Platelet-to-lymphocyte Ratio Research Articles

Clinical utility of complete blood count indices in pediatric MOG antibody-associated disease.

Clinical utility of complete blood count indices in pediatric MOG antibody-associated disease.

Association between platelet-to-lymphocyte ratio at admission and short-term mortality in severe burn patients: A meta-analysis.

Association between platelet-to-lymphocyte ratio at admission and short-term mortality in severe burn patients: A meta-analysis.

Prognostic biomarkers for colorectal cancer in a Nigerian population.

e15575 Background: Colorectal cancer (CRC) is a significant global health disease, with over one million new cases and more than 500,000 deaths in 2018. The incidence rate in Nigeria is 3.4 per 100,000 and the median overall survival is less than a year. More than 50% of patients present with metastatic disease and this has progressively worsened with no active routine national screening program in Nigeria. With an increasing burden of the disease there is a need to improve the prognosis and reduce the cancer related mortality from CRC. This study evaluates the prognostic value of cost-effective hematology/immunology biomarkers in the management of CRC in Nigeria. This prospective study aims to correlate hematology/immunology biomarkers with overall survival in CRC patients in a low resource setting. Biomarkers studied include neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), mean platelet volume (MPV), interleukin-6 (IL-6), and carcinoembryonic antigen (CEA). The study also assessed the utilization of these biomarkers to predict for advanced CRC (stages 3 and 4) at presentation. Methods: The study included 35 treatment-naïve CRC patients and 35 apparently healthy controls, with written consent obtained. Participants with CRC were clinically staged using the TNM staging AJCC UICC 8th edition. Baseline levels of biomarkers and plasma viscosity were measured and at 3- and 6-months post-treatment (surgery and/chemotherapy). Baseline levels for Serum IL-6 were measured only in participants with CRC. Data analysis included independent t-tests, Mann-Whitney U tests, and receiver operating characteristic curve analysis. Ethical approval was obtained from the Obafemi Awolowo University Teaching Hospital Complex (OAUTHC) Ethics and Research Committee, Nigeria. Results: The median age was 53 years, with a male-to-female ratio of 3:2. Advanced CRC (stages 3 and 4) was present in 74.29% of patients. All biomarkers except MPV were significantly higher in CRC patients than controls (p < 0.001). Higher pretreatment levels of CEA, NLR, and PLR were associated with advanced CRC stages (p < 0.05). Baseline NLR and PLR cut off values of 1.47 and 124.56 predicted advanced CRC. Post-treatment, significant reductions were seen in CEA and plasma viscosity at 3 and 6 months, and in PLR at 3 months. Conclusions: Pretreatment levels of CEA, NLR, and PLR effectively identify CRC patients with poor prognosis. CEA is an independent predictor of overall survival. These biomarkers are cost effective tools for monitoring treatment response and for early identification of CRC with poor prognosis. This may help inform individualization of treatment in low resource settings.

HBV-TCR T cell therapy: Preclinical and clinical insights into specificity, safety and efficacy for treating HBV-related HCC.

e14525 Background: LioCyx-M, an autologous T-cell therapy modified with mRNA encoding HBV-specific TCRs, was developed using a TCR selected from a proprietary library of HBV-specific TCRs. LioCyx-M has shown promise in hepatocellular carcinoma (HCC) patients. This study presents preclinical specificity, safety and pharmacological effects of LioCyx-M, further supported by clinical pharmacological data in HBV-related HCC patients who failed standard systemic therapies, including anti-PD-L1 antibodies. Methods: TCR specificity was assessed in vitro using human peptides with identical key recognition sites to the target peptide, identified via alanine scanning, to evaluate cross-reactivity. Cross-reactivity with HLA-A2 subtypes and human primary cells of different tissue origins was evaluated. Comprehensive in vivo safety and efficacy were assessed in NPG tumor-bearing mice treated with multiple LioCyx-M infusions over 14 days (n = 136) and 25 days (n = 200) in a GLP-certified lab. Two HCC patients (NCT04745403) each received 8 bi-weekly LioCyx-M infusions, at doses of up to 5×10 6 cells/kg, without prior lymphodepletion. Immune responses induced by LioCyx-M were evaluated by measuringCXCL9, CXCL10, Neutrophil-to-Lymphocyte Ratio (NLR), Platelet-to-Lymphocyte Ratio (PLR), and T cell phenotypes in blood. Results: LioCyx-M selectively recognized HBV antigens presented by HLA-A*02:01+ lymphoblastoid cell lines (LCL) but showed no cross-reactivity with peptides sharing the target motif. Moreover, there was minimal cross-reactivity with other HLA-A2 subtypes or primary human cells of different tissue origins from 6 donors with different HLA subtypes. In HCC xenograft mice, tumour inhibition was accompanied by increased blood lymphocytes and IFN-γ with no significant histopathological abnormalities in vital organs. In patients, we observed transient increase in CXCL9, CXCL10, NLR and PLR in responders (4 out of 7 patients) in an earlier clinical study (NCT03899415) 1 . Post-treatment, both patients exhibited an immune reprogramming shift from a naive/central memory T to an effector/effector memory T cell phenotype, mirroring in vivo findings of enhanced tumor killing and immune activation. In one patient, effector T cells (CD45RA+CCR7-) and effector memory (CD45RA-CCR7-) T cells increased 4-fold post treatment, while PD1+Tim3+ and PD1+Tim3- exhausted T cells were halved. Conclusions: Preclinical and clinical data demonstrate the specificity, safety and efficacy of multiple LioCyx-M infusions. LioCyx-M treatment reprograms patient’s immunity from exhausted status to immune active status, implying its potential in cancer immunotherapy. Reference Tan et al. Immunological alterations after immunotherapy with short lived HBV-TCR T cells associates with long-term treatment response in HBV-HCC. Hepatol Commun. 2022. Clinical trial information: NCT04745403 .

Implementing novel complete blood count-derived inflammatory indices in the diabetic kidney diseases diagnostic models.

Hemogram inflammatory markers, including neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), red-cell distribution width (RDW), and mean platelet volume (MPV) have been associated with type 2 diabetes mellitus (T2DM) and its complications, namely diabetic kidney diseases (DKD). We aimed to develop and validate logistic regression (LR) and CatBoost diagnostic models and study the role of adding these markers to the models. All individuals who were managed in our secondary care center from March 2020 to December 2023 were identified. After excluding the ineligible patients, train-test splitting, and data preprocessing, two baseline LR and CatBoost-based models were developed using demographic, clinical, and laboratory features. The AUC-ROC of the models with biomarkers (NLR, PLR, RDW, and MPV) was compared to the baseline models. We calculated net reclassification improvement (NRI) and integrated discrimination index (IDI). One thousand and eleven T2DM patients were eligible. The AUC-ROC of both LR (0.738) and CatBoost (0.715) models was comparable. Adding target inflammatory markers did not significantly change the AUC-ROC in both LR and CatBoost models. Adding RDW to the baseline LR model reclassified 41.7% of patients without DKD, in the cost of misclassification of 38.4% of DKD cases. This change was absent in CatBoost models, and other markers did not achieve improved NRI or IDI. The basic models with demographical and clinical features had acceptable performance. Adding RDW to the basic LR model improved the reclassification of the non-DKD participants. However, adding other hematological indices did not significantly improve the LR and CatBoost models' performance. The online version contains supplementary material available at 10.1007/s40200-024-01523-2.

The relationship of inflammatory markers NLR and PLR with HbA1c in Turkish diabetic patients.

The relationship of inflammatory markers NLR and PLR with HbA1c in Turkish diabetic patients.

Esketamine mitigates systemic inflammation via modulating phenotypic transformation of monocytes in patients undergoing thoracic surgery.

Esketamine mitigates systemic inflammation via modulating phenotypic transformation of monocytes in patients undergoing thoracic surgery.

Investigating clinical and molecular characteristics of BRAF mutated MSS CRC and impact of inflammatory markers on survival outcomes.

e15595 Background: Approximately 8% of patients with MSS metastatic colorectal cancer (mCRC) have BRAF mutation, which is typically associated with worse prognosis. In this study, we investigated clinical and molecular features of BRAF mutated mCRC including systemic inflammatory markers and examined their impact on prognosis. Methods: A total of 70 patients (pts) with BRAF mutated microsatellite stable colon cancer were identified from 2014-2022 using our institutional molecular database. Patients with no evidence of distant metastatic disease were excluded, with 53 patients finally analysed. Neutrophil lymphocyte ratio (NLR) and platelet lymphocyte ratio (PLR) at diagnosis were calculated as simple ratios of neutrophils to lymphocytes and platelets to lymphocytes, respectively, as inflammatory biomarkers. Time to next treatment was defined as the time between initiation of first line and second line treatments. Kaplan Meier analysis and cox proportional hazard models were used to analyze survival data. Results: Nearly half of the pts (45%) were diagnosed with de novo metastatic disease. Around 70% of the pts had class I BRAF (V600E) mutation. Pts were predominantly treated with FOLFOX, and only 3 pts received FOLFIRINOX/FOLFOXIRI in the first line setting for metastatic colon cancer. Only 12/29 (41%) patients with BRAF V600E mutation received BRAF targeting agents. Notably, 44% underwent metastasis-directed local treatments, including CRS+ HIPEC, metastatectomy, and liver ablation. PS at diagnosis showed significant association with overall survival (p=0.001), however, due to small sample size with PS 2 and 3, the reliability of this finding is limited. Interestingly, NLR was associated with shorter time from first to second line treatment (p = 0.012). This association remained significant in multivariate analyses (p=0.024). This relation was not seen for OS outcomes. Conclusions: In this single-center retrospective analysis, we noted that patients with BRAF V600E more likely to present with de novo metastatic disease and less than half the pts with BRAF V600E mutation received BRAF targeting agent supporting the use of these agents in the first line based on recent data from the BREAKWATER trial Additionally, NLR at diagnosis is an important prognostic marker associated with a shorter time to next treatment, indicative of poor response to first-line therapy. Baseline characteristics. Characteristic N = 53 1 Median age at initial dx 67.00 (41.00 - 91.00) Gender Female 30 (57%) Male 23 (43%) Ethnicity African American 2 (3.8%) White 51 (96%) Initial Stage Group I 2 (3.8%) II 11 (21%) III 16 (30%) IV 24 (45%) Right vs left Unknown 1 (1.9%) Left 10 (19%) Right 42 (79%) Liver mets N 19 (36%) Y 24 (45%) Unknown 10 (19%) Number of sites of met 1 20 (38%) 2 17 (32%) 3 5 (9.4%) 4 1 (1.9%) Unknown 10 (19%) PS at diagnosis 0 37 (70%) 1 12 (23%) 2 3 (5.7%) 3 1 (1.9%) TMB (Muts/Mb) 7.86 (0.00 - 73.64)

Clinical features associated with an exceptional response to immunotherapy in patients with metastatic non-small cell lung cancer (NSCLC).

8544 Background: Immunotherapy with PD1 axis inhibitors is approved for metastatic non-small cell lung cancer (NSCLC). Outside of tumor PD-L1 expression, which predicts immunotherapy sensitivity in metastatic NSCLC, no clinicopathologic characteristics have been identified that reliably predict long-term survival after immunotherapy. To identify clinicopathologic predictors of exceptional response, we compared patients with dissimilar outcomes after immunotherapy. Methods: Patients with advanced NSCLC treated at Yale Cancer Center with immunotherapy between 2010–2020 were enrolled on an IRB-approved protocol allowing chart review of clinicopathologic data and further archival tumor tissue analysis. Data collection cutoff was January 14, 2025. We defined three subsets of patients who received immunotherapy without concurrent chemotherapy: Exceptional responders (ER) (continued response without progression ≥3 years after first dose), non-exceptional responders (NER) (initial response followed by progression within 3 years), and primary progressors (PP) (best response of progressive disease). Results: 50 ER, 45 NER, and 62 PP were identified. At a median follow-up of 7.2 years, 25, 9, and 6 ER had continued response at 5, 7, and 10 years. ER had a lower frequency of baseline lung, bone, and liver metastases, prior chemotherapy (p=0.005), or lymph node/thoracic radiation (p=0.016) than NER and PP. ER had higher pre-treatment absolute lymphocyte count (ALC) and lymphocyte-to-albumin ratio (LAR), with lower platelet-to-lymphocyte ratio (PLR) and monocyte-to-lymphocyte ratio (MLR). Of 24 evaluable ER patients, 19 had tumor PD-L1 TPS score ≥50%, compared to 13/21 evaluate NER and 14/34 valuable PP. 47/50 ER were nonsquamous, compared to 36/45 NER and 53/62 PP. Compared to NER only, ER were less likely to have bone metastases (p=0.049) or prior lymph node/thoracic radiation (8% vs 24%, p=0.028). Variables associated with primary progression were female sex (OR = 3.73, 95% CI 1.55–8.9), lung metastases (OR 6.46, 95% CI 2.73–15.27), and low albumin (OR 0.29, 95% CI 0.12–0.72). The presence of brain metastases was not different between cohorts. Conclusions: Patients with metastatic NSCLC exhibiting exceptionally durable responses to immunotherapy demonstrate distinct baseline features, with higher pre-treatment ALC and LAR, lower PLR and MLR, and lower prevalence of lung, bone, or liver metastases. They were less likely to have had thoracic/lymph node radiation, suggesting lymph node radiation may influence immunotherapy response. Ongoing molecular studies of biospecimens from these patients include genomic/transcriptomic analysis, HLA typing, and tumor microenvironment analysis of archived tissue to further characterize drivers of differential immunotherapy response.

Evaluating inflammatory biomarkers as predictors of outcomes and immune-related adverse events (irAE) in the Big Ten Cancer Research Consortium (BTCRC) LUN16-081 phase II clinical trial.

e20087 Background: Immune checkpoint inhibition has improved patient outcomes across nearly every stage of NSCLC, and consolidation immunotherapy has become the standard of care following CCRT for unresectable stage III disease. However, these drugs can have significant adverse events, and improved biomarkers to improve patient selection are desperately needed. Numerous prior studies have evaluated the role of inflammatory biomarkers to predict outcomes in metastatic disease, but few have looked at their use in unresectable stage III NSCLC treated with immunotherapy. Methods: The BTCRC LUN 16-081 trial was a prospective, open-label phase II trial randomizing patients to either nivolumab or nivo/ipilimumab following CCRT for unresectable stage III NSCLC. From October 2017 to April 2021, 105 patients were enrolled and treated, and inflammatory biomarkers including neutrophil-lymphocyte ratio (NLR, <2.5 vs. ≥2.5), platelet-lymphocyte ratio (PLR, <200 vs. ≥200), von Willebrand Factor (vWF, <150% vs. ≥150%), erythrocyte sedimentation rate (ESR, <20 vs. ≥20), C-reactive protein (CRP, <median vs. >median), and ferritin (<median vs. >median) were collected at screening and each treatment timepoint. An analysis of samples from screening, C1D1, and C2D1 was performed and correlated with rates of irAEs as well as PFS and OS. An analysis comparing differences in inflammatory biomarkers between genders, histologies, and by PD-L1 status was also performed. Results: None of the biomarkers demonstrated an ability to predict for or against the development of irAEs at any of the timepoints. When evaluating changes from C1 to C2, there was a trend toward increased irAEs for increasing NLR (p=0.162) and CRP (p=0.168) but these were not statistically significant. In looking at PFS/OS across biomarkers, only vWF and CRP correlated with prognosis. Elevated vWF at C1 (median 24.8 months vs. NE, p=0.0194) and C2 (median 24.8 months vs. NE, p=0.0127) correlated with reduced PFS, and OS was numerically lower in this group though not statistically significant. At C2D1, high CRP correlated with reduced PFS (median 22.8 vs. 30.9 months, p=0.0427) and OS (median NE vs. NE, p= 0.0192). When comparing between groups, females demonstrated increased inflammation with higher median PLR, rates of elevated PLR, median ESR, and rates of elevated ESR at screening. At C1D1 and C2D1, only higher median ESR remained significant. By histology, median ferritin was higher in non-SqCC vs. SqCC patients at screening but not different at other timepoints. Median CRP and rate of elevated CRP were higher in SqCC patients at C2D1 but not other timepoints. None of the biomarkers correlated with PD-L1 score (pos vs neg) at any timepoints. Conclusions: Inflammatory biomarkers did not correlate with the incidence of irAEs. Most biomarkers did not appear predictive of PFS/OS. High vWF at C1 and C2 correlated with reduced PFS, and high CRP at C2 correlated with reduced PFS and OS. Novel biomarkers are needed to help personalize care in unresectable stage III NSCLC. Clinical trial information: NCT03285321 .

Inflammation-related biomarkers as predictors of pathological complete response in early-stage breast cancer.

Neoadjuvant systemic therapy (NAT) represents an attractive option for improved outcomes of early-stage breast cancer (BC) patients, as it can significantly reduce tumor burden thus permitting breast-conserving resections. Equally important, the eradication of viable cancer cells post-NAT, also known as pathological complete response (pCR), has emerged as a strong prognostic biomarker, reflecting tumor's biology and subsequent treatment responses. Yet to date, no validated markers predictive of pCR have been identified. The present retrospective study aimed to explore the value of neutrophil-tolymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) as potential predictors of pCR. Despite no statistically significant associations have been reported, NLR and PLR dynamics during NAT, as longitudinal inflammatory phenotypes, merit further investigation in larger cohorts. In the future, the integration of a comprehensive inflammatory biomarker panel into clinical practice could assist in a priori treatment selection process.

Significance of Inflammation Markers to Predict Curative Treatment for Prostate Cancer Patients on Active Surveillance

ABSTRACTPurposeActive surveillance (AS) strategy aims to avoid unnecessary or excessive early treatment in patients at a low risk for prostate cancer (PCa). However, a biomarker that can predict the need for early curative treatment in patients under AS has not been identified to date. In this study, we aimed to investigate the potential of inflammatory biomarkers in predicting the requirement of curative treatment in the early period in patients under AS.Materials and MethodsThis study included a total of 83 patients with the diagnosis of PCa and under AS. Patient age, prostate‐specific antigen (PSA) level, prostate volume (PV), PSA density (PSAD), neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), systemic immune‐inflammation index (SII) and follow‐up period were compared between the groups.ResultsThere was a significant difference between the two groups in terms of PSAD, NLR, PLR and SII (p = 0.037, p = 0.046, p = 0.008, p = 0.004 and p = 0.005, respectively). The cut‐off value determined by performing ROC analysis to evaluate the levels that predict the need for curative treatment before AS was 0.125 for PSAD (sensitivity: 61.8%, specificity: 61.2%), 2.01 for NLR (sensitivity: 67.6%, specificity: 55.1%), 115.49 for PLR (sensitivity: 73.5%, specificity: 59.2%) and 465.40 for SII (sensitivity: 70.6%, specificity: 59.2%).ConclusionsThe analysis of PSAD, NLR, PLR and SII before making the decision to conduct AS can guide clinicians regarding curative treatment in the early period.

The Role of Duration of Untreated Illness (DUI) on the Course and Biochemical Parameters of Female Patients Affected by Anorexia Nervosa

ABSTRACTObjectiveAnorexia nervosa (AN) presents the highest rate of mortality among psychiatric disorders, making an early diagnosis and proper management essential. The purpose of the study was to investigate the role of duration of untreated illness (DUI) on the course and biochemical parameters in a sample of 76 female patients with AN.MethodCorrelation analyses and one‐way analyses of variance were performed to analyze the relation between DUI and quantitative and qualitative variables, respectively. Statistically significant factors from correlation analyses were inserted in a linear regression model as independent variables with the DUI as the dependent variable.ResultsA longer DUI was directly correlated with age (r = 0.35, p < 0.01), duration of illness (r = 0.61, p < 0.01), potassium (K) plasma levels (r = 0.47, p = 0.02), and platelet/lymphocyte ratio (PLR) (r = 0.25, p = 0.04). A longer DUI was inversely correlated with the sodium/potassium ratio (Na/K) (r = −0.42, p = 0.047). Linear regression analysis confirmed the direct association between a longer DUI with age (B = 0.12, p = 0.01) and K levels (B = 3.18, p = 0.017).DiscussionThe higher K plasma levels in patients with longer DUI may indicate an abuse of supplements and/or an alteration of the hypothalamus–pituitary–axis (HPA) or renin–angiotensin systems. In support of this hypothesis, alterations in PLR were identified in subjects with abnormal bone mineral density. Further research is needed to confirm the present findings.

Prognostic value of nine inflammatory biomarkers for critically ill patients with rheumatic heart disease: a retrospective study

BackgroundAmong various inflammatory biomarkers, the prognostic value in critically ill patients with rheumatic heart disease (RHD) remains unclear. This study aimed to compare the prognostic value of different inflammatory biomarkers in patients with RHD.MethodsThis study identified critically ill patients admitted to the intensive care unit from the Medical Information Mart for Intensive Care IV database (MIMIC-IV). Nine systemic inflammatory biomarkers, derived from various combinations of neutrophils, lymphocytes, monocytes, and platelets, were evaluated for their association with 30-day all-cause mortality. Receiver operating characteristic curve analysis was performed to identify the most predictive biomarker. Furthermore, Cox proportional hazards regression and restricted cubic spline analysis were employed to evaluate the association between the optimal biomarker and survival outcomes.ResultsA total of 1002 patients with RHD were included. Eight inflammatory biomarkers were predictive for 30-day all-cause mortality and the platelet-to-lymphocyte ratio (PLR) demonstrated the highest area under the curve value of 0.794 among these biomarkers. Then patients were divided into tertiles based on PLR. Multivariate Cox proportional hazards analysis demonstrated that an elevated PLR was significantly associated with increased 30-day all-cause mortality. After adjustment for potential confounders, elevated PLR remained an independent predictor of mortality (adjusted hazard ratio: 2.53; 95% confidence interval: 1.87–3.42; p < 0.001). Furthermore, restricted cubic spline analysis revealed a progressively increasing risk of all-cause mortality with higher PLR levels.ConclusionThese findings indicate that the PLR may be a useful indicator for evaluating the severity and guiding the treatment of RDH patients.

Association between the immune-inflammation index and the severity and clinical outcomes of patients with inflammatory bowel disease: a systematic review and meta-analysis

BackgroundExisting studies have explored the association between immune-inflammatory indices and inflammatory bowel disease (IBD), but there is a lack of comprehensive evidence. This meta-analysis and systematic review seeks to synthesize the data of available clinical research and offer the latest and comprehensive evidence-based conclusions regarding whether these immune-inflammatory indices can effectively predict the severity, activity, and prognosis of IBD.MethodsSeven databases were comprehensively retrieved from their establishment to March 23, 2025. The combined results were described through standardized mean differences (SMD) or odds ratios (OR) with 95% confidence intervals (CI). Review Manager 5.4 and STATA 15.0 were leveraged for data analysis.ResultsOur analysis included 35 studies involving 5,870 patients. The aggregated data revealed that the neutrophil-to-lymphocyte ratio (NLR) (OR = 1.18, 95% CI:1.04 to 1.34; P = 0.001) (SMD = 1.01, 95%CI = 0.73 to 1.29, P < 0.001), platelet-to-lymphocyte ratio (PLR) (SMD = 0.60, 95%CI = 0.46 to 0.74, P < 0.001), neutrophil-to-platelet ratio (NPR) (OR = 1.20, 95% CI:1.08 to 1.32, P < 0.001), and C-reactive protein to albumin ratio (CRP/ALB) (OR = 1.50, 95% CI:1.38 to 1.65, P < 0.001) were potentially linked to disease activity in IBD patients. PLR (SMD = 1.08, 95%CI = 0.60 to 1.55, P < 0.001) showed potential associations with disease severity in IBD patients. Additionally, NLR (SMD = 0.43, 95%CI = 0.15 to 0.70, P = 0.002) and eosinophil-to-lymphocyte ratio (ELR) (SMD = 0.63, 95%CI = 0.26 to 1.00, P < 0.001) had potential associations with endoscopic response in IBD patients. Moreover, NLR was potentially associated with disease relapse(OR = 1.35, 95% CI:1.09 to 1.68; P = 0.006) and steroid responsiveness (SMD = 0.50, 95%CI = 0.15 to 0.85, P = 0.005).ConclusionNLR, PLR, NPR, and CRP/ALB are potential predictors of disease activity in IBD patients. PLR shows the potential to predict disease severity, while NLR and ELR are potential indicators of endoscopic response. Furthermore, NLR is also a potential predictor of relapse and steroid responsiveness. Currently, there is insufficient evidence to support an association between NLR and the severity of IBD, whereas lymphocyte-to-monocyte ratio (LMR) appears to be associated with both the severity and activity of IBD and PLR and eosinophil*neutrophil-to-lymphocytes ratio (ENLR) are associated with endoscopic response in IBD.PROSPERO registrationCRD 42024609659.

Identifying Key Hematological and Biochemical Indicators of Disease Severity in COVID-19 and Non-COVID-19 Patients

Background: This study investigated hematological and biochemical parameters, including cell population data (CPD), to evaluate their association with severity in COVID-19 and non-COVID-19 patients. Identifying these parameters could aid in disease monitoring and clinical decision-making. Methods: A retrospective analysis of 8401 patients, including 603 COVID-19 cases and 7546 non-COVID-19 cases, were conducted. Complete blood count (CBC) and routine chemistry results obtained near the time of real-time polymerase chain reaction testing were analyzed to assess their associations with disease severity. A matched cohort analysis was performed to adjust for potential confounding factors, such as age and sex. Results: COVID-19 patients with elevated neutrophil side fluorescence light (NE-SFL), platelet-to-lymphocyte ratio (PLR), glucose, and aspartate aminotransferase (AST), along with decreased plateletcrit, were more likely to experience severe outcomes, such as hospitalization or death. In addition, decreased hemoglobin, lymphocyte side scatter (LY-SSC), and albumin, as well as increased leukocyte and monocyte side scatter (MO-SSC), were associated with a greater severity, regardless of COVID-19 status. Conclusions: We identified hematologic and chemical assay biomarkers that correlate with severe COVID-19. These findings may provide important information regarding the disease progression and clinical management. Incorporating these biomarkers into clinical decision support systems could facilitate personalized treatment strategies, optimize resource allocation, and enable real-time severity stratification.

Predictive Role of Complete Blood Count-Derived Inflammation Indices and Optical Coherence Tomography Biomarkers for Early Response to Intravitreal Anti-VEGF in Diabetic Macular Edema

Background: Diabetic macular edema (DME) is the leading cause of vision impairment in diabetic patients, with intravitreal anti-vascular endothelial growth factor (anti-VEGF) injections being the first-line therapy. However, one-third of patients exhibit persistent DME despite treatment, suggesting additional pathogenic factors. This study aimed to evaluate the predictive value of complete blood count (CBC)-based inflammation indexes and optical coherence tomography (OCT) parameters in determining early anti-VEGF treatment effectiveness in DME. Methods: One hundred and four naïve patients with DME, treated with 0.05 mL of intravitreal aflibercept were retrospectively analyzed. Blood parameters analyzed included neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), platelet-to-lymphocyte ratio (PLR), and systemic immune-inflammation index (SII). Baseline OCT biomarkers included subretinal fluid (SRF), intraretinal cysts (IRC), hyperreflective retinal spots (HRS), and disorganization of retinal inner layers (DRIL). Treatment response was defined as a minimum 10% reduction in central macular thickness (CMT) at one month post-injection. Results: NLR, MLR, PLR, and SII were significantly higher in non-responders (p &lt; 0.001), but their predictive value was fair, with an area under the ROC curve ranging between 0.704 (MLR) and 0.788 (SII). A multivariate model including SII, initial CMT, and the presence of IRC showed an excellent prediction value for early anatomical response (AUC ROC of 0.911). At the same time, lower PLR, DRIL, SRF, and the absence of HRF were correlated with early gain in BCVA. Conclusions: CBC-derived inflammation indices and OCT biomarkers have prognostic value in predicting early response to anti-VEGF therapy in DME in terms of functional and anatomical outcomes. These findings could help identify poor responders and guide personalized treatment strategies.

The clinical value of lymphocyte percentages and the monocyte-to-lymphocyte ratio in differentiating immune-mediated necrotizing myopathy from dermatomyositis

ObjectiveImmune-mediated necrotizing myopathy (IMNM) and dermatomyositis (DM) represent distinct subtypes of idiopathic inflammatory myopathies (IIMs). While both conditions share clinical manifestations, including muscle weakness and inflammatory infiltrates on muscle biopsy, their pathophysiological characteristics differ significantly. This study investigated the clinical utility of hematological inflammatory biomarkers in differentiating these two entities.MethodsIn this retrospective analysis, we compared complete blood count parameters among 27 patients with IMNM, 14 patients with DM, and 85 healthy controls (HC). Demographic characteristics, clinical presentations, and hematological indices including the neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), and platelet-to-lymphocyte ratio (PLR) were analyzed.ResultsMyalgia and skin rash were observed more frequently in the DM group compared to the IMNM group. The patients with IMNM exhibited significantly higher serum creatine kinase (CK) and lactate d0.2815ehydrogenase levels. Red blood cell distribution width (RDW), monocyte counts, and MLR were elevated in the patients with IMNM compared to the HC. The patients with DM showed significantly increased neutrophil percentages, monocyte percentages, monocyte counts, NLR, MLR, and PLR, as well as decreased lymphocyte percentages and counts, compared to the HC. When directly comparing DM and IMNM, the patients with DM had lower lymphocyte percentages and counts, along with higher NLR and MLR. Receiver operating characteristic (ROC) curve analysis revealed that lymphocyte percentages and the MLR had moderate predictive value for differentiating IMNM from DM, with area under the curve (AUC) values of 0.709 and 0.7487, respectively.ConclusionRDW and the MLR in IMNM and the NLR, MLR, and PLR in DM represent accessible and cost-effective biomarkers for assessing inflammation. Lymphocyte percentages and the MLR may serve as inexpensive and readily available supplementary markers for distinguishing IMNM from DM.

Complete blood count parameters as potential predictive factors of brain metastases in lung cancer

IntroductionBrain metastases are common and devastating complication of the lung cancer (LC) but predictive biomarkers for their risk are still lacking.ObjectivesTo analyze the relationships between complete blood count (CBC)-based and selected biochemical indices and occurrence of brain metastases in patients diagnosed with LC.Patients and methodsThe study was based on retrospective analysis of medical records of 217 patients diagnosed with LC and undergoing follow-up in one specialist center. Clinical and laboratory data on admission were determined, including: neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), neutrophil-to-platelet ratio (NPR) and red cell distribution width-to-platelet ratio (RPR) and selected biochemical parameters. Relationships were evaluated between these parameters and occurrence of brain metastases, other distant metastases and death within 12 months of follow-up.Results168 patients had the follow-up data for 6 months, and 128 - for 12 months. Brain metastases were detected in 41 patients and 1-year mortality rate was 17.61%. Patients who developed brain metastases during 12 months had significantly higher baseline NLR (4.66 vs 2.75, p&amp;lt;0.001), PLR (170.83 vs 142.42, p=0.03) and lower LMR (1.61 vs 2.33, p=0.008).In univariate analysis, higher leukocyte count (HR 1.08, p=0.016), neutrophil count (HR 1.11, p=0.0036), NLR (HR 1.09, p=0.005), d-dimer levels (HR 1.0002, p=0.0043), and lower LMR (HR 0.67, p=0.018) were significantly associated with the risk of developing brain metastases. Liver metastases were associated with lower LMR (1.69 vs 2.29, p=0.04), while metastases to the other lung – with lower PLR (126.52 vs 161.8, p=0.02) and higher LMR (2.51 vs 1.96, p=0.02) and RPR (0.184 vs 0.154, p=0.03). No significant relationships were found between CBC-based indices and mortality.ConclusionsCBC-based indices could be useful and easily accessible predictive markers of brain metastases in the patients with lung cancer.

Evaluation of hematological profiles in pediatrics: a focus on blood cell indices and electrolyte changes in febrile seizure

Background: Febrile seizures (FS) are the most common neurological disorder in children, often associated with systemic and hematological changes. Laboratory investigations play a crucial role in identifying potential biomarkers that may aid in risk evaluation and management. This study aims to evaluate various laboratory parameters, including platelet-to-lymphocyte ratio (PLR), neutrophil-to-lymphocyte ratio (NLR), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), Hemoglobin (Hgb), serum sodium, platelet count (PLT), and white blood cell count (WBC), to assess their role as predictive markers in febrile seizures. Methods: A prospective observational study was conducted on pediatric patients diagnosed with febrile seizures. Blood samples were analyzed for hematological and biochemical markers. The collected data were statistically analyzed to determine significant associations between these parameters and febrile seizures. Results: The study findings highlight variations in hematological and biochemical markers among febrile seizure patients. Altered PLR and NLR levels were observed, indicating a possible inflammatory response. MCV, MCH, and Hgb levels were assessed for potential anemia-related influences, while serum sodium levels were evaluated for their role in seizure pathophysiology. Conclusion: The study provides insights into the laboratory profile of febrile seizure patients, which may help in early identification, risk assessment, and management. Further large-scale studies are required to validate these findings and establish potential predictive markers.