Platelet-to-lymphocyte Ratio Research Articles

Clinical Efficacy of Taxol Plus Platinum (TP) Chemotherapy Combined with Delayed Administration of PD-1 Inhibitors in Patients with Locally Advanced, Recurrent or Metastatic Esophageal Squamous Cell Carcinoma: A Retrospective Study.

Immune checkpoint inhibitors (ICIs) combined with chemotherapy have become the first-line standard treatment for locally advanced or metastatic esophageal squamous cell carcinoma (ESCC). The evidence also demonstrates improved synergistic effects of chemotherapy when combined with delayed administration of ICIs. In this study, we conducted a retrospective investigation into the treatment efficacy of taxol plus platinum (TP) chemotherapy combined with delayed administration of PD-1 inhibitors for ESCC patients. Clinical data of ESCC patients who received PD-1 inhibitors 3-5 days after TP chemotherapy as first-line treatment was retrospectively reviewed between January 2019 and April 2023. Clinical outcomes and treatment safety were analyzed. The potential roles of neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), and pan-immune-inflammation value (PIV) were investigated. A total of 34 locally advanced, recurrent or metastatic ESCC patients received PD-1 inhibitors 3-5 days following TP chemotherapy were included. The objective response rate (ORR) and disease control rate (DCR) were 85.3% and 97.1% respectively. The median progression-free survival (PFS) and overall survival (OS) were 13.2 and 19.1 month respectively. Seven patients received radical surgery, 1 patient achieved pathologic complete response (pCR) and 3 patients achieved major pathologic response (MPR). Among the 27 patients without surgery, the median PFS and OS were 9.7 and 19.1 month respectively. A more favorable prognosis was correlated with NLR less than 3 at the 3rd and 4th cycle of immunochemotherapy. No significant correlations between other parameters (PLR, MLR and PIV) and prognosis were observed. A total of 22 patients developed grade 3-4 toxicity events. The optimized sequence of PD-1 inhibitors administered 3-5 days after TP chemotherapy as the first-line treatment of ESCC demonstrated favorable treatment efficacy. Pretreatment NLR of less than 3 at the 3rd and 4th cycle of immunochemotherapy is associated with a better prognosis.

The Efficacy of C-Reactive Protein (CRP) to Albumin Ratio (CAR) and Fibrinogen to CRP Ratio (FCR) in Predicting the Latent Period of Preterm Labor.

To investigate the role of inflammatory markers, including neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), and monocyte to lymphocyte ratio (MLR), c-reactive protein (CRP) to albumin ratio (CAR), fibrinogen to albumin ratio (FAR), and fibrinogen to CRP ratio (FCR) in predicting the latency period (≤72vs.>72 hours) before preterm birth. In a retrospective study, we assessed 135 patients meeting the specified criteria with signs of preterm labor (<34 weeks). The patients were categorized into two groups: 71 patients giving birth within 72 h (latency ≤ 72 h) and 64 patients giving birth after 72 h (latency> 72 h). We examined the demographic and medical characteristics and perinatal outcomes of all participants. Categorical variables between groups were compared using the Chi-square test. The Student's t-test was utilized for normally distributed continuous variables, and the Mann-Whitney U test was applied for non-normally distributed data. Receiver operating characteristic (ROC) curve analysis was conducted to identify the optimal cut-off levels for inflammatory markers in predicting the latency period before birth. Among the parameters examined, significant differences were observed between the groups only in terms of CAR and FCR. While CAR showed a significantly higher value in the group with latency period ≤72 h (0.537±1.239vs. 0.247±0.325, p=0.022), FCR showed a significantly lower value in the group with latency period ≤72 h (63.58 (2.99-1165) vs. 88.93 (9.35-1165), p=0.013). The identified cut-off value for CAR was 0.190, providing a sensitivity of 57.7% and a specificity of 56.3% (p=0.022). The cut-off value for FCR was 71.67, with a sensitivity of 42.3% and a specificity of 42.2% (p=0.013). The CAR and the FCR, serving as predictive markers for preterm labor, may offer a simple, cost-effective, and easily accessible approach, particularly in resource-limited settings.

Hematological Parameters in Patients with Pulmonary Tuberculosis and its Presentation among Favorable and Unfavorable Treatment Outcomes.

Tuberculosis (TB) management continues to be a challenge globally; weakened immunity plays a significant role in the reactivation of TB. There is limited information on hematological parameters in patients with pulmonary TB and its association with outcome. We present hematological parameters of newly diagnosed sputum-positive pulmonary TB patients enrolled in a randomized, clinical trial that assessed the efficacy and safety of 3 and 4 regimens using moxifloxacin. Blood hematological parameters at baseline, comparison of the baseline and end of treatment values, including the monocytes by lymphocytes ratio (M/L), neutrophil lymphocyte ratio (N/L), and platelet lymphocyte ratio (P/L) between the patients with favorable and unfavorable TB treatment outcome, and among different age group and sex presented in this paper. Among the total 1059 patients, 782 were males, the mean hemoglobin (HB) ± standard deviation (SD) was 11.5 g/dL ± 2.0, the mean white blood cell (WBC) count ± SD was 9800 ± 3009 and the mean platelet count (in lakhs) ± SD was 4.24 ± 1.42 cells/uL. There was an increase from baseline in the mean hemoglobin, eosinophil, and lymphocyte count and a decrease in mean neutrophil, monocyte counts to the end of treatment. There was a decrease in baseline mean total WBC count posttreatment, both in favorable (10,271 cells/uL ± 3007 SD to 6689 cells/uL ± 1837 SD, [P ≤ 0.001]), and unfavorable TB outcome patients. An increase in HB, and a decrease in WBC count, M/L, N/L, and P/L ratio is possible at the end of TB treatment and future studies to correlate blood hematology parameters with TB treatment outcome.

The Study of Associated Factors for Non-Tuberculous Mycobacterial Pulmonary Disease Compared to Pulmonary Tuberculosis: A Propensity Score Matching Analysis.

Investigate the differences in clinical manifestations, imaging features, and associated inflammatory markers between Nontuberculous Mycobacterial Pulmonary Disease (NTM-PD) and Pulmonary Tuberculosis (PTB), identify potential risk factors for NTM-PD, and establish a logistic regression model to evaluate its diagnostic value. Baseline data were collected from 145 patients with NTM-PD and 206 patients with PTB. Propensity score matching (PSM) was utilized to achieve a 1:1 match between the two groups, resulting in 103 matched pairs. The differences in comorbidities, imaging features, and inflammatory markers were compared between the two groups. Multivariate binary logistic regression analysis was conducted to identify independent influencing factors, and the diagnostic value of the established model was evaluated. After matching, significant differences were observed between the NTM-PD group and the PTB group in terms of diabetes, bronchiectasis, chronic obstructive pulmonary disease(COPD), cystic and columnar changes, lung cavity presentation, and monocyte percentage (MONO%), lymphocyte count (LYMPH#), platelet-to-lymphocyte ratio (PLR), and lymphocyte-to-monocyte ratio (LMR) (P<0.05). Logistic regression analysis confirmed that diabetes, bronchiectasis, COPD, and lung cavities were risk factors for NTM-PD. The established regression analysis model was analyzed by the Receiver Operating Characteristic (ROC) curve, the Area Under the Curve (AUC) was obtained as 0.795 (P<0.001, 95% CI 0.734-0.857). At a Youden index of 0.505, the sensitivity was 84.5% and the specificity was 66.6%. The Hosmer-Lemeshow test was used to evaluate the model's calibration, with a chi-square value of 11.023 and P=0.200>0.05, indicating no significant difference between predicted and observed values. For patients without diabetes but with bronchiectasis, COPD, and imaging characteristics of lung cavities, a high level of vigilance and active differential diagnosis for NTM-PD should be exercised. Given that the clinical manifestations of NTM-PD are similar to those of PTB, a detailed differential diagnosis is necessary during the diagnostic process to avoid misdiagnosis.

Associations of three differential white blood cell counts, platelet counts, and their derived inflammatory indices with cancer-related fatigue in patients with breast cancer undergoing chemotherapy.

Inflammation is thought to be a vital element in the etiology of cancer-related fatigue (CRF), and circulating blood cell parameters could be important markers of inflammatory response. However, the associations of several major blood cell counts and their derived inflammatory indices with CRF are not well described. The present study aimed to establish whether a relationship exists between the counts of three white blood cell (WBC) types, platelets, and CRF and investigate whether several systemic inflammatory indices were associated with CRF in patients with breast cancer (BC). A cross-sectional survey was conducted with a sample of 824 patients with BC undergoing chemotherapy. The cancer fatigue scale was administered to assess CRF. Hematological indicators, including neutrophils, lymphocytes, monocytes, and platelets, were retrieved from routine blood test. Network analyses were used to examine the associations among them. Among 824 participants, the mean score of CRF was (27 ± 10), ranging from 0 to 57. The results of network models indicated that physical fatigue was negatively linked to lymphocyte counts (weight = - 0.161), and affective fatigue was positively associated with neutrophil counts (weight = 0.070). Additionally, physical fatigue was positively linked to the platelet-to-lymphocyte ratio (PLR) (weight = 0.049). There were preliminary associations of counts of three WBC types, platelet counts, and systemic inflammatory indices, with distinct dimensions of CRF in patients with BC. Findings provide empirical support for the cellular basis of fatigue-associated inflammatory states.

Comparative Immune Profiles: Platelet-to-Lymphocyte and Neutrophil-to-Lymphocyte Ratios in Preeclampsia versus Healthy Women

Background &amp; Objective: Pre-eclampsia is a hypertensive disorder linked with immune dysregulation and systemic inflammation in pregnancy. An elevated neutrophil count alongside a relatively stable lymphocyte count leads to an increased Neutrophil-to-Lymphocytic Ratio (NLR), serving as a parameter of widespread systemic inflammation. Platelet to lymphocyte ratio (PLR) is a also used as a hematological marker that reflects the balance between platelets and lymphocytes. A higher NLR and PLR may reflect increased endothelial activation and damage, contributing to the pathogenesis of preeclampsia. The objective of the present study was to compare the Neutrophil to lymphocytic ratio (NLR as well as platelet-to-lymphocytic ratio (PLR) between women affected by preeclampsia (PE) and those with uncomplicated pregnancies. Methods: It was a cross-sectional comparative study. Fifty-five registered preeclamptic patients were enrolled as cases along with fifty-five healthy pregnant women. Total leukocyte counts, including neutrophils and lymphocytes as well as platelet count, were calculated using an automated hematology analyzer, and the Neutrophil-to-Lymphocyte Ratio (NLR) as well as Platelet to Lymphocyte ratio were subsequently calculated. Results: Higher value of TLC and neutrophils were recorded in pre-eclampsia. The normotensive women had higher platelet as well as lymphocyte count. NLR was significantly high in the preeclampsia contrary to PLR ratio that showed a higher value in normotensive pregnancies. Conclusions: In conclusion, our study highlights significant alterations in the immune-inflammatory profile of patients with preeclampsia compared to controls. The observed high neutrophil-to-lymphocyte ratio (NLR) and low platelet-to-lymphocyte ratio (PLR) suggest a distinct systemic inflammatory response associated with preeclampsia.

The association between systemic immune inflammation index and disease activity in patients with rheumatoid arthritis

Background. Novel blood-derived indices are a potential substitute for traditional inflammatory markers which have disputable correlations and clinical applications in different immunological diseases. Hereby, we aimed to reveal the association of neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and systemic immune-inflammation index (SII) with disease activity score (DAS28) and clinically active disease according to simple disease activity index (SDAI). Methods. We included 250 patients and they were grouped equally based on SDAI into two groups of patients in remission and with active disease. A blood sample was drawn from our patients to measure NLR, PLR, SII, rheumatoid factor, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP). Independent samples t-tests, chi-square, and Mann-Whitney U test were used accordingly. Logistic regression evaluated the factors that affect active RA. Results. PLR, DAS28, rheumatoid factor, quantitative and qualitative ESR and CRP had a significant difference between patients with active RA and in remission. SII had significant correlation with DAS28 but PLR and NLR were not correlated with DAS28. Also, PLR was the only index to be correlated with clinically active disease based on SDAI. The logistic regression showed that NLR, SII, ESR, and CRP were independent factors predicting active RA. Conclusion. We demonstrated that SII was significantly correlated with DAS28 and PLR was correlated with active RA. NLR, SII, CRP, and ESR were independent risk factors for RA flare-ups.

Age and Peripheral Blood Values Relationship Evaluation of Trichomonas Vaginalis, Candida, and Gardnerella Vaginalis Frequency in Cervicovaginal Pap Smear Screening in Aksaray Province

This study aimed to explore the correlation between causative agents of vaginitis detected in Pap smear screenings and various hematological indices, alongside the severity of infections observed in Pap smears. We analyzed 348 Pap smear results, which were categorized into normal and abnormal findings and further subdivided into groups based on the presence of Vulvovaginal Candidiasis (VVC), Bacterial Vaginosis (BV), and Trichomoniasis (TV). The degree of inflammation (mild, moderate, severe) was assessed in relation to hematological indices (Platelet Index Value (PIV), Systemic Immune-Inflammation Index (SII), Systemic Inflammatory Response Index (SIRI), Neutrophil to Lymphocyte Ratio (NLR), Platelet to Lymphocyte Ratio (PLR), and Lymphocyte to Monocyte Ratio (LMR)), guided by the 2014 Bethesda System for evaluation. Out of 1654 patients screened, 348 met the inclusion criteria (253 aged below 45 years; 95 aged 45 years and above). In the under-45 age group, 83.3% had normal findings, with prevalence rates for VVC, BV, and TV at 73.4%, 60.2%, and 80.0%, respectively. In the over-45 group, these figures were 16.7% (normal), 26.6% (VVC), 39.8% (BV), and 20% (TV). The prevalence of moderate vaginitis in Pap smears was 45.3% for VVC, 96.1% for mild BV, and 53.3% for moderate TV. In cases of Atypical Squamous Cells of Undetermined Significance (ASCUS), BV was predominant, while VVC and TV were absent in Low-Grade Squamous Intraepithelial Lesion (LSIL) and High-Grade Squamous Intraepithelial Lesion (HSIL) cases. BV was present in 7.8% of normal smears. Significant associations were observed between hematological parameters and the severity of inflammation in the normal smear category (p&amp;lt;0.001). In squamous cell anomaly cases, especially ASCUS, differences in SII, NLR, PLR, SIRI, and PIV were noted between severe and mild infections, as well as between moderate and severe infection groups. This research underscores the linkage between the severity of infection and cellular abnormalities identified in cervical cytology, causative agents of vaginitis, and hematological indices with inflammatory parameters, potentially informing clinical management strategies

Clinical value of Hemoglobin in Combination with Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio as a Prognostic Factor in Advanced Lung Cancer

The absence of effective prognostic factors for assessing the survival outlook of patients with lung cancer has not significant improvement. Thus, this study aims to investigate the potential of a combination of serum haptoglobin (Hp), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) in blood as reliable prognostic markers for lung cancer patients. There were 62 lung cancer patients (male and female) at advanced stage (stage III and IV) with age mean (65.25) years, and 62 healthy participants with age mean 64.27 years. The levels of some hematological parameters were estimated by a hematology analyzer. Heptoglobin level was evaluated in serum by ELISA technology. There was significant increase in mean of haptoglobin, NLR, and PLR in SCLC (3.43 ±0.16, 2.47±0.88, and 221 ±23.21, respectively) and NSCLC groups (3.64 ±0.09, 3.68±1.3, and 210.26±12.6, respectively) compared with control group. Haptoglobin, NRL and PRL did not differ significantly between SCLC and NSCLC. The results indicate that the mean haptoglobin, NLR, and PLR were significantly increased in lung cancer group in contrast to controls and also showed a positive association with the severity of the disease, where they increased in patients at stage IV and receiving chemotherapy for 2 months. This makes them possible markers for prognostic advanced lung cancer and predictive responses to chemotherapy in lung cancer patients.

Systemic Immune-Inflammation Index (SII) as Prognostic Indicator for BCG Therapy in Bladder Cancer: A Systematic Review and Meta-analysis

Background: Bacillus Calmette-Guérin (BCG) immunotherapy is a standard treatment for high-risk non-muscle invasive bladder cancer (NMIBC) after tumor resection. However, not all patients respond to BCG therapy. Reliable prognostic markers are needed to predict treatment outcomes. Objectives: This study reviewed the prognostic value of systemic immune-inflammation index (SII) and related markers in BCG response. Methods: A systematic literature search was conducted in PubMed, Web of Science, and Scopus databases from inception to October 2023 for studies on SII index, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and monocyte-to-lymphocyte ratio (MLR) in bladder cancer patients receiving BCG therapy. Four retrospective studies involving 1124 patients met the inclusion criteria and were included in qualitative synthesis. Three studies were included in the meta-analysis of progression-free survival (PFS) and recurrence-free survival (RFS). Data on study characteristics and demographics, follow-up duration, cancer stage/grade, and pre-treatment marker levels were extracted. Hazard ratios (HRs) were pooled using a random effects model. Results: Elevated pre-treatment SII was associated with significantly worse PFS (HR: 3.72, 95% CI: 1.74-7.98, P&lt;0.001) and RFS (HR: 3.72, 95% CI: 1.42-9.77, P=0.007). However, significant heterogeneity was found among trials in the overall survival (OS) (I2 =83.49, P=0.002) and RFS (I2 =89.69%, P=0.002). In multivariate analysis, SII&gt;672.75 was an independent predictor of BCG failure (OR: 2.229, 95% CI: 1.172-4.238, P=0.015). NLR, PLR, and MLR also showed potential prognostic value with area under the curve (AUC) values ranging from 0.592 to 0.663 for predicting non-response to BCG therapy. Specifically, NLR&gt;3.0435, PLR&gt;123.4398, and MLR&gt;0.1995 were significantly associated with non-response to BCG (P&lt;0.001 for all). In univariate analysis, BCG non-response was associated with high pre-treatment levels of PLR, NLR, and MLR (P&lt;0.001). Conclusion: Pre-treatment SII and other inflammatory markers may predict poor outcomes after BCG immunotherapy in bladder cancer patients. SII holds promise as an accessible prognostic biomarker that can guide treatment decisions. Further large prospective studies are warranted to validate these preliminary findings.

Tumor immune microenvironment remodeling and prognosis of patients with esophageal squamous cell carcinoma after neoadjuvant chemotherapy with and without immunotherapy: a retrospective cohort study.

Immunochemotherapy was an emerging neoadjuvant treatment mode that can potentially benefit patients with esophageal carcinoma, but its synergistic mechanism and impact on the tumor immune microenvironment were still unclear. The purpose of this study was to investigate the outcomes of neoadjuvant chemotherapy (nCT) and neoadjuvant immunochemotherapy (nICT) in tumor microenvironment (TME) remodeling among patients with esophageal squamous cell carcinoma (ESCC) and to evaluate the prognostic value of immune-related biomarkers and clinicopathological characteristics. Patients with locally advanced ESCC who underwent neoadjuvant therapy followed by esophagectomy at the Fourth Hospital of Hebei Medical University between December 2019 and March 2022 were enrolled in this retrospective study. We examined TME features and immune antigen-related biomarkers before and after neoadjuvant therapy. Logistic and Cox regression model were used to evaluate the correlation between these factors and other clinical features and outcomes. A total of 50 eligible participants were analyzed, including 31 males (62%), 25 patients of ≥65 years old, 4/28/18 of upper/middle/lower thoracic cancer, 25/17/8 of poor/moderate/high tumor differentiation, 8/42 of cT1+2/T3+4 stages and 30/20 of cN0/N+ stages. In the entire cohort, the rates of pathological complete response (pCR) and major pathological response (MPR) were 18% and 30%, respectively. pCR rates were 7.1% and 22.2% (χ2=0.699; P=0.40) MPR rates were 7.1% and 38.9% (χ2=4.837; P=0.03) in the nCT and nICT groups, respectively. Compared with the non-pCR patients, the pCR patients had a higher baseline programmed cell death ligand-1 (PD-L1) tumor proportion score (TPS) positive expression rate (16.7% vs. 77.8%, χ2=13.089; P<0.001). Following neoadjuvant therapy, the expression rates of PD-L1, CD3+ T cells, and CD8+ T cells in the tumor tissue was higher in the nICT group compared to the nCT group (P<0.05). Deficient expression of mismatch repair (MMR) genes was only observed in one patient (2%). Among patient-related biomarkers, lymphocyte and neutrophil counts decreased after treatment, with no significant changes in the neutrophil-to-lymphocyte ratio or platelet-to-lymphocyte ratio (PLR). Cox regression analysis showed that pretreatment, well-differentiated tumors and positive PD-L1 status were positive predictors of MPR (P<0.05). MPR was an independent predictor of disease-free survival (DFS) (P=0.03). Compared to nCT, nICT could more significantly upregulates PD-L1 TPS, PD-L1 combined positive score (CPS), CD3+ T cells, and CD8+ T cells. Pretreatment tumor differentiation and PD-L1 TPS level could be predictive of MPR. Our findings suggested that the combination of chemotherapy and immunotherapy may be more beneficial for activating anti-tumor immunity in the TME.

CRP, Fibrinogen, White Blood Cells, and Blood Cell Indices as Prognostic Biomarkers of Future COPD Exacerbation Frequency: The TIE Cohort Study.

Background/Objective: Systemic inflammation is common in chronic obstructive pulmonary disease (COPD), and evidence suggests that inflammatory biomarkers can predict acute exacerbations (AECOPDs). The aim of this study was to analyse whether C-reactive protein (CRP), fibrinogen, white blood cell count (WBC), or the blood cell indices PLR (platelet-to-lymphocyte ratio), SII (systemic immune inflammation index), SIRI (systemic inflammation response index), and AISI (aggregate index of systemic inflammation) can predict future AECOPDs. Methods: In the Tools Identifying Exacerbations (TIE) cohort study, participants with spirometry-confirmed COPD were recruited from primary and secondary care in three Swedish regions and assessed during a stable phase of COPD. AECOPD frequency during the three-year follow-up was reviewed in medical records. Associations were analysed via ordinal logistic regressions. Results: Of the 571 participants, 46% had ≥1 AECOPD during follow-up, and the mean ± SD AECOPD frequency was 0.63 ± 1.2/year. In unadjusted analyses, high levels of CRP (odds ratio 1.86, 95% CI 1.29-2.67), fibrinogen (2.09, 1.38-3.16), WBCs (2.18, 1.52-3.13), SII (1.52, 1.05-2.19), SIRI (1.76, 1.23-2.52), and AISI (1.99, 1.38-2.87) were associated with a higher AECOPD frequency. After adjustment for AECOPD history, age, sex, smoking, body mass index, COPD Assessment Test score, lung function, and inhaled corticosteroid use, associations remained for high levels of CRP (adjusted odds ratio of 1.64; 95% CI of 1.08-2.49), fibrinogen (1.55; 1.07-2.24), and WBC (1.65; 1.10-2.47). Conclusions: CRP, fibrinogen, and WBC, assessed during stable-phase COPD, enhanced AECOPD prediction, whereas PLR, SII, SIRI, and AISI did not.

Rotavirus vaccination is a protective factor for adverse outcomes in primary intussusception: a single-center retrospective study.

The clinical features and prognosis of intussusception in children vaccinated against rotavirus were undefined. Hence, we conducted the study to explore the clinical characteristics and outcomes of primary intussusception patients who received rotavirus vaccine. A single-center retrospective study was performed in 327 primary intussusception patients between January 2019 and December 2021. Of these, 168 were vaccinated against rotavirus and 159 were not, the latter serving as the control group. Data on patients' clinical characteristics, commonly used inflammatory biomarkers, treatment, and outcomes were collected and evaluated. Most of the vaccination group received pentavalent rotavirus vaccine produced by Merck, USA (89.88%). There were no differences in demographic characteristics, time from onset to hospital attendance, clinical symptoms and signs between the vaccination group and the control group. The success rate of air enema reduction in the vaccination group was higher than that in the control group (98.21% vs. 88.68%, q=0.01). The vaccination group had lower rates of surgery and complication (1.79% vs. 11.32%, q=0.008; 2.98% vs. 12.58%, q=0.006). Both platelet-lymphocyte ratio (PLR) and C-reactive protein (CRP) levels were lower in the vaccinated group (q=0.02, q=0.004). Higher CRP level [odds ratio (OR): 1.635; 95% confidence interval (CI): 1.248-2.143; P=0.006] and the longer time from onset to hospital attendance (OR: 3.040; 95% CI: 2.418-12.133; P=0.01) were associated with increased adverse events. Rotavirus vaccination (OR: 0.527; 95% CI: 0.103-0.751; P=0.02) was associated with a reduction in the probability of adverse events. Adverse events such as surgery and complications were lower in the vaccination group. Rotavirus vaccination was an independent protective factor for adverse events in patients with primary intussusception.

Association between blood inflammatory indicators and prognosis of papillary thyroid carcinoma: a narrative review.

Papillary thyroid carcinoma (PTC) is the most common subtype of thyroid cancer, accounting for up to 85-90% of cases, with the best overall prognosis and mostly inert tumors. However, some tumors are aggressive, causing metastasis, recurrence, and other bad outcomes. Preoperative inflammation indices, such as lymphocyte-to-monocyte ratio (LMR), neutrophil-to-lymphocyte ratio (NLR), and systemic immune inflammation index (SII) in peripheral blood, have recently gained attention as nonspecific markers of inflammatory response in thyroid. In this study, we reviewed the interactions between preoperative inflammatory factors and outcomes in patients with PTC. This is a narrative review. We searched for English articles published between January 2014 and December 2023 on PubMed and Web of Science to identify how do these blood indicators affect the prognosis of patients with papillary thyroid cancer. All retrievable indicators that have predictive significance for the prognosis of PTC were included, and the prognosis mainly included tumor-node-metastasis (TNM) staging, survival rate, recurrence, clinical and pathological risk factors such as lymph node metastasis (LNM), etc. From the general evidence, the prognostic predictive value of cell count alone was unknown, and low LMR was usually associated with poor prognosis, high NLR and high platelet-to-lymphocyte ratio (PLR) usually indicated poor prognosis. These minimally invasive, low-cost, and easily obtainable blood indicators provide convenience for precise prognosis management of PTC patients, but many of the findings are conflicting and need to be validated by prospective studies that are more multi-sample, multi-centre and incorporate factors such as age that affect the immune response.

A novel inflammatory nutrient index for predicting survival outcomes in patients with non-small cell lung cancer.

Lung cancer is one of the most common contributors to cancer-related deaths worldwide. This study aimed to develop a new blood index on the basis of the patient's systemic inflammation and nutritional status, which can be used to predict the prognosis of patients with non-small cell lung cancer (NSCLC). Pre-treatment blood markers were analyzed in 556 NSCLC patients from 2010 to 2019. A least absolute shrinkage and selection operator (LASSO) method was used to select indicators to establish a new integrated biomarker (PNAGR). Kaplan-Meier survival curves were used to assess the prognostic impact of platelet-to-lymphocyte ratio (PLR), albumin (ALB), and the PNAGR. The prognostic value was verified using univariate and multivariate Cox analyses. We used four biomarkers including PLR, ALB, 1/albumin-to-globulin ratio (1/AGR), and neutrophil/albumin-to-globulin ratio (N/AGR) were used to screen for the PNAGR using LASSO. Patients with high PNAGR demonstrated lower overall survival (OS) compared to those with low PNAGR. In both univariate and multivariate analyses, PNAGR was revealed as an independent prognostic factor for OS. The predictive power of PNAGR [area under the curve (AUC): 0.753] was higher than that of the metrics alone. PNAGR is a novel and effective clinical prognostic tool with good clinical predictive value for NSCLC patients.

Preoperative Laboratory Values Predicting Periprosthetic Joint Infection in Morbidly Obese Patients Undergoing Total Hip or Knee Arthroplasty.

Morbidly obese patients are an ever-growing high-risk population undergoing total hip arthroplasty (THA) and total knee arthroplasty (TKA) for end-stage osteoarthritis. This study sought to identify preoperative laboratory values that may serve as predictors of periprosthetic joint infection (PJI) in morbidly obese patients undergoing THA or TKA. All morbidly obese patients with preoperative laboratory data before undergoing primary elective TKA or THA were identified using the Premier Healthcare Database. Patients who developed PJI within 90 days after surgery were compared with patients without PJI. Laboratory value thresholds were defined by clinical guidelines or primary literature. Univariate and multivariable regression analyses were utilized to assess the association between PJI and preoperative laboratory values, including total lymphocyte count, neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), monocyte-lymphocyte ratio (MLR), systemic immune-inflammation index (SII), albumin level, platelet count, albumin-globulin ratio, hemoglobin level, and hemoglobin A1c. Of the 6,780 patients identified (TKA: 76.67%; THA: 23.33%), 47 (0.69%) developed PJI within 90 days after surgery. The rate of PJI was 1.69% for patients with a hemoglobin level of <12 g/dL (for females) or <13 g/dL (for males), 2.14% for those with a platelet count of <142,000/µL or >417,000/µL, 1.11% for those with an NLR of >3.31, 1.69% for those with a PLR of >182.3, and 1.05% for those with an SII of >776.2. After accounting for potential confounding factors, we observed an association between PJI and an abnormal preoperative NLR (adjusted odds ratio [aOR]: 2.38, 95% confidence interval [CI]: 1.04 to 5.44, p = 0.039), PLR (aOR: 4.86, 95% CI: 2.15 to 10.95, p < 0.001), SII (aOR: 2.44, 95% CI: 1.09 to 5.44, p = 0.029), platelet count (aOR: 3.50, 95% CI: 1.11 to 10.99, p = 0.032), and hemoglobin level (aOR: 2.62, 95% CI: 1.06 to 6.50, p = 0.038). This study identified preoperative anemia, abnormal platelet count, and elevated NLR, PLR, and SII to be associated with an increased risk of PJI among patients with a body mass index of ≥40 kg/m 2 . These findings may help surgeons risk-stratify this high-risk patient population. Prognostic Level III . See Instructions for Authors for a complete description of levels of evidence.

Clinical study of neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio in hypertriglyceridemia-induced acute pancreatitis and acute biliary pancreatitis with persistent organ failure.

The neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) are novel inflammatory indicators that can be used to predict the severity and prognosis of various diseases. We categorize acute pancreatitis by etiology into acute biliary pancreatitis (ABP) and hypertriglyceridemia-induced acute pancreatitis (HTGP). To investigate the clinical significance of NLR and PLR in assessing persistent organ failure (POF) in HTGP and ABP. A total of 1450 patients diagnosed with acute pancreatitis (AP) for the first time at Shanxi Bethune Hospital between January 2012 and January 2023 were enrolled. The patients were categorized into two groups according to the etiology of AP: ABP in 530 patients and HTGP in 241 patients. We collected and compared the clinical data of the patients, including NLR, PLR, and AP prognostic scoring systems, within 48 h of hospital admission. The NLR (9.1 vs 6.9, P < 0.001) and PLR (203.1 vs 160.5, P < 0.001) were significantly higher in the ABP group than in the HTGP group. In the HTGP group, both NLR and PLR were significantly increased in patients with severe AP and those with a SOFA score ≥ 3. Likewise, in the ABP group, NLR and PLR were significantly elevated in patients with severe AP, modified computed tomography severity index score ≥ 4, Japanese Severity Score ≥ 3, and modified Marshall score ≥ 2. Moreover, NLR and PLR showed predictive value for the development of POF in both the ABP and HTGP groups. NLR and PLR vary between ABP and HTGP, are strongly associated with AP prognostic scoring systems, and have predictive potential for the occurrence of POF in both ABP and HTGP.

Correlation analysis of patients with diabetic foot ulcers treated with tibial cortex transverse transport surgery and platelet-to-lymphocyte ratio and monocyte-to-neutrophil ratio.

Diabetic foot ulcers (DFUs) represent one of the most severe late-stage complications of diabetes. Tibial cortex transverse transport (TTT) surgery stands as the prevailing method for addressing DFUs. This surgical intervention holds the promise of expediting DFU wound healing and diminishing the rate of amputations, with the mitigation of inflammatory responses playing a pivotal role. In this study, we aim to explore the correlation between inflammation and TTT surgery, with the overarching goal of facilitating swift prognostic assessments in clinical practice. The correlation between the severity of DFUs and clinical test results remains ambiguous. A clinical prediction model was devised to explore the connection between DFU severity and the efficacy of TTT surgery, utilizing straightforward and efficient clinical indicators. Clinical data and examination results were gathered by tracking hospitalized DFU patients who underwent TTT surgery at the First Affiliated Hospital of Guangxi Medical University (Nanning, China). Indicators associated with DFU severity and wound healing time post-surgery were identified through logistic regression and least absolute shrinkage and selection operator (LASSO) regression analyses. Subsequently, a clinical prediction model was constructed. Finally, the intersection of these 2 sets of indicators revealed factors correlated with wound severity and post-operative healing duration. Our study was comprised of 202 patients who were categorized into 2 groups based on Wagner's grading classifications. Utilizing Student's t-tests, LASSO regression and logistic regression analyses, we identified 3 factors indicative of DFU severity: platelet-to-lymphocyte ratio (PLR), mixed lymphocyte reaction (MLR) and hemoglobin (HGB). Univariate COX regression analysis revealed 12 factors such as: white blood cells (WBC), neutrophils (NEUT), monocytes (MO), PLR, MLR, neutrophil-to-lymphocyte ratio (NLR), erythrocyte sedimentation rate (ESR), age, lymphocytes (LY), monocyte-to-neutrophil ratio (MNR), uric acid (UA), and albumin (ALB) associated with the postoperative healing duration. Ultimately, we identified 2 factors, PLR and MNR, at the intersection of these 2 datasets. Platelet-to-lymphocyte ratio and MNR were identified as factors associated with both the severity of DFUs and the prognosis following TTT surgery.

Correlation between Neurotransmitters (Dopamine, Epinephrine, Norepinephrine, Serotonin), Prognostic Nutritional Index, Glasgow Prognostic Score, Systemic Inflammatory Response Markers, and TNM Staging in a Cohort of Colorectal Neuroendocrine Tumor Patients.

Neuroendocrine tumors are uncommon in the gastrointestinal system but can develop in the majority of the body's epithelial organs. Our goal was to examine the presence and clinical application of serum dopamine (DA), serotonin (ST), norepinephrine (NE), and epinephrine (EPI), in addition to determining the significance of the Prognostic Nutritional Index (PNI), Glasgow Prognostic Score (GPS), and systemic inflammatory response (SIR) markers as a prognostic factor for patients with colorectal neuroendocrine tumors (CR-NETs), in various tumor-node-metastasis (TNM) stages. We also wanted to identify the possible connection between them. This study included 25 consecutive patients who were diagnosed with CR-NETs and a control group consisting of 60 patients with newly diagnosed colorectal cancer (CRC). We used the Enzyme-Linked Immunosorbent Assay (ELISA) technique. This study revealed that CR-NET patients showed significantly higher serum levels of DA compared to CRC patients. We showed that serum DA was present in the early stages of CR-NETs, with increasing levels as we advanced through the TNM stages. Moreover, we found a close relationship between the levels of DA and the inflammation and nutritional status of the CR-NET patients in this study. CR-NET patients from the PNI < 47.00 subgroup had a higher level of DA than those from the PNI ≥ 47.00 subgroup. Pearson's correlation analysis revealed correlations between DA, PNI, and the neutrophil/lymphocyte ratio (NLR) and the platelet/lymphocyte ratio (PLR). Both hematological indices were negatively correlated with albumin (ALB). Our investigation's findings relating to the PNI, GPS, SIR, and DA indicate that these tools can be markers of nutritional and systemic inflammatory status, are simple to use, and are repeatable. Further research on this topic could provide valuable insights into which biomarkers to incorporate into clinical practice for the management of CR-NET patients.

The role of hematological parameters in asymptomatic and non-severe cases of Omicron variant infection

BackgroundOmicron variants are currently the predominant circulating lineage worldwide and most cases are mild or asymptomatic. The Omicron variant is characterized by high transmissibility and immune evasion. Early identification of Omicron cases in clinical settings is crucial for controlling its spread. Previous studies have indicated that changes in hematological parameters can be used to predict the severity of coronavirus disease 2019 (COVID-19). However, the role of hematological parameters in non-severe and asymptomatic cases remains unknown. This study aimed to investigate the role of hematological parameters in non-severe and asymptomatic Omicron variant infections.MethodsHematological parameters and results were analyzed and compared in symptomatic (n = 356) and asymptomatic (n = 171) groups respectively, and between these two groups with positive COVID-19 tests. The utility of hematological parameters for predicting positive COVID-19 tests was analyzed using receiver operating characteristic curves.ResultsIndividuals with non-severe cases exhibited decreased levels of platelets, lymphocytes, eosinophils, basophils, lymphocytes (%), eosinophils (%), and basophils (%), while exhibiting elevated counts of monocytes, neutrophils (%), monocytes (%), neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio (PLR), and C-reactive protein (CRP) when compared to suspected cases or asymptomatic carriers. In asymptomatic patients, positive carriers had lower leukocyte, neutrophil, and lymphocyte counts but higher monocyte, monocyte (%), PLR, and CRP levels than negative carriers. Basophil counts combined with lymphocytes or the PLR demonstrated a more significant predictive value in screening non-severe cases earlier compared to other parameters. The combined assessment of the monocyte (%) and the PLR had the highest area under the curve for diagnosing asymptomatic carriers.ConclusionsCirculating basophils, alone or in combination with other hematological parameters, may be used as efficient biomarkers for early screening of non-severe Omicron cases.