured 12 hours before surgery (day 0) and 24 hours after surgery (day 1). It was investigated whether these results had predictive value for wound infection.
 Results: The mean age of patients included in the study was 30.6 (17-55) years, and body mass index was 28.4±3.95 kg/m2. The optimal cut-off value for NLR day 0 was 4.0, with a sensitivity of 80%, a specificity of 38.7%, a positive likelihood ratio of 1.31, a negative likelihood ratio of 0.52. Factors that were effective for the development of wound infection were NLR day 0, 1, and delta. In addition, body mass index was found to be greater than 27, number of cesarean sections was greater than one, and operative time was greater than 50 minutes and less than 30 minutes.
 Conclusion: We demonstrated that NLR values during cesarean section predicted the development of infections after cesarean section.

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.

Hematological and biochemical markers in determining the diagnosis and stage prediction of endometrial cancer.

To establish whether there is a statistically significant difference in hematological and biochemical parameters between the patients with premalignant changes of the uterine mucosa and those with malignant changes. The aim is to establish whether hematological and biochemical parameters may be useful in predicting the stages of endometrial malignancy and in differentiating premalignant and malignant endometrial changes. A retrospective study included 100 patients (70 with endometrial carcinoma diagnosis and 30 with atypical hyperplasia). We compared hematological and biochemical parameters in both groups. CRP, granulocytes, platelets, neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR) are statistically significantly higher in patients with malignant changes. Lymphocyte count is statistically significantly lower in patients with malignant changes. Platelet count is statistically significantly lower in patients with stages I and II in comparison to patients with higher disease stage. NLR and PLR have good discriminatory power for carcinoma presence. Patients with advanced changes have statistically significantly higher CRP values, higher granulocyte and platelet count, as well as higher values of NLR and PLR, and statistically significantly lower values of lymphocytes and MPV in comparison to benign changes. There is a possibility of using hematological and biochemical parameters in the assessment of endometrial changes as well as in the prediction of stages, in confirmed malignant changes of the endometrium.

Roleof Hematological Markers in Oral Potentially Malignant Disorders and Oral Squamous Cell Carcinoma.

Various haematological markers have been shown to be diagnostic and prognostic in oral cancer. This study compares the values of the inflammatory metrics neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), ESR and HB in precancerous and cancerous lesions to see if one of them can be utilised to make an early diagnosis of oral squamous cell carcinoma. To compare haematological markers as a diagnostic marker to differentiate healthy individuals, oral potentially malignant disorders from oral squamous cell carcinoma patients. One hundred fifty patients were divided into three groups which includes 50 apparently healthy individuals (group A), 50 individuals with premalignant disorders (group B) and 50 individuals with oral squamous cell carcinoma (OSCC) (group C). The levels of various haematological parameters obtained from 5ml of intravenous blood was drawn from each subject were compared between these three groups. Using Kruskal Wallis and the Mann Whitney post hoc U test, comparisons between the NLR values were examined. A total of number of 150 individuals were included in the current study. The mean age is 43.3years out of which 49 (81.6%) were male and 11(18.3%) were female. The mean NLR in group 1, 2 and 3 were 2.16, 3.12 and 3.67 respectively and mean PLR were 91.1, 110.3 and 160.6 respectively. The mean Hb content was 14.8, 13.77 and 12.76 respectively. The mean ESR was 9.65, 17.2 and 27.4 respectively. These parameters can be used as valuable adjuvant in identifying and understanding the nature of disease of both potentially malignant diseases and oral cancer.

Neutrophil-to-lymphocyte ratio as a biomarker for Guillain-Barré Syndrome: A systematic review with meta-analysis (P10-5.004)

<h3>Objective:</h3> We conducted a systematic review and meta-analysis to summarize the evidence on neutrophil-lymphocyte ratio (NLR) as a potential biomarker for Guillain-Barré syndrome (GBS). <h3>Background:</h3> GBS is an immune-mediated neuropathy. This has raised the possibility that the NLR may be a biomarker of its activity. <h3>Design/Methods:</h3> We systematically searched databases (PubMed, Ovid-Medline, Embase, Scopus, Web of Science, SciELO, LILACS, and Google Scholar) until October 2021 for studies evaluating pre-treatment NLR values in GBS patients. A meta-analysis using a random-effects model to estimate pooled effects was planned for each outcome and a narrative synthesis when this was not possible. Subgroup and sensitivity analysis were planned. GRADE criteria were used to identify the certainty of evidence for each result. <h3>Results:</h3> We screened ten studies for full-text review from 745 in the initial search. Regarding GBS patients versus healthy controls, a meta-analysis of six studies (968 patients) demonstrated a significant increase in NLR values in GBS patients (MD: 1.76; 95% CI: 1.29, 2.24; I2 = 86%) with moderate certainty due to heterogeneity and irrespective of GBS diagnosis criteria used. Regarding GBS prognosis, assessed by Hughes Score ≥3, NLR had a sensitivity ranged 67.3 and 81.5 and a specificity between 67.3 to 87.5 with low certainty due to imprecision, and heterogeneity. In relation to respiratory failure, NLR had a sensitivity of 86.5 and specificity of 68.2 with high and moderate certainty, respectively. Regarding sensitive analysis, these suggest that the results estimated by meta-analysis were stable. <h3>Conclusions:</h3> With moderate certainty, mean NLR is higher in GBS patients compared to healthy controls. Furthermore, we found that NLR could be a prognostic factor for disability and respiratory failure with low and moderate certainty, respectively. These results may prove useful for NLR in GBS patients; however, further research is needed. <b>Disclosure:</b> Mr. Cabanillas Lazo has nothing to disclose. Mr. Vicuña has nothing to disclose. Miss Cruzalegui Bazán has nothing to disclose. Miss Pascual-Guevara has nothing to disclose. Dr. Mori has received personal compensation in the range of $0-$499 for serving as a Consultant for Roche. Dr. Mori has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche. Dr. Mori has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Sanofi. Dr. Mori has received personal compensation in the range of $0-$499 for serving on a Speakers Bureau for Sanofi. Carlos Alva-Diaz has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche Farma. Carlos Alva-Diaz has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Roche Farma. The institution of Carlos Alva-Diaz has received research support from Roche farma.

Simple and easily accessible prognostic markers in ewing sarcoma; neutrophil-lymphocyte ratio, neutrophil-platelet score and systemic-inflammation index.

Inflammation markers are the new point of view in cancer due to increasing data on the interaction of immune system with tumor cells and their prognostic and predictive importance were found in many different types of solid tumors. Therefore, we aimed to evaluate the prognostic value of neutrophil-lymphocyte ratio (NLR), neutrophil-platelet score (NPS), and systemic inflammation index (SII) in Ewing sarcoma patients in which risk groups are still not clearly defined. A total of 64 patients were evaluated retrospectively. Receiver operating characteristic analysis was performed to find cut-off values for NLR and SII. Survival analysis was calculated by using Kaplan-Meier method. Cox regression analysis was performed to determine prognostic factors such as age, stage, and neoadjuvant chemotherapy were statistically significant prognostic factors for OS in multivariate analysis. While patients with low NLR and SII had longer OS (P = 0.003 and P = 0.018), patients with high NPS score had shorter OS (67.7 vs 21.7 months, P = 0.001). Patients with lower NLR, NPS, and SII score have a better prognosis compared with those with higher NLR, NPS, and SII score and these simple parameters may be monitoring tools of the tumor microenvironment.

The Clinical Value of Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio for Predicting Hematoma Expansion and Poor Outcomes in Patients with Acute Intracerebral Hemorrhage.

There is little knowledge of the effect of inflammatory markers on the prognoses of hematoma expansion (HE) in patients with intracranial hemorrhage (ICH). We evaluated the impact of neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) on HE and worse outcomes after acute ICH. This study included 520 consecutive patients with ICH from the registry database enrolled over 80 months. Patients' whole blood samples were collected upon arrival in the emergency department. Brain computed tomography scans were performed during hospitalization and repeated at 24 h and 72 h. The primary outcome measure was HE, defined as relative growth >33% or absolute growth <6 mL. A total of 520 patients were enrolled in this study. Multivariate analysis showed that NLR and PLR were associated with HE (NLR: odds ratio [OR], [95% CI] = 1.19 [1.12-1.27], p < 0.001; PLR: OR, [95% CI] = 1.01 [1.00-1.02], p = 0.04). Receiver operating characteristic curve analysis revealed that NLR and PLR could predict HE (AUC of NLR: 0.84, 95% CI [0.80-0.88], p < 0.001; AUC of PLR: 0.75 95% CI [0.70-0.80], p < 0.001). The cut-off value of NLR for predicting HE was 5.63, and that of PLR was 23.4. Higher NLR and PLR values increase HE risk in patients with ICH. NLR and PLR were reliable for predicting HE after ICH.

Association of systemic inflammatory markers with prognosis in erlotinib-treated EGFR-mutant non-small cell lung cancer.

To evaluate the relationship of overall survival (OS) and progression-free survival (PFS) with the derived neutrophil-lymphocyte ratio (dNLR), neutrophil-lymphocyte ratio (NLR), lymphocyte-monocyte ratio (LMR), and platelet-lymphocyte ratio (PLR) in patients with epidermal growth factor receptor (EGFR)-mutant non-small cell lung cancer (NSCLC). The study included 43 patients with EGFR-mutant metastatic NSCLC. The dNLR, NLR, LMR, and PLR values were calculated using the baseline complete blood counts before and after treatment with erlotinib. The NLR value had the best diagnostic test performance with a sensitivity of 91.3%. dNLR, NLR, LMR, and PLR were found to be significant for the prediction of OS and PFS. While the delta dNLR and NLR values were significant for OS, only the delta NLR value was significant for PFS. The dNLR, NLR, LMR, and PLR values were found to be significant in the prediction of OS and PFS in erlotinib-treated metastatic NSCLC. Further clinical studies are needed to determine the ideal target-specific tyrosine kinase inhibitor in cases of metastatic NSCLC presenting with the EGFR-activating mutation.

Evaluation of the performance of simple laboratory parameters used in the diagnosis of acute appendicitis.

Acute appendicitis (AA) is one of the most common emergency surgery. To evaluate the performance of laboratory parameters used in the diagnosis of AA. There were two groups. In both groups, leukocyte (WBC), neutrophil, lymphocyte count, neutrophil/lymphocyte ratio (NLR), mean platelet volume (MPV), red cell distribution width (RDW), and platelet distribution width (PDW) values were examined in complete blood count (CBC). In addition, serum bilirubin (total bilirubin and direct bilirubin) values were examined. All laboratory parameters studied were compared to evaluate their diagnostic performance. A total of 128 people were in the AA group and 122 people were in the healthy group (control). WBC count, neutrophil count, NLR, total bilirubin, direct bilirubin, and PDW values were significantly higher in the AA group than in the control group (P value <0.05). Lymphocyte counts and MPV values in the AA group were significantly lower than in the control group (P value <0.05). The sensitivity and selectivity of the WBC and neutrophil counts in AA were 95.13%, 89.34%, 94.53%, and 93.44%, respectively. The sensitivity and selectivity of the total bilirubin values were 59.38% and 73.77%, respectively. Area under the ROC curve (AUC) values within 95% confidence interval were over 0.900 for neutrophil count, WBC count, direct bilirubin, NLR, and PDW values. AUC values for total bilirubin, lymphocyte count, RDW, and MPV values were below 0.700. Diagnostic performances of the laboratory parameters were determined as follows: neutrophil count > WBC count > direct bilirubin = NLR = PDW > total bilirubin = lymphocyte count = RDW = MPV.

Systemic Inflammatory Marker Levels in Serous Macular Detachment Secondary to Retinal Vein Occlusion.

To evaluate the association of systemic inflammatory marker levels in macular edema with serous macular detachment (SMD) secondary to retinal vein occlusion (RVO). Patients diagnosed with RVO were categorized into two groups based on the presence or absence of SMD: Group 1 included 30 eyes with SMD, while Group 2 included 30 eyes without SMD. Levels of neutrophils, monocytes, lymphocytes, thrombocytes, and mean platelet volume (MPV) were analyzed. Systemic inflammatory markers, including neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and systemic immune-inflammation index (SII), were calculated and compared between the two groups. The mean neutrophil levels were significantly higher in Group 1 (P = 0.002). The mean lymphocyte, monocytes, thrombocyte, and MPV levels did not differ significantly between groups. NLR and SII levels were significantly higher in the SMD group (P = 0.004 and P = 0.016, respectively). There was no significant difference between the groups in terms of PLR. The optimal receiver operator characteristic (ROC) cut-off value of NLR for SMD was calculated as 1.55 with 73% sensitivity and 63% specificity (area under the curve [AUC] = 0.714, 95% confidence interval [CI]: 0.584-0.845). The optimal ROC cut-off value of SII for SMD was calculated as 451.75 with 63% sensitivity and 63% specificity (AUC = 0.681, 95% CI: 0.546-0.816). In this study, branch RVO was present in 48 patients, and central RVO was present in 12 patients. Neutrophil, MPV levels, and NLR, PLR, SII ratios were similar between patients with branch and central occlusion. Neutrophil levels, NLR, and SII were found to be significantly higher in eyes with SMD secondary to RVO.

Importance of the neutrophil-lymphocyte ratio and systemic immune-inflammation index in predicting colorectal pathologies in fecal occult blood-positive patients.

The fecal occult blood (FOB) test is one of the primary screening methods for colorectal cancer (CRC). In this study, we aimed to investigate the effect of the neutrophil/lymphocyte ratio (NLR) and systemic immune-inflammation index (SII) in predicting CRC and other colorectal pathologies in patients with a positive FOB test. This retrospective study included patients with a positive FOB test who underwent colonoscopy for the investigation of the etiology. The optimal cutoff levels of NLR and SII for predicting colorectal pathologies were determined using the receiver operating characteristic analysis. Of the 157 FOB+ patients, 35% were male and 65% were female, with a median age of 59 years. There were 96 patients in Group 1 and 61 patients in Group 2. The mean age of the patients in Group 2 was significantly higher (p < 0.001). The rate of male patients was significantly higher in Group 2. NLR and SII were significantly higher in Group 2 than in Group 1 (p < 0.001). The area under the curve values of NLR and SII in predicting colorectal pathologies in FOB+ patients were 0.817 and 0.825, respectively. At the cutoff values of 0.689 and 0.795, NLR and SII had a sensitivity of 60.66% and 95.83%, respectively, and a specificity of 95.83% and 100%, respectively. Neutrophil/lymphocyte ratio and SII can be used as important biomarkers in the early diagnosis of CRC and other colorectal lesions in patients with a positive FOB test.

Evaluation of the Determination of Platelet/Lymphocyte and Neutrophil/Lymphocyte Ratios in the Diagnosis of Acute Abdomen

Giriş ve Amaç: Acil servise karın ağrısı ile başvuran hastalarda hastanede kalış süresini kısaltma ve mortalite, morbitide oranlarının azaltılmasında biyobelirteçlerin önemi büyüktür. Bu çalışmada karın ağrısı ile başvuran hastaların başvuru şikayetlerinin ciddiyetini belirleyebilmede platelet lenfosit oranı (PLO), nötrofil lenfosit oranının (NLO) önemi, hastalığın ciddiyeti arasındaki ilişkisi ve akut karını göstermede beyaz küre (WBC), PLO ve NLO’nun birbirine üstünlükleri değerlendirilmiştir. &#x0D; Gereç ve Yöntemler: Bu çalışma 3. Basamak Üniversite Hastanesi Acil Tıp Kliniğine karın ağrısı şikayetiyle başvuran ve radyolojik olarak “akut batın” tanısı konan 200 hasta ve sağlıklı 100 kontrol grubu üzerinde prospektif olarak yapılmıştır.&#x0D; Bulgular: Çalışmaya 200’ü hasta grubu, 100’ü kontrol grubu olmak üzere toplam 300 olgu dahil edilmiştir. Hasta ve kontrol grubunu ayırt etmede WBC duyarlılığı %79, özgüllüğü %79, PKD düzeyi %88,3, NKD düzeyi %65,3, NLO duyarlılığı %85, özgüllüğü %83, PKD düzeyi %90,9, NKD düzeyi %73,5 ve PLO duyarlılığı %69, özgüllüğü %68, PKD düzeyi %81,2, NKD düzeyi %52,3 olarak saptanmıştır. Olguların NLO değerleri ile WBC değerleri arasında pozitif yönde 0.510 düzeyinde, PLO değerleri ile WBC değerleri arasında pozitif yönde 0.115 düzeyinde istatistiksel olarak anlamlı ilişki olduğu saptanmıştır.&#x0D; Sonuç: WBC, NLO ve PLO değerleri akut inflamasyonu gösteren belirteçlerden olup NLO’nun karın ağrısı ile başvuran hastalarda kritik hastaları tanımlamak, ileri görüntüleme sayısının azaltılmasını sağlamak ve primer sonlanımı öngörmede klinisyene yol göstereceğini düşünmekteyiz.

Performance of the systemic immune-inflammation index in predicting survival to discharge in out-of-hospital cardiac arrest

ObjectiveTo investigate whether the systemic immune-inflammatory index (SII) could be used as a prognostic marker of out-of-hospital cardiac arrest (OHCA). MethodsWe evaluated patients aged 18 years and older, who presented to the emergency department (ED) due to OHCA between January 2019 and December 2021 and achieved the return of spontaneous circulation after successful resuscitation. Routine laboratory tests were obtained from the first blood samples measured following the patients’ admission to ED. The neutrophil–lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) were calculated by dividing the neutrophil and platelet counts by the lymphocyte count. SII was calculated as platelets × neutrophils / lymphocytes. ResultsAmong the 237 patients with OHCA included in the study, the in-hospital mortality rate was 82.7%. The SII, NLR, and PLR values were statistically significantly lower in the surviving group than in the deceased group. The multivariate logistic regression analysis revealed that SII [odds ratio (OR): 0.68, 95% confidence interval (CI): 0.56–0.84, p = 0.004] was an independent predictor of survival to discharge. In the receiver operating characteristic analysis, the power of SII to predict survival to discharge [area under the curve (AUC): 0.798] was higher than either NLR (AUC: 0.739) or PLR (AUC: 0.632) alone. SII values below 700.8% predicted survival to discharge with 80.6% sensitivity and 70.7% specificity. ConclusionOur findings showed that SII was more valuable than NLR and PLR in predicting survival to discharge and could be used as a predictive marker for this purpose.

Prognostic Value of Lymphocyte-to-Monocyte Ratio and Neutrophil-to-Lymphocyte Ratio in Patients with Colorectal Cancer: "A Retrospective Cohort Study"

Background: In the past decade, advancements in the treatment of colorectal cancer (CRC) have greatly improved survival; nevertheless, simple biomarkers to predict responsiveness to therapy or survival that seem relevant to all medical oncology settings globally have yet to be developed. The neutrophil/lymphocyte ratio (NLR) and the lymphocyte-to-monocyte ratio (LMR) are two simple and generally accessible examples of inflammation markers based on differential white cell counts. Methods: LMR and NLR were evaluated in 69 patients diagnosed with CRC and received different treatment approaches depending on the stage, ECOG, and treatment guidelines. The correlation between LMR and clinical pathology was retrospectively evaluated. The predicted values of NLR and compared the predicted values of LMR and NLR were also assessed. Results: After analyzing the receiver operating characteristic (ROC) curve, the cut-off level for LMR and NLR was determined to be 2. Out of the total patients, 55 (79.7%) were classified into the high LMR group, while 14 (20.3%) were categorized into the low LMR group. Among the patients, 30 (43.5%) and 39 (56.5%) were grouped into low and high NLR groups, respectively. It was concluded that tumor markers (CEA) (p 0.031), TNM staging (p=0.016), distant metastasis (p=0.014), and disease progression (p=0.038) were significant. NLR was significant in only tumor markers (p=0.014) and tumor location (p=0.046). OS was significant. Conclusion: The results indicate that prior to treatment, both LMR and NLR were significant independent predictors in colon cancer and that incorporating NLR/LMR alongside TNM staging may enhance prognostic evaluation in patients with colon cancer. However, the study was limited by a retrospective methodology and a relatively small sample size. To determine the exact cut-off values for NLR and LMR as prognostic indicators in colorectal cancer, larger-scale prospective studies involving multiple centers will be required.