Peripheral Neutrophil-lymphocyte Ratio Research Articles

Neutrophil-to-lymphocyte ratio trend: A novel prognostic predictor in patients with nasopharyngeal carcinoma receiving radiotherapy.

Peripheral neutrophil-lymphocyte ratio (NLR), reflecting immune-inflammation status, shows great potential for tumor progression and outcome. Pre-treatment NLR does not fully reflect the immune-inflammatory response to treatment. This study aimed to introduce the NLR trend as a new indicator and to investigate its prognostic value in patients with nasopharyngeal carcinoma receiving radiotherapy. This retrospective study evaluated patients with nasopharyngeal carcinoma treated with radiotherapy. The NLR trend value was calculated from the fitted line gradient via the NLRs before, during (at least once), and after each patient's first radiotherapy. The Kaplan-Meier curve and log-rank test were used to calculate and compare survival outcomes of different pretreatment NLRs and NLR trends for progression-free survival, locoregional recurrence-free survival (LRFS), and overall survival at 3 and 5 years. Multivariate Cox regression analyses were performed to assess the association between the NLR trend plus 3- and 5-year overall survival. The study included 528 patients. A lower NLR trend predicted worse progression-free survival, LRFS, plus 3- and 5-year overall survival. Multivariate Cox regression analysis showed that the NLR trend independently predicted 3- and 5-year overall survival. Sub-group analysis showed that the prognosis of patients with a low pretreatment NLR and a high NLR trend were superior to those of other groups. The NLR trend independently predicted the prognosis of patients with nasopharyngeal carcinoma receiving radiotherapy. The NLR trend and the pretreatment NLR combination is more precise than pretreatment NLR in predicting prognosis. A high NLR trend may be evidence of a positive immune response to radiotherapy in patients with nasopharyngeal carcinoma.

Peripheral blood immune cell dynamics reflect antitumor immune responses and predict clinical response to immunotherapy

BackgroundDespite treatment advancements with immunotherapy, our understanding of response relies on tissue-based, static tumor features such as tumor mutation burden (TMB) and programmed death-ligand 1 (PD-L1) expression. These approaches are...

Correlation between neutrophil lymphocyte count ratio and outcomes of severe traumatic head injury

Background: Raised peripheral neutrophil lymphocyte ratio is associated with poorer outcomes in conditions such as severe brain injury, ICH, cardiovascular conditions, cancer.Methods: Retrospective analysis of 96 severe Traumatic Brain injury data treated at our institute over a period of 1 year. The patients were followed up for a period of at least 1 month. The primary outcome of the study was 1 month GOS and the various variables which may be associated with the poor GOS at 1 month follow up. Model based analysis was done for NLCR <24 hrs at 48 hrs and GCS at the time of presentation and discriminative ability of the models were studied by the Area under the curve.Results: Univariate analysis were done of 96 patients of severe traumatic brain injury for various variables such as age, sex, mode of head injury, type of head injury, presenting GCS and NLCR at 24 hrs and 48 hrs to that of GOS at 1 month follow up. Initial GCS <7 (p=0.0138) with AUC=0.6689 and peak NLCR (<24 hr) of > 9.6 (AUC=0.931) with a p value of <0.001 with sensitivity of 100% and specificity of 79.27% and peak NLCR (48 hrs) of >12.4 (AUC= 0.973) with a p value of <0.001 with sensitivity of 100% and specificity of 89.02% were associated with unfavourable outcome.Conclusions: High NLCR and initial poor GCS are independent unfavourable prognostic factors in 1 month GOS following severe traumatic head injury.

Prognostic Role of Peripheral Neutrophil-Lymphocyte Ratio (NLR) and Platelet-Lymphocyte Ratio (PLR) in Patients with Rectal Cancer Undergoing Neoadjuvant Chemoradiotherapy.

To investigate the predictive and prognostic role of pretreatment hematological parameters for tumor response and outcomes in locally advanced rectal cancer (LARC) patients undergoing surgery after neoadjuvant chemoradiotherapy (nCRT). From 2010 to 2016, 53 patients with LARC who underwent surgery following nCRT were analyzed. All hematological parameters were obtained from the initial blood tests performed before nCRT. The optimal cutoff values of significant hematological parameters for pathological tumor response (pTR), disease-free survival (DFS), and overall survival (OS) were determined using receiver operating characteristic (ROC) analysis. Patients have categorized into "good" and "poor" response groups according to their pathological results, and clinical-pathologic variables compared between the two groups. All survival analysis was calculated by the Kaplan-Meier method. Uni-multivariate analyses were performed using the Cox proportional hazard model. In the ROC analysis, neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) for OS and absolute platelet count and PLR for DFS were found as significant prognostic factors. In multivariate analysis, surgical margin, ypN stage, and elevated PLR were significantly associated with OS, and likewise, high PLR was found as an independent poor prognostic factor for DFS. The 5-year OS and DFS rates were worse in patients with high PLR group (82.3 vs. 47.3% for OS, p = 0.018 and 88.2 vs. 51.3% for DFS, p = 0.002). Pretreatment high PLR is associated with worse OS and DFS in patients with rectal cancer. To use in daily practice, further studies are needed on its validation.

The prognostic role of the pretreatment peripheral neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) in patients with cervical cancer

The prognostic role of the pretreatment peripheral neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) in patients with cervical cancer

Pre-treatment Peripheral Neutrophil-Lymphocyte Ratio as a Prognostic Marker in Gastric Cancer.

Gastric cancer is the fifth cancer worldwide. Inflammatory response increases metastasis through apoptosis inhibition and angiogenesis augmentation. The neutrophil-lymphocyte ratio (NLR), which is a balance between pro-cancer inflammatory and anti-cancer immune responses, was proved as prognostic marker. Peripheral NLR is a good reflection of tumor microenvironment. We retrospectively collected data of gastric and gastro-esophageal cancer patients treated from January 2015 till December 2016. Sixty-one patients were included. Pre-treatment NLR was calculated. We extracted the different clinic-epidemiological and pathological data. Event-free and overall survivals were plotted using Kaplan-Meier curves. The median age was 55. Male to female ratio was 1:1. Forty-seven patients were smokers. Most of the patients (93.4%) had good performance status (ECOG 0-2). Forty-six patients had gastric and 15 had gastro-esophageal cancer. 50.8% had diffuse gastric type. Grade III represented 49.2% and grade II 46%. Twelve patients had ascites at diagnosis. Stage at presentation was 1.6%, 4.9%, 27.9%, 50.8%, and 14.8% for stage I, II, III, IV, and unknown respectively. The median NLR was 2.4. The NLR showed no significant correlation with different clinic-epidemiologic and pathological variables except presence of ascites; p = 0.046. Median event-free survival (EFS) and overall survival (OS) were 6 and 8months respectively. High NLR was significantly associated with worse survival; EFS, 5months vs 8months (95% CI, p = 0.001). OS, 6months vs 9months (95% CI, p = 0.013). Gastric cancer is an aggressive and fatal disease. NLR can be used as a prognostic marker.

P-053 - Pre-treatment peripheral neutrophil-lymphocyte ratio as a prognostic factor in gastric cancer

P-053 - Pre-treatment peripheral neutrophil-lymphocyte ratio as a prognostic factor in gastric cancer

Value of neutrophil-lymphocyte ratio in predicting hepatitis B-related liver failure

Objective: To investigate the value of neutrophil-lymphocyte ratio (NLR) in predicting hepatitis B-related liver failure. Methods: A total of 349 subjects were enrolled, among whom 60 were healthy persons who underwent physical examination (group A), 111 had severe chronic hepatitis B (group B), 92 had decompensated hepatitis B cirrhosis (group C), and 86 had acute-on-chronic liver failure (ACLF) (group D). Routine blood test results, liver function parameters, and coagulation parameters were collected, and NLR was calculated. According to disease progression, group B was further divided into groups B1 (with progression to ACLF) and B2 (without progression to ACLF). NLR was compared between groups, and its prognostic value was evaluated. Results: NLR was 2.22(1.76-3.05) in group A, 2.54(1.78-3.49) in group B, 3.07(1.95-5.04)in group C, and 3.41(2.01-5.15) in group D, and NLR gradually increased with the aggravation of disease condition. The univariate and multivariate regression analyses of groups B1 and B2 showed that NLR and prothrombin activity were prognostic factors for disease progression. There was a significant difference in baseline NLR between groups B1 and B2 (3.87 ± 1.54 vs 2.71 ± 1.54, P = 0.004). There was a significant increase in NLR when severe hepatitis B in 16 patients progressed to ACLF (P = 0.042). The receiver operating characteristic (ROC) curve analysis showed that the cut-off value of NLR for predicting the progression of severe hepatitis B to ACLF was 2.79, with an area under the ROC curve (AUC) of 0.739 (P = 0.002). NLR was also a reference index for judging end-stage liver disease with a cut-off value of 3.94 (AUC = 0.612, P = 0.001). Conclusion: Peripheral NLR can reflect disease progression and predict the development of liver failure.

Can the Peripheral Neutrophil-Lymphocyte Ratio Rule Out Subarachnoid Hemorrhage?

An elevated peripheral neutrophil-lymphocyte ratio (NLR) is an indicator of inflammation. Investigators from a Turkish university hospital hypothesized