Predictive Value Of Neutrophil-lymphocyte Ratio Research Articles

744P - Predictive value of neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) In hepatocellular carcinoma (HCC) patients treated with nivolumab (N)

BackgroundCurrently there are no recognized or validated biomarkers to identify HCC patients(pts) likely to benefit from N. Several studies have established the inverse relationship between inflammation-based scores such as NLR, PLR and survival in other solid tumours treated with immunotherapy. We evaluated the relationship between NLR and PLR and survival outcomes in HCC pts treated with N at Mount Sinai Hospital. MethodsOne hundred and four HCC pts treated between June 2016 and July 2018 were identified. NLR=Absolute neutrophil count/ Absolute lymphocyte count (ALC) and was calculated pretreatment and at 6-8 weeks after 3 doses (Posttreatment) of N. PLR=Platelet count/ALC. Kaplan-Meier analysis and the log-rank test were used to calculate and compare Overall and Progression free survival (OS, PFS) between NLR <5 vs≥5 and among PLR tertiles. ResultsMedian age was 66 (29-89) years. Median treatment duration was 26 (2-149) weeks. Child Pugh score (CPS, N=96) was A in 64 (66%) and B in 32 (33%) pts. Barcelona Clinic Liver Cancer (BCLC) stage was B in 21 (20%) and C in 83 (80%) pts. Median follow-up time was 17 months (95% CI (15.7, 20.7). NLR was <5 in 64 (62%) pts pretreatment and 59 (60%) pts post treatment. NLR<5 was associated with improved OS compared to NLR≥5 both pretreatment (23 Vs 10 months, P=0.0037) and post treatment (35 Vs 9 months, P<0.0001). Survival also differed significantly among PLR tertiles (Table), with median OS for the lowest post treatment tertile not yet reached. Median PFS differed significantly between pre (16 Vs 5 months, P=0.0217) and post (35 Vs 5 months, P=0.0002) treatment NLR. PLR was not significantly associated with PFS. In a multivariable model, port treatment PLR and NLR were significantly associated with OS.Table744PTablePretreatment PLR groupN(%)OS (months)< 11936(36)35P=0.0495>= 119 & < 22432(31)10>= 22433(33)15Post treatment PLR group< 12635(35)Not ReachedP=0.0126>= 126 & < 22931(31)19>= 22933(33)10 ConclusionsThis study suggests that lower NLR and PLR levels may predict better survival outcomes in HCC patients treated with N. The potential role of NLR and PLR as early predictors of immunotherapy outcomes in HCC pts warrants further evaluation. Legal entity responsible for the studyMount Sinai Hospital. FundingHas not received any funding. DisclosureAll authors have declared no conflicts of interest.

The Predictive Value of Neutrophil-Lymphocyte Ratio in Disability of Gullain-Barrѐ Syndrome

The Predictive Value of Neutrophil-Lymphocyte Ratio in Disability of Gullain-Barrѐ Syndrome

The predictive value of Neutrophil-Lymphocyte ratio in patient with heart failure in Morocco: A retrospective cross-sectional study

The purpose of this study was to test the hypothesis that the Neutrophils to Lymphocytes count ratio (NLR) provides better correlate of the Heart failure (HF) the severity in addition to the physical examination in patients with suspected HF. Thus, its use in the resource limited health facilities lacking with ultrasound and or CT scan, may reduce treatment delay and also improve the follow-up and referral system for HF patients. Patients admitted for HF underwent physical examination, ECG and echocardiogram. Venous blood collected from each patient was assessed for the haematological and biochemistry parameters. Of 105 patients were included in this study, of them, 81 cases were classified into moderate including NYHA class I and II and 24 cases as severe including NYHA class III and IV. The median-age was 64.8 years (IQR: 55.5-72.6) and 58.4 (IQR: 52.3-67.84) for moderate and severe HF respectively. The NLR (p = 0.029) and HDL levels (p = 0.018) were found to be an independent risk factor for a severe HF. After adjusting other factors, area under the ROC curve of NLR and HDL in predicting severe HF were 0.68 (95% CI = 0.541–0.816) and 0.168 (95% CI = 0.076–0.259) respectively. NLR showed the better predicting ability of the severe HF. Our findings revealed that NLR derived as a simple marker using a routine complete blood count data, was significantly and independently related to the severity of HF. Therefore, NLR is a potential indicator for HF severity in the resource limited health facilities.

Abstract 1824: Predictive value of neutrophil-lymphocyte ratio for the efficacy of preoperative chemotherapy in triple-negative breast cancer

Abstract Purpose: Abnormalities in the subpopulations in white blood cells, such as neutrophilia and lymphopenia, have been reported in tumor-bearing patients, and the neutrophil/ lymphocyte ratio (NLR) has been found to associate with prognosis in patients following radical surgery. The NLR was reported to associate with prognosis in cancer patients by influencing both cancer progression and chemosensitivity. The correlation between NLR and the outcome of neoadjuvant chemotherapy (NAC) in breast cancer patients has not been elucidated yet. The aim of this study is to evaluate NLR as one of the possible markers to predict the outcome of NAC in patients with TNBC by a retrospective investigation of the consecutive patient series treated with a standardized single protocol in our institute. Experimental Design: NLR was evaluated in a total of 177 patients with early-stage breast cancer treated with NAC consisting FEC (5-fluorouracil, epirubicin, and cyclophosphamide) followed by weekly paclitaxel followed by curative surgery. The correlation between NLR and the prognosis including the efficacy of the NAC was evaluated retrospectively. NLR was calculated from the preoperative blood sample by dividing the absolute neutrophil count by the absolute lymphocyte count. On the basis of previous studies, an NLR value of 3.0 was used as the cut-off value to discriminate between high-NLR (3.0 and over) and low-NLR (less than 3.0) groups. Results: NLR distributed from 0.5 to 10.6 with a median of 2.0. Fifty-eight patients with low NLR (less than 3) had a higher pCR rate (p&amp;lt;0.001), and more frequently diagnosed to have TNBC (p&amp;lt;0.001) compared with those with high NLR (3 and over). Among TNBC patients who achieved pCR, DFS (p = 0.006) and OS (p&amp;lt;0.001) were significantly longer in patients with low NLR than that with high NLR. Low NLR was associated with a significantly favorable prognosis in TNBC patients who achieved pCR, according to univariate analysis (p = 0.044, HR = 0.06). Conclusions: Low NLR in patients with TNBC could be expected to show high efficacy, and favorable outcome after NAC. Citation Format: Yuka Asano, Shinichiro Kashiwagi, Tamami Morisaki, Satoru Noda, Hidemi Kawajiri, Tsutomu Takashima, Naoyoshi Onoda, Kosei Hirakawa. Predictive value of neutrophil-lymphocyte ratio for the efficacy of preoperative chemotherapy in triple-negative breast cancer. [abstract]. In: Proceedings of the 106th Annual Meeting of the American Association for Cancer Research; 2015 Apr 18-22; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Res 2015;75(15 Suppl):Abstract nr 1824. doi:10.1158/1538-7445.AM2015-1824

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Objective:Recent studies have shown a strong predictive value of Neutrophil-Lymphocyte Ratio (NLR) for the risk of coronary heart disease. Higher values of NLR are useful to reclassify arteriosclerotic risk in subjects at low CV risk. On the other hand, high-sensitivity C-Reactive Protein (hsCRP) ha

Predictive value of elevated neutrophil-lymphocyte ratio for leftventricular systolic dysfunction in patients with non ST-elevatedacute coronary syndrome.

Objective:We aimed to study the predictive value of the neutrophil-lymphocyte ratio (NLR) for left ventricular systolic dysfunction (LVSD) in patients with non ST-elevated acute coronary syndrome (NST-ACS).Methods:A total of 405 patients (mean age 62 years and 75% male) with NST-ACS were included in the study. The study population was divided into tertiles based on admission NLR values. The low, medium and high tertiles defined as NLR≤1.81 (n=135), 1.81<NLR≤3.2 (n=135) and NLR>3.2 (n=135), respectively.Results:The patients in the high NLR group were older (p<0.001), have higher rate of diabetes mellitus (p=0.028) and non-ST elevated myocardial infarction (NSTEMI) (p<0.001) and have lower left ventricular ejection fraction (LVEF) (p<0.001). Baseline WBC (p=0.02) and neutrophil (p<0.001) levels and NLR (p<0.001) were significantly higher, baseline hemoglobin (p=0.044), hematocrit (p=0.019) and lymphocyte (p<0.001) levels were significantly lower in the high NLR group. NLR was negatively correlated with LVEF in correlation analysis. An NLR >3.2 and age ≥70 were found to be an independent predictor of systolic dysfunction in multivariate analyses.Conclusion:An NLR >3.2 is a useful predictor for LVSD in patients with NST-ACS. The practice of using an NLR count on admission may be useful for identifying high-risk patients and their associated treatment methods.

Predicting value of dynamic alteration of blood neutrophil/lymphocyte ratio on recurrence-free survival in patients with advanced colon cancer after operation and chemotherapy

To evaluate whether neutrophil-lymphocyte ratio(NLR) predicts risk of recurrence in patients with advanced colon cancer undergoing curative resection followed by adjuvant chemotherapy. A total of 149 patients with advanced colon cancer undergoing curative resection followed by adjuvant chemotherapy(FOLFOX6 protocol) were included. NLR was calculated preoperatively and before chemotherapy. The changes in NLR and the predictive value of NLR for prognosis were analyzed. The NLR of 149 patients was 2.8±1.5. NLR of 3.5 was identified according to the ROC curve. NLR<3.5 and NLR≥3.5 were classified as low and high NLR group, respectively. The 5-year recurrence-free survival(RFS) of patients with high preoperative NLR(n=22) was significantly worse than that of those with low preoperative NLR(n=127)(50.9% vs. 76.4%, P=0.025). The difference of 5-year RFS between high pre-chemotherapy NLR group(n=34) and low pre-chemotherapy NLR group(n=115) was statistically significant(50.1% vs. 71.4%, P=0.032). The 5-year RFS was 79.5% in patients with low preoperative NLR converting to high pre-chemotherapy NLR(n=16), similar to the group with high pre-chemotherapy group(P=0.077). The 5-year RFS was 17.7% in patients with high preoperative NLR reverting to low pre-chemotherapy NLR(n=12), similar to the group with low pre-chemotherapy group(P=0.978). There was significant difference in 5-year RFS between the postoperatively elevated group and postoperatively decreased group(P=0.036). An elevated blood NLR may be a biomarker of poor RFS in patients with advanced colon cancer after curative resection and chemotherapy.