Platelet-lymphocyte Ratio Values Research Articles

Prediction of Peritoneal Cancer Index and Prognosis in Peritoneal Metastasis of Gastric Cancer Using NLR-PLR-DDI Score: A Retrospective Study.

ObjectiveThe peritoneal cancer index (PCI) is used to evaluate the peritoneal metastasis of gastric cancer. A higher value indicates more widespread and/or larger tumors in the peritoneal cavity. The neutrophil–lymphocyte ratio (NLR) and platelet–lymphocyte ratio (PLR) are representative blood markers of systemic inflammatory responses, and D-dimer (DDI) is the final stable product of fibrin. This study explores the association of NLR, PLR, and DDI with PCI and assesses the clinical utility of a new blood score combining the NLR, PLR, and DDI (NPD score) for PCI and the prognosis prediction of gastric cancer.MethodsThis was a single-center, nonrandomized, retrospective, cohort study. We evaluated the risk factors for high PCI (≥15) using univariate and multivariate analyses. According to the findings of the ROC analysis, we determined the cut-off values of NLR, PLR and DDI and created the NPD score. The patients were grouped into high-risk and low-risk groups based on their NPD score (<2 and ≥2, respectively).ResultsUnivariate and multivariate analysis demonstrated that the NLR, PLR, and DDI were independent risk factors for high PCI (P < 0.05). The NPD score of the high-risk group was ≥2, and the NPD score of the low-risk group was <2. The median survival time was 14.2 in the high-risk group and 25.6 in the low-risk group. The NPD score was significantly higher in the high-PCI group than that in the low-PCI group. The survival of the high-risk group was significantly worse than that of the low-risk group (P = 0.003). NPD score decrease was an independent predictive factor for PCI decrease.ConclusionNLR, PLR, and DDI are potential independent risk factors for high PCI in patients with peritoneal metastasis of gastric cancer. The NPD scoring system can help in predicting PCI and the prognosis of patients with peritoneal metastasis of gastric cancer.

Prognostic nutritional index - A predictive tool for treatment tolerance in head and neck radiotherapy

Background: Head-and-neck cancer (HNC) constitutes one-third of all cancers in developing countries, and the majority present in locally advanced stages. Poor nutritional status is invariably present which compromises treatment compliance, quality of life and survival outcome, posing a major treatment challenge. The aim of this study was to assess the role of pretreatment biomarkers including neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and prognostic nutritional index (PNI) in predicting treatment tolerance. Materials and Methods: This prospective observational study included 82 patients receiving definitive and adjuvant radiotherapy for HNC. Utilizing baseline blood investigations, the NLR, PLR, and PNI (10 × albumin + 0.005× lymphocyte count) were calculated for each patient. The cutoff values of NLR, PLR, and PNI were based on the median values. Treatment tolerance in terms of weight loss of more than 10% during treatment, the need for feeding procedure, treatment breaks, and not completing planned treatment as per the schedule were assessed. Associations of NLR, PLR, and PNI with the treatment tolerance factors were assessed using the Chi-square test and Fisher's exact test, and a P < 0.05 was considered statistically significant. Results: Low PNI significantly correlated with feeding procedure requirement and treatment breaks, thus compromising treatment completion. NLR and PLR did not show statistically significant correlations. Conclusion: Low PNI is a reliable predictive factor of poor treatment tolerance. It is an accessible screening tool to identify patients at risk of poor treatment tolerance in whom early interventions can be made to aid in uneventful treatment completion.

Comparison of the predictive values of CRP, CRP/albumin, RDW, neutrophil/lymphocyte, and platelet/lymphocyte levels in determining the severity of acute pancreatitis in patients with acute pancreatitis according to the BISAP score.

In our study, it was aimed to find out whether it would be possible to determine the disease severity by comparing the values of red cell distribution width (RDW), c-reactive protein (CRP), CRP/albumin, neutrophil/lymphocyte ratio (NLR), and platelet/lymphocyte ratio (PLR) in patients with acute pancreatitis according to Bedside Index of Severity in Acute Pancreatitis (BISAP) scores at the time of admission. Five hundred patients diagnosed with acute pancreatitis were included in the study. According to BISAP scores, 388 (77.6 %) patients were evaluated as having mild acute pancreatitis and 112 (22.4 %) patients as having severe acute pancreatitis. In ROC analysis, values of 70.54 % sensitivity and 70.10 % specificity for CRP, 71.43 % sensitivity and 70.88 % specificity for CRP/albumin, 80.36 % sensitivity and 30.30 % specificity for RDW, 75.00 % sensitivity and 43.98 % specificity for NLR, and 55.36 % sensitivity and 38.51 % specificity for PLR were determined. Values of 85.71 % sensitivity and 66.49 % specificity were determined for the NLR-CRP/Albumin-RDW 2** score as a newly created scoring system. CRP/albumin, NLR, PLR, and RDW values ​​were found to be statistically significantly higher in patients with severe acute pancreatitis compared to those with mild acute pancreatitis according to the BISAP score (pthat this scoring system could be a practical and reliable guide in the treatment and follow-up of patients with acute pancreatitis (Tab. 6, Fig. 3, Ref. 22).

Predictive evaluation of SIRI, SII, PNI, and GPS in cholecystostomy application in patients with acute cholecystitis.

The aims of this study were to investigate the clinical significance of systemic inflammatory response index (SIRI), systemic inflammation index (SII), prognostic nutritional index (PNI), and Glasgow prognostic score (GPS) in deciding whether to perform cholecystostomy when determining if cholecystostomy is the right choice for acute cholecystitis (AC) patients. Between January 2018 and December 2020, 126 consecutive patients with AC with and without cholecystostomy were retrospectively recruited from the Trakya University in Edirne, Turkey. Group I included AC patients with cholecystostomy and Group II included AC patients without cholecystostomy. The neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), and lymphocyte/monocyte ratio (LMR) were calculated. The PNI and SII were calculated RESULTS: There is significant difference between the two groups by the comparison of SIRI, SII, PNI, and GPS values (p<0.001). In Group I, SIRI, SII, and GPS values are higher than the Group II and PNI value in Group I is lower than the Group II. Furthermore, the NLR and PLR ratios in Group I are significantly higher than Group II, and the LMR ratio in Group I is significantly lower than Group II. According to our study, we can say that NLR, PLR, SII, SIRI, and GPS are positive predictors and LMR and PNI are negative predictors for the severity of AC. Therefore, when we decide to treat AC medically, we may prefer the application of chole-cystostomy tube at the beginning of hospitalization by the help of evaluating NLR, PLR, LMR, SIRI, SII, GPS, and PNI values.

Predictive Ability of Prognostic Markers in Cystic Echinococcosis with Bile Leakage

Objective: The most important post-surgical complication of cystic echinococcosis (CE) is cystobiliary communication and bile leakage in terms of mortality and morbidity. Therefore, we aimed to predict bile leakage using prognostic markers before the operation. Materials and Methods: All patients hospitalized with the diagnosis of CE in the Hepatobiliary Surgery Service of Atatürk University Research Hospital between 2011 and 2021 were retrospectively analyzed. Patients who were operated for CE and developed postoperative leakage were included in the study. Prognostic markers were calculated using preoperative laboratory tests. And these values were analyzed according to the recovery time of the patient. Results: The mean recovery time of postoperative biliary fistula was 13.97 ± 7.33 days. No mortality was observed in the patients. The mean prognostic nutritional index (PNI), the neutrophil–lymphocyte ratio (NLR) and platelet–lymphocyte ratio (PLR) values were 48.68 ± 8.46, 3.09 ± 2.61, and 149.34 ± 86.17, respectively. PLR significantly affected the recovery times. An increase in PLR meant a prolonged recovery period. PNI and NLR had no significant effect on the recovery times of biliary fistula. Conclusion: In patients with a high PLR value, caution should be exercised in terms of postoperative biliary fistula. PLR can be used as a marker if the cyst is to be intervened in the preoperative period.

Evaluation and Correlation of Preoperative Serum C- Reactive Protein, Neutrophil-lymphocyte Ratio and Platelet-lymphocyte Ratio for Cervical Metastasis in Patients of Primary Oral Squamous Cell Carcinoma

Background: The influence of cervical metastasis on prognosis in a person who is suffering from oral squamous cell carcinoma (OSCC) has been notorious. C- reactive protein (CRP) is a prior biomarker for inflammation. Recent literature provide evidence of systemic inflammatory markers playing important role in determining survival rate on patient with OSCC. Hence, in current study the “utility of Neutrophil-lymphocyte ratio (NLR) ,Platelet-lymphocyte ratio (PLR), and serum CRP are evaluated and correlated for cervical metastasis”.&#x0D; Objectives: This study intends to evaluate and correlate preoperative serum CRP, NLR, and PLR for cervical metastasis in patients of primary oral squamous cell carcinoma.&#x0D; Methodology: The clinicopathological data, CRP and the preoperative complete blood investigation details were obtained from 40 primary OSCC patients who will undergo surgery. The optimal cut-off value of CRP, PLR and NLR was determined. The prognostic significance of markers will be determined by Univariate and multivariate analysis.&#x0D; Expected Results: The elevation of CRP, NLR, and PLR levels will significantly evaluate and correlate with cervical metastasis.&#x0D; Conclusion: Preoperative serum CRP, NLR, and PLR level will be a prognosticator in OSCC.

Clinical Significance of Nlr(Neutrophil Lymphocyte Ratio) and Plr(Platelet Lymphocyte Ratio) in Predicting Post Operative Complication in Major Abdominal Surgery

Background: The Expression Major abdominal surgery is defined as a lengthy surgical procedure that lasts more than 30 minutes. Gastrectomy, Pancreatectomy, Hepatectomy, Colectomy, Small Bowel Resection, Tumor Resection, And Laparoscopic Gastrointestinal Operations are among the procedures covered. The term "abdominal tumour resection" refers to a wide range of procedures used to remove benign and malignant intraabdominaltumours. There Is A Greater Tendency Of Systemic Inflammatory Reaction When The Abdomen Organs Are Exposed To The External Environment For A Long Period Of Time. As a result, the goal of this research was to concentrate on the clinical significance of the neutrophil lymphocyte ratio and platelet lymphocyte ratio in patients undergoing major abdominal surgery.&#x0D; This review included a total of 15 studies conducted between 2000 and 2021. The influence of Clinical Importance Of The Neutrophil Lymphocyte Ratio and Platelet Lymphocyte Ratio In Patients Undergoing Major Abdominal Surgery has been reviewed collectively.&#x0D; Results: 15 studies were included in this review were Iincluded. The present study evaluated the value of nlr and PLR as predictive markers of post operative complications in major abdominal surgeries. In the current study, we investigated the value of nlr and PLR for predicting post operative complications in patients undergoing major abdominal surgeries.&#x0D; Conclusions: In Cases of Major Abdominal Surgeries, The nlr and PLR Ratio Is An Important Inflammatory Predictive Value In Assessing Post-Operative Morbidity. The platelet/lymphocyte ratio (PLR) and the neutrophil/lymphocyte ratio (NLR) are two affordable, reproducible, and quantitative measures of systemic inflammation.

Predictive values of combined platelet count, neutrophil-lymphocyte ratio, and platelet-lymphocyte ratio in preeclampsia

We aimed to determine predictive values of the platelet count (PC), Neutrophil lymphocyte ratio (NLR), and platelet lymphocyte ratio (PLR) in preeclampsia independently and in combination. One hundred and eighty pregnant women (96 normal pregnancies, 84 preeclampsia) were included in this study. ROC evaluated the predictive value of PC, NLR, and PLR. AUC, Youden’s index, and optimal cut-off thresholds were calculated independently and in combination. The PC significantly decreased in preeclampsia (p < .0001, 95% CI −60.6437 to −24.5963) with cut-off level ≤250.3, whereas NLR was significantly increased in preeclampsia (5.28 ± 4.77, p = .0001, 95% CI 0.9813–2.9187) with cut-off level >4.47. In preeclampsia, PLR significantly decreased (94.32 ± 30.81, p = .0001, 95% CI 58.2583 to −29.6817) with cut-off level ≤100.48. Combined indices of PC, NLR, and PLR were significantly more predictive of preeclampsia when compared to independent indices (AUC 0.86, p < .001, 95% CI 0.801–0.907, sensitivity 75.0, and specificity 81.2) compared to independent indices. IMPACT STATEMENT What is already known on this subject? Many studies have tried to find out a simple screening test that would predict the risk of developing preeclampsia. Platelet count, Neutrophil lymphocyte ratio, and platelet lymphocyte ratio have been investigated independently to predict preeclampsia. These parameters are simple, cheap, and are usually available for all patients. Unfortunately, there are no universal cut-off levels accepted. What do the results of this study add? The use of a combination of platelet count, neutrophil-lymphocyte ratio, and platelet lymphocyte ratio is a simple and effective test to predict preeclampsia. The use of a scoring system involving cut-off levels of platelet count, neutrophil-lymphocyte ratio, and platelet lymphocyte ratio is a highly predictive index for developing preeclampsia. What are the implications of these findings for clinical practice and/or further research? In this study, we aimed to highlight the importance of using a combination of platelet count, neutrophil-lymphocyte ratio, and platelet lymphocyte ratio as a scoring index instead of using these parameters independently. More studies are needed to reach a universal cut-off level for each parameter.

Predictive value of inflammatory indices LMR, PLR and NLR in patients with muscle-invasive bladder cancer

BACKGROUND: Increasing the efficiency of predicting the results of treatment of patients with bladder cancer is one of the important tasks of modern urology.&#x0D; AIM: Our aim was to identify and evaluate the association between the most significant clinical, morphological and immunological markers and survival of muscle-invasive bladder cancer patients treated with radical cystectomy. We also developed an algorithm for diagnosis and treatment of patients with muscle-invasive bladder cancer.&#x0D; MATERIALS AND METHODS: This retrospective study included 100 muscle-invasive bladder cancer patients, who underwent radical cystectomy between 1995 and 2013. The study endpoints were overall survival.&#x0D; RESULTS: Univariable analysis revealed that continuous (Lymphocyte-monocyte ratio), PLR (platelet-lymphocyte ratio) и NLR (neutrophil-lymphocyte ratio) were significantly associated with overall survival. On multivariable regression model analysis, continuous LMR, NLR, and PLR independently predicted both endpoints.&#x0D; CONCLUSIONS: Our findings indicate that the cheap and simple blood-based biomarkers may be valuable in identifying muscle-invasive bladder cancer patients treated with radical cystectomy, who are at higher risk of all-cause mortality.

The predictive role of neutrophil-lymphocyte ratio, platelet lymphocyte ratio, and other complete blood count parameters in eclampsia and HELLP syndrome

Background/Aim: Previous studies declared the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio, and other routine complete blood count (CBC) components as sensitive preeclampsia biomarkers. We speculated that the same associations existed with eclampsia and HELLP syndrome. Methods: This retrospective case-control study was conducted on 120 pregnant women between the ages of 18 and 40 years. Forty-nine patients with HELLP syndrome, 40 patients with eclampsia/preeclampsia, and 40 healthy pregnant women were included in the study. All groups were evaluated in terms of clinical characteristics and first-trimester hematological parameters. The primary outcomes were neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and the secondary results were hemoglobin, red blood distribution width, mean platelet volume, platelet count, neutrophil count, and lymphocyte count. Results: The median gestational age was 34 weeks (ranging between 23 and 41), with a median birth weight of 2300 grams. The median NLR was 3.9 (1.3-25.1), and the median PLR was 113.6 (20.7-693). The NLR and PLR values were significantly different between the three groups (P=0.014, P=0.002, respectively). NLR was different between normotensive and eclamptic pregnant women. PLR values were higher in normotensive pregnant women than in pregnant women with a history of HELLP. The median red cell distribution width was 44.6 in normotensive women, 41.5 in women with eclampsia, and 44.3 in women with a history of HELLP (P=0.017). Conclusion: TLR value was higher in pregnant women who had eclampsia. Platelet count and MPV were significantly lower in the HELLP group.

The Role of Neutrophil-Lymphocyte Ratio (NLR), Platelet-Lymphocyte Ratio (PLR), and D-Dimer in Predicting the Outcome of Confirmed COVID-19 patients

Background: Cytokine storm or hyperinflammation condition in COVID-19 patients could result in fatal outcomes. Inflammation could also result in coagulation disorders. The Neutrophil-Lymphocyte Ratio (NLR) and Platelet-lymphocyte ratio (PLR) have been known as inflammation markers in several diseases. D-dimer value can be used to assess a patient's coagulation status. Further study on thromboinflammation biomarkers in COVID-19 patients is needed. Therefore, we conducted a study to assess the association between NLR, PLR, and d-dimer on the clinical outcome of confirmed COVID-19 patients at Persahabatan Central Hospital.Methods: Observational cohort retrospective analysis was conducted on 214 medical records of confirmed COVID-19 patients who meet the inclusion criteria in Persahabatan Central Hospital from March to July 2020.Results: The mean patient’s age in this study is 54.35 years, dominated by male patients (60.7%). Most of the patients had normal nutritional status (54.7%). The proportion of patients with comorbidities is 65.4%. The most common comorbid is hypertension, followed by diabetes mellitus. 76.1% of patients have severe-critically ill disease, followed by moderate (20.1%) and mild disease (3.7%) The length of hospitalization median were 12 days. Sixty patients (28%) have died during hospitalization. The median of initial value of NLR, PLR, and d-dimer is 5.75 (0.68–81.5), 243.5 (44.7–1607), and 1140 (190–141300) respectively. We found significant associations between NLR (p = 0.000), PLR (p=0.013) and d-dimer (p = 0.032) on clinical outcome. Conclusion: Initial value of NLR, PLR, and D-dimer of confirmed COVID-19 patients at Persahabatan Central Hospital were associated with clinical outcome.

Haematological inflammatory markers for indicating ischemic bowel in patients with incarcerated abdominal wall hernias

To reveal the clinical significance of preoperative haematological inflammatory markers in the diagnosis of abdominal wall hernias with strangulation. The data of 200 patients who underwent surgery for incarcerated hernia were retrospectively analysed. The patients were grouped into three groups; Group 1; only surgical reduction and hernia repair, Group 2; small bowel resection and Group 3; omentum resection. Age, gender, hernia type, the presence of radiological bowel obstruction and preoperative complete blood count data were obtained. Neutrophil-leukocyte ratio (NLR), lymphocyte-monocyte ratio (LMR), platelet-lymphocyte ratio (PLR), haematological inflammatory index (HII) and systemic immune-inflammation index (SII) values were calculated. The study was consisted of; Group 1: 119 patients (59.5%), Group 2: 46 patients (23%) and Group 3: 35 patients (17.5%). Advanced age (p = 0.001), female gender (p = 0.036), incisional hernias (p = < 0.001) and the presence of bowel obstruction (p = < 0.001) were found to be statistically significant in terms of strangulation. NLR, PLR and SII values were significantly higher in Group 2 compared to Group 1, and PLR values were significantly higher in Group 2 compared with Group 3 (p < 0.05). The preoperative elevated NLR, PLR and SII values may indicate strangulation and possible intestinal resection, in incarcerated abdominal wall hernias.

A nomogram combining inflammatory markers and clinical factors predicts survival in patients with diffuse glioma.

In this study, we aimed to investigate the prognostic value of neutrophil/lymphocyte ratio (NLR), monocyte/lymphocyte ratio (MLR), and platelet/lymphocyte ratio (PLR) in diffuse glioma, and to establish a prognostic nomogram accordingly.The hematologic and clinicopathological data of 162 patients with primary diffuse glioma who received surgical treatment from January 2012 to December 2018 were retrospectively analyzed. Receiver operator characteristic (ROC) curve was carried out to determine the optimal cut-off values for NLR, MLR, PLR, age, and Ki-67 index, respectively. Kaplan–Meier method was used to investigate the correlation between inflammatory indicators and prognosis of glioma patients. Univariate and multivariate Cox regression were performed to evaluate the independent prognostic value of each parameter in glioma. Then, a nomogram was developed to predict 1-, 3-, and 5-year postoperative survival in diffuse glioma patients based on independent prognostic factors. Subsequent time-dependent ROC curve, calibration curve, decision curve analysis (DCA), and concordance index (C-index) were performed to assess the predictive performance of the nomogram.The Kaplan–Meier curve indicated that patients with high levels of NLR, MLR, and PLR had a poor prognosis. In addition, we found that NLR level was associated with World Health Organization (WHO) grade and IDH status of glioma. The multivariate Cox analysis indicated that resection extent, WHO grade, and NLR level were independent prognostic factors, and we established a nomogram that included these three parameters. The evaluation of the nomogram indicated that the nomogram had a good predictive performance, and the addition of NLR could improve the accuracy.NLR, MLR, and PLR were prognostic factors of diffuse glioma. In addition, the nomogram including NLR was reliable for predicting survival of diffuse glioma patients.

OR38. Hematological Parameter of Contrast Induced Acute Kidney Injury in ST Elevation Myocardial Infarction Patient Underwent Percutaneous Coronary Intervention

Abstract Aim To determine the relationship of Neutrophil/Lymphocyte Ratio (NLR), Platelet/Lymphocyte Ratio (PLR) as simple inflammatory parameter to incident of Contrast Induce - Acute Kidney Injury (CI-AKI) in ST Elevation Myocardial Infarction (STEMI) patient underwent Percutaneous Coronary Intervention (PCI). Method and Result We collected laboratory and angiographic data of 113 consecutive STEMI patient that treated with PCI in M. Djamil Hospital Padang since April 2020 – April 2021. CI-AKI define as increasing creatinine serum 25% or 0,5 gr/dl over 48 hours after contrast administration. Patient with end stage renal failure were exclude. In this study we found 17.6 % patient developed CI-AKI after PCI. These patients have older age (mean 61 ± 8.7 years) with hypertension as majority of risk factor (65%). PLR and NLR were higher in CI-AKI group (220.11 ± 144.57; 7.49 ± 5.36) with significant differences in PLR (p &amp;lt; 0.08). Hemoglobin was lower in CI-AKI group (mean 12.56 ± 1.50) and amount of contrast used during PCI were more in CI-AKI group (mean 135.75 ± 27.63) but there was no significant differences. Conclusion STEMI patient who underwent PCI with higher baseline PLR and NLR value have higher incident of CI-AKI. PLR have the most significant correlation to incident of CI -AKI in this population.

Systemic inflammatory response in predicting outcomes of patients undergoing curative resection for oral squamous cell carcinoma

This study aimed to evaluate the prognostic significance of the modified Glasgow prognostic score (mGPS), neutrophil:lymphocyte ratio (NLR), and platelet:lymphocyte ratio (PLR) in patients undergoing resection of oral squamous cell carcinoma (OSCC) with curative intent. We also aimed to explore the relation between activated systemic inflammation and adverse tumour characteristics. Between February 2006 and December 2019, data on 825 patients undergoing curative resection of OSCC were retrospectively gathered. Preoperative C-reactive protein and serum albumin levels were obtained to calculate a mGPS. Full blood count parameters were collected to calculate NLR and PLR values. Categorical factors were analysed using the chi squared test. Multivariate regression was performed to identify independent prognostic variables and the predictive value of each model generated. For disease-specific survival (DSS) and overall survival (OS), mGPS (DSS and OS both p<0.001), NLR (DSS and OS both p<0.001) and PLR (DSS and OS both p<0.001) were significant on univariate analysis. Independent predictive variables for DSS included mGPS, clinical node stage, categorised depth of tumour invasion, non-cohesive invasive front, and lymphovascular invasion. The concordance index was acceptable (0.756) for this model. Replacing mGPS with NLR or PLR as a marker of systemic inflammation demonstrated the same preoperative variables as independently predictive for DSS. The concordance index for these models were acceptable (NLR 0.76 and PLR 0.756). The systemic inflammatory response is prognostically significant in patients undergoing curative resection of OSCC. The potential link between an inflammatory tumour microenvironment and activated systemic inflammation merits further investigation.

The Clinical Values of Afamin, Triglyceride and PLR in Predicting Risk of Gestational Diabetes During Early Pregnancy.

ObjectiveTo establish a model to predict gestational diabetes mellitus (GDM) based on the clinical characteristics, early pregnancy (10-12 weeks gestation) peripheral blood routine, and biochemical indicators, and to explore its predictive efficiencies.MethodsData from 607 pregnant women with GDM were compared to the data from 833 pregnant women without GDM admitted to the Obstetrics Department of Fujian Maternity and Child Health Hospital (affiliated to Fujian Medical University) from May 2018 to December 2018 were retrospectively included. The ages of the pregnant women, paternal ages, number of pregnancies, number of deliveries, pre-pregnancy heights/weights, and the calculated body mass indexes (BMI) were recorded. In all participants, 10-12 weeks of pregnancy, afamin concentration, routine blood work, prenatal aneuploidy screening, and biochemical testing were performed. At weeks 24-28 of gestation, patients underwent oral glucose tolerance test (OGTT) for GDM screening.ResultsMultivariate logistic regression analysis showed that maternal age, early pregnancy afamin level, triglycerides, and platelet/lymphocyte ratio (PLR) were independent risk factors for gestational diabetes. The formula for predicting GDM probability was as follows: P = 1/1 + exp( − 6.054 + 0.774 × triglycerides + 0.002 × afamin + 0.155 × age − 0.012 × PLR)]. From the established ROC curve, the area under the curve (AUC) was 0.748, indicating that the model has a good degree of discrimination. When the predictive probability cut-off value was set on 0.358, sensitivity, specificity, positive predictive value, and negative predictive value were 69.2%, 68.3%, 42.5%, and 86.2%, respectively, and the accuracy rate was 70.2%. The Hosmer-Lemeshow test results showed that the goodness of the model fit has a good calibration ability (χ2 = 12.269, df=8, P=0.140).ConclusionsMaternal age, early pregnancy afamin level, triglycerides, and PLR are independent risk factors for gestational diabetes. When combined, the above indicators are helpful for prediction, early diagnosis, and intervention of gestational diabetes.

Predictive value of platelet to lymphocyte ratio and neutrophil to lymphocyte ratio in evaluating both lung involvement and severity of patients with coronavirus disease 2019.

Objectives:To investigate the relationship of the neutrophil lymphocyte ratio (NLR) and the platelet lymphocyte ratio (PLR) with lung involvement and total lung severity score (TLSS) in computed tomography (CT) of patients with coronavirus disease -19 (COVID-19) and to evaluate their clinical usability.Methods:Basic laboratory, clinical features and imaging data of patients was obtained by examining the file and archive records of our hospital. According to the findings of lung CT scan at the time of diagnosis among COVID-19 patients, 2 groups were formed.Results:The NLR was 2.22±11.15 and the PLR was 142.77±387.10 in patients with COVID-19 pneumonia. The NLR was 1.88±7.47 and the PLR was 130.65±203.6 8 in patients without COVID-19 pneumonia. The differences in the NLR and the PLR were determined to be statistically significant between the 2 groups. A positive correlation was observed between NLR and PLR (r=0.225, p=0.010) and TLSS (r=0.244, p=0.005).Conclusion:This study showed that the NLR and PLR values can be 2 inflammatory markers that can be used to evaluate lung involvement and disease severity in COVID-19 patients. At the time of initial diagnosis and during follow-up, these markers can give an idea in terms of prognosis, together with other clinical findings and markers.

English

BACKGROUND Cardiovascular disease is a significant health problem in India with an estimate 3.7 million deaths each year. Mechanisms of myocardial ischemia include inflammation, endothelial dysfunction, platelet aggregation and coagulation. Acute coronary syndrome occurs due to rupture of atherosclerotic plaque. Platelets play a role in both development and rupture of the atherosclerotic plaque. Lymphocytes play a role in chronic inflammation of atherosclerosis. Lower lymphocyte count has increased mortality after acute myocardial infarction. METHODS The study was conducted in Department of General Medicine, Karnataka Institute of Medical Sciences, Hubli from February 2019 to December 2020. It is a prospective observational study. Patients aged ≥ 18 years with ST-elevated myocardial infarction (STEMI) were included in the study. Total 156 cases were selected based on inclusion and exclusion criteria. Cardiovascular events during the in-hospital period were noted. The study population was divided into tertiles based on the platelet-lymphocyte ratio (PLR) values. The low PLR group (n = 104) was defined as having values in the lower 2 tertiles (PLR ≤ 148.4) and the high PLR group (n = 52) was defined as having values in the highest tertile (PLR &gt; 148.4). A ‘P’ value &lt; 0.05 was considered statistically significant. RESULTS Out of 156 patients, 103 (66 %) were males and 53 (34 %) cases were female. Mean age group was 59 ± 10 years. Percentage of patients who underwent thrombolysis was higher in high PLR group (65.38 % vs. 48.07 %, P = 0.041). Death rate was higher in high PLR group (28.84 % vs. 8.65 %, P = 0.001). PLR &gt; 148.4 was found to be an independent predictor of in-hospital cardiovascular mortality in multivariate analyses (hazard ratio: 13.222 (2.113-21.749) P = 0.006 with 95 % confidence interval). Receiver operating curve (ROC) analyses, a PLR value of 148.4 for in-hospital mortality rate had sensitivity of 62.5 % and a specificity of 72 % (area under the curve = 0.627, 95% confidence interval 0.485 – 0.769). CONCLUSIONS In our study, higher PLR had significant association with in-hospital mortality in patients with STEMI. KEYWORDS ST Elevation Myocardial Infarction (STEMI), Platelet/Lymphocyte Ratio (PLR), Ischemic Heart Disease (IHD)

Prognostic Significance of Pre-treatment Serum Inflammatory Biomarkers on Survival in Patients with Carcinoma Cervix Treated by Radical Radiotherapy or Chemo-radiation

Background: Inflammation has an important role in the initiation and progression of carcinoma cervix. The measurement of inflammatory biomarkers is a cost-effective method of identifying patients at high risk of recurrence after treatment. This study was done to identify the influence of pre-treatment inflammatory biomarkers on survival in patients treated with radical chemo-radiation or radiation. Methods: Patients with biopsy proven carcinoma cervix treated with Radiotherapy or Chemo-radiation from January 1st, 2016 to September 30th, 2017 were included. Pre-treatment complete blood counts, differential counts, serum albumin and C-reactive protein (CRP) were obtained. Neutrophil lymphocyte ratio (NLR), platelet lymphocyte ratio (PLR) and CRP Albumin ratio (CAR) were calculated. The best cut off values for NLR, PLR, serum albumin, CRP and CAR were found out from receiver operating characteristic (ROC) curves. OS (Overall Survival) and DFS (Disease Free Survival) were estimated using Kaplan -Meier method. The prognostic value of inflammatory biomarkers on survival was assessed by cox regression model. Results: Sixty-three patients were included. The median follow up was 42.5 months. The best cut off values for NLR, PLR, albumin, CRP and CAR from the ROC curve were 2.36, 122.725, 3.95, 0.65 and 0.8 respectively. The three-year OS and DFS probability were 68.3% and 63.5% respectively. Patients with CAR &gt;0.8 had 5.7 times more risk of death and 6.01 times risk of relapse or progression compared to patients with CAR ≤0.8. Conclusion: Patients with a CRP-Albumin ratio of more than 0.8 are at significant risk of relapse and death after chemoradiation or radiation.

Profile of mean platelet volume, neutrophil - lymphocyte ratio and platelet - lymphocyte ratio in patient with psoriasis

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; Psoriasis is a chronic, inflammatory, systemic disease. In response to therapy in psoriasis patients, the psoriasis area severity index (PASI) is used to evaluate the disease activity. However more objective laboratory tools should be developed besides PASI. In various inflammatory diseases, mean platelet volume (MPV), neutrophil-lymphocyte ratio (NLR), and platelet lymphocyte ratio (PLR) are inflammatory biomarkers that are known to be evaluated. The aim of the study was to assess the frequency of platelet activation and leukocyte infiltration by measuring MPV, NLR, and PLR.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; This was a case-control observational study conducted at department of dermatology and venereology at Bangabandhu Sheikh Mujib Medical University from July 2016 to December 2017. A total of 55 psoriasis cases and 55 healthy controls were included according to inclusion and exclusion criteria.&lt;strong&gt;&lt;/strong&gt;&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; We have investigated a total of 55 psoriasis patients and another 55 age-sex matched control. There were 31 males (56.36%) and 24 females (43.44%) psoriasis patients in the study. The mean age of the patient was 34.27±13.44 years. Mean±standard deviation (SD) value of MPV, NLR, and PLR in our study cases were 9.92±1.21, 4.32±8.53, and 292.96±88.80 whereas in the case of control values were 9.46±0.636, 4.54±8.51, and 162.26±103.38 respectively.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; In conclusion, we suggest MPV is a strong indicator of psoriasis severity. MPV and PLR should be followed up routinely to take preventive measures against psoriasis-related micro and macro vascular thrombotic complications.&lt;/p&gt;