Relationship Of Neutrophil-lymphocyte Ratio Research Articles

Relationship of neutrophil/lymphocyte ratio with cerebral small vessel disease and its common imaging markers.

High neutrophil/lymphocyte ratio (NLR) is associated with poor prognosis in ischemic stroke. However, the role of NLR in cerebral small vessel disease (CSVD) is controversial. Herein, we evaluated the value of NLR in identifying CSVD and its relationship with the common imaging markers of CSVD. A total of 667 patients were enrolled in this study, including 368 in the CSVD group and 299 in the non-CSVD group. Clinical, laboratory, and imaging data were collected. The relationship of NLR with CSVD and common imaging markers of CSVD were analyzed with univariate and multivariate logistic regression analysis. The predictive value of NLR was assessed with the receiver operating characteristic curve. NLR (odds ratio [OR] = 1.929, 95% confidence interval [CI] = 1.599-2.327, p < .001) was an independent risk factor for CSVD. NLR was also independently associated with moderate to severe white matter hyperintensity (WMH) (OR = 2.136, 95% CI = 1.768-2.580, p < .001), moderate to severe periventricular WMH (OR = 2.138, 95% CI = 1.771-2.579, p < .001), and moderate to severe deep WMH (OR = 1.654, 95% CI = 1.438-1.902, p < .001), moderately to severely enlarged perivascular spaces (EPVS) (OR = 1.248, 95% CI = 1.110-1.402, p < .001), moderately to severely EPVS in the basal ganglia (OR = 1.136, 95% CI = 1.012-1.275, p = .030), and moderately to severely EPVS in the centrum semiovale (OR = 1.140, 95% CI = 1.027-1.266, p = .014). However, NLR was not statistically significantly associated with lacune. The optimal cutoff point of NLR in predicting CSVD was 2.47, with sensitivity and specificity of 84.2% and 66.9%, respectively (p < .01). The diagnostic effect was maximized when NLR was combined with other risk factors. NLR is an independent risk factor for CSVD and is independently associated with common imaging markers of CSVD. NLR may serve as a valid and convenient biomarker for assessing CSVD.

Relationship of Neutrophil Lymphocyte Ratio and Glomerulus Filtration Rate in Diabetic Nephropathy Patients at H. Adam Malik Hospital, Medan, Indonesia

Background: Diabetic nephropathy is a serious complication of diabetes mellitus (DM). The neutrophil-lymphocyte ratio is the result of the relative count of neutrophils divided by the relative number of lymphocytes in diabetic nephropathy patients in % units obtained from routine hematology results using EDTA blood samples and measured by flow cytometry with Sysmex XN-1000, glomerular filtration rate was measured according to the Cockroft-Gault formula. This study aimed to determine the relationship between neutrophil lymphocyte ratio (NLR) and glomerular filtration rate in diabetic nephropathy patients. Subjects and Method: This was a cross sectional study conducted at H. Adam Malik Hospital, Medan, North Sumatera, Indonesia, from November 2022 – January 2023. 30 diabetic nephropathy patients were selected for this study consecutively. The dependent variable was the glomerular filtration rate. The independent variable was the NLR. Blood sample was taken for a complete blood count and creatinine examination. Data were analyzed using the Spearman test. Results: NLR was negatively associated with eGFR in patients with diabetic nephropathy, but it was statistically non significant (r= -0.25; p= 0.186). Conclusion: NLR is negatively associated with eGFR in patients with diabetic nephropathy, but it is statistically non significant. Keywords: neutrophil lymphocyte ratio, glomerular filtration rate, diabetic nephropathy

The Relationship of Neutrophil Lymphocyte Ratio (NLR), Nutritional Status and Length of Hemodialysis to The Incidence of Inpatient Community Pneumonia in Regular Hemodialysis Patients

Background: Pneumonia, a leading cause of death worldwide, is common in chronic kidney disease (CKD) patients undergoing hemodialysis due to pulmonary infections and poor nutritional status. Prolonged hemodialysis worsens nutritional disorders, increasing pneumonia risk. Biomarkers like the neutrophil-lymphocyte ratio (NLR) and low albumin can indicate infection and inflammation. This study explores the relationship between NLR, nutritional status, and hemodialysis duration with pneumonia in CKD patients. Methods: This study was an observational analytic study with a cross-sectional design. Using SPSS to univariate analysis in the form of tables with frequency, mean and media; bicariat analysis using chi square test and multivariate analysis with logistic regression. Results: 72 patients undergoing regular hemodialysis, ROC analysis obtained an NLR cut off value of 6.09. Chi Square test results showed a significant association between NLR and pneumonia (OR 2.04; p &lt; 0.05; CI 95% 1.26-3.33) and Hemeodyalisis (HD) duration with pneumonia (OR 4.71 times; CI 95% 1.72-12.93; p 0.004), while there was no significant difference in nutritional status between community pneumonia and non-community pneumonia. Based on the results of multivariate analysis, it was found that NLR levels &gt; 6.09, HD duration &gt; 1 year, and the presence of comorbid heart failure were risk factors that significantly increased the incidence of community pneumonia in patients undergoing regular HD. Conclusion: There is a significant association between NLR &gt;6.09 and HD duration and comorbid heart failure with community pneumonia in patients undergoing regular HD at Prof. I.G.N.G. Ngoerah Hospital.

Neutrophil lymphocyte ratio and platelet lymphocyte ratio as a marker for disease severity in children with COVID-19

Background: It had been observed that there is relationship of neutrophil lymphocyte ratio (NLR) and platelet lymphocyte ratio (PLR) with disease severity in children with COVID-19 and post-COVID, multisystem inflammatory disease in children (MIS-C). Study conducted to determine NLR and PLR correlation with this disease severity. Methods: Prospective descriptive analytical study conducted at the children’s hospital and university of child health sciences, Lahore. Consecutive confirmed cases of COVID-19 infection and post-COVID, MIS-C diagnosed on the basis of RT-PCR from nasopharyngeal swab and antibody test admitted from March 2020 to October 2021 were included through consecutive sampling. Complete blood (CBC) was done and NLR and PLR was determined Results: Majority 198 (74.2%) of the 267 patients had a diagnosis of COVID-19 and 69 (25.8%) were post-COVID MIS-C. There was a male preponderance 177 (66.3%) and the mean age was 6.1±4.7 years (95% CI: 5.62-6.74). Majority children had mild disease 80 (30%), 34 (12.7%) were critical and there were 37 (13.8%) deaths. Underlying comorbidity was present in 55 (20.6%). As the severity of symptoms changed from asymptomatic to severe disease, there was a significant rise of mean NLR from 1.88±1.40 to 5.47±4.77 respectively (p&lt;0.001). PLR however, failed to show any kind of association with severity of the symptoms (p=0.922). Conclusions: NLR served as a marker of disease severity among pediatric patients suffering from COVID-19 and MIS-C. However, PLR failed to show any relation with disease severity.

CD39 and LDHA affects the prognostic role of NLR in metastatic melanoma patients treated with immunotherapy

BackgroundIdentifying response markers is highly needed to guide the treatment strategy in patients with metastatic melanoma.MethodsA retrospective study was carried out in patients with unresectable/metastatic melanoma (stage IIIb–IV), treated with anti-PD-1 in the first line setting, to better explore the role and the timing of neutrophil/lymphocyte ratio (NLR) as potential biomarker of response. The relationship of NLR with inflammation-immune mediators and the underlying negative effect of raising NLR during immunotherapy, have been investigated with transcriptomic gene analysis.ResultsThe results confirmed previous findings that a high baseline NLR is associated with a poorer prognosis and with higher serum level of lactate dehydrogenase (LDH), regardless of the presence of brain metastases. The transcriptomic analysis showed that high baseline NLR is associated with a characteristic gene signature CCNA1, LDHA and IL18R1, which correlates with inflammation and tumorigenesis. Conversely, low baseline NLR is associated with the signature CD3, SH2D1A, ZAP70 and CD45RA, linked to the immune-activation. The genes positively associated with NLR (CD39 (ENTPD1), PTEN, MYD88, MMP9 and LDH) are involved in processes of immunosuppression, inflammation and tumor-promoting activity. Increased expression of CD39 correlated with TGFβ2, a marker of the N2 neutrophils with immunosuppressive activity.ConclusionsThese results suggest that increasing NLR is associated with an increased neutrophil population, with polarization to the N2 phenotype, and this process may be the basis for the negatively prognostic role of NLR.

Relationship of NLR and PLR with fracture severity in patients with Proximal Femur Fractures

Objectives: The aim of this study is to investigate the role of hematological markers in predicting the severity of proximal femur fractures, which is an important mortality and morbidity problem. Materials and Methods: Patients who applied to our clinic for proximal femur fracture for 2 years between 2017 and 2019 were included in this study. Demographic information, fracture severity, fracture classification and blood values of the patients were recorded. Patients with proximal femoral fractures who were registered in the hospital information operating system and accepted to participate in this study were included in the study, while patients with a concomitant fracture, a history of malignancy, and those who applied for revision surgery were excluded from the study. Results: A total of 89 patients with proximal femoral fractures, 51 of whom were women (57.3%), with a mean age of 79.2±10.9 (range, 25 to 98) years were included in this study. The patients were divided into two groups as stable and unstable according to the severity of the fracture. When the preoperative hemogram parameters of the patients were examined, it was noted that the neutrophil (p=0.013), lymphocyte (p=0.012), Neutrophil/Lymphocyte ratio (NLR) (p=0.001) and Platelet/Lymphocyte ratio (PLR) (p=0.035) values were statistically significantly different between the groups. NLR and PLR values were found to be higher in the unstable fracture group than in the stable fracture group. It was observed that values of 6.45 and above for NLR and 172.2 and above for PLR were predictive of unstable fracture. Conclusion: In conclusion, NLR and PLR are useful biomarkers in determining the severity of proximal femur fractures. It can guide us in the management of proximal femur fractures because it can be routinely, inexpensively and easily measured.

The Relationship of Neutrophil-Lymphocyte Ratio and Glycemic Control in Type 2 Diabetes Mellitus Patients

Progressivity of type 2 Diabetes Mellitus (DM) is associated with a condition of chronic inflammation. The Neutrophil-Lymphocyte Ratio (NLR) has become a potential new marker of inflammation to detect chronic inflammation. This research aimed to determine NLR differences between controlled type 2 DM and uncontrolled type 2 DM groups. This research conducted an observational with a cross-sectional approach to 56 patients with type 2 diabetes. The identity, anthropometric measurements, and laboratory data of routine blood exam and HbA1c were carried out on each research subject, and then the NLR calculations were performed. The subjects were 20 (35.70%) controlled type 2 DM patients, 36 (64.30%) uncontrolled type 2 DM patients, consisting of 36 (64.30%) male and 20 (35.70%) females. The NLR value was statistically significantly higher in uncontrolled type 2 DM patients than controlled type 2 DM patients, which was 1.90±0.84 compared to 1.52±0.50 (p=0.035). There was a significant difference in the NLR value between the uncontrolled type 2 DM group and the controlled type 2 DM group.

The Relationship of Neutrophil Lymphocyte Ratio and Levels of Vitamin D against Disease Activity Systemic Lupus Erythematosus

Background: Systemic lupus erythematosus (SLE) is an autoimmune disease characterized by the presence of autoantibodies against cell nuclei and immune complexes involving multiple organ systems in the body. The Lupus Foundation estimates about 1.5 million cases of SLE in America and at least 5 million cases of SLE in the world and from year to year, the number of people with lupus also tends to increase. Several laboratory findings are also associated with signs and symptoms of SLE activity including the ratio of neutrophil lymphocytes and vitamin D levels. Method: This study is an observational analytic study using medical record data from central installation patients at H. Adam Malik Hospital in the period December 2019 to March 2021. The sample is calculated using the large proportion estimation formula. Then the distribution test was carried out with the Shapiro Wilk test. Bivariate analysis was carried out to determine the relationship between neutrophil lymphocyte ratio and vitamin D levels with the MEX SLEDAI score using the ANOVA test if the data was normally distributed. Results: 75 subjects participated in the study and there were 12 people (16%) experiencing mild systemic lupus erythematosus, 38 people (51%) moderate degree, and 25 people (33%) severe degree. The neutrophil-lymphocyte ratio was associated with systemic lupus erythematosus disease activity (p=0.001) and vitamin D levels were associated with systemic lupus erythematosus disease activity. Conclusion: Neutrophil-lymphocyte ratio and vitamin D levels are associated with systemic lupus erythematosus disease activity. Keywords: neutrophil lymphocyte ratio, vitamin D levels, systemic lupus erythematosus.

Clinical and diagnostic significance of blood leukocyte ratios in young patients with stage III grade C periodontitis

Objectives Blood leukocyte ratios have been recently proposed as simple, rapid, cheap and easily accessible biomarkers of systemic inflammation. However, little is known about the relationship of neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR) and lymphocyte-monocyte ratio (LMR) with periodontitis, which might not only serve as the potential biomarkers of systemic inflammation but also aid in diagnosis/screening of severe periodontitis. Hence, the purpose of this study was to evaluate the differences in the serum levels of these leukocyte ratios in healthy subjects and patients with generalized stage III Grade C periodontitis, and their applicability in identifying patients with the risk of developing severe periodontitis. Material and methods The subjects were categorized into case and control group. Clinical parameters including Plaque index (PI), modified Gingival Index (mGI), Mean ratio of bleeding sites, Probing Pocket depth (PPD) and the clinical attachment loss (CAL) were assessed in both the groups. Venous blood samples were collected from subjects from both groups for the biochemical analysis and blood leukocyte ratios- NLR, PLR and LMR were calculated. The values were then subjected to statistical analysis. Results The results showed significantly higher NLR and lower LMR values in patients with generalized stage III grade C periodontitis. Both the blood leukocyte ratios were moderately associated with increasing clinical parameters of periodontal disease. However, the values of PLR, although found to be higher in the periodontitis group, did not make a significant difference when compared with periodontally healthy subjects. The cut-off value of >2.15 for NLR and <7.16 for LMR fairly predicted the risk of severe periodontitis in young adults. Conclusions NLR and LMR can provide a new insight into the relationship between periodontitis and systemic diseases and can be of potential diagnostic value in identifying patients with severe periodontitis of younger age group.

Relationship between in-hospital mortality and inflammation markers in COVID-19 patients with the diagnosis of coronary artery disease

Introduction: Inflammation plays an important role in the basis of coronary artery diseases and their adverse outcomes. Neutrophil-lymphocyte ratio (NLR), Systemic Immune Inflammation Index (SII) and C-reactive protein (CRP) are simple and useful markers that reflect the inflammatory state. Our study evaluated the usability of these markers in predicting in-hospital mortality in patients with COVID-19 with the diagnosis of coronary artery disease. Material and Method: Our study population consisted of 111 (48 male, 63 female) newly diagnosed patients with COVID-19. Neutrophil-lymphocyte ratio (NLR) was estimated using neutrophil (N), and lymphocyte (L) counts and the systemic immune inflammation index SII (NxP / L) was calculated using N, L and platelet (P) values. The relationship of NLR, SII and CRP values with in-hospital mortality was investigated. Results: During the treatment process, 16 patients exited. Any statistically significant intergroup difference was not observed as for SII and NLR values obtained by their use in combination (p = 0.872, p = 0.979, respectively), CRP values were statistically significant in the group with in-hospital mortality (p &amp;lt;0.001). In logistic regression analysis, CRP (odds ratio [OR] = 1.078, 95% confidence interval [CI]: 1.0225-1.133, p = 0.003) was associated with in-hospital mortality. In ROC analysis, the cut-off values of 3.1 mg / dL, for CRP were significant with 87% sensitivity and 58% specificity in predicting in-hospital mortality (p &amp;lt;0.001). Conclusions: CRP levels are associated with in-hospital mortality in patients with COVID-19 who had also received coronary artery disease with a history of coronary intervention.

Relationship of Neutrophil Lymphocyte Ratio (NLR) with Parathyroid Hormone (PTH) in Maintenance Hemodialysis Patients

Background: Neutrophil-Lymphocyte-Ratio (NLR), a simple derived parameter of routine CompleteBlood Counts (CBC), has been shown to be better than WBC count as a marker for inflammation inmany contexts. Inflammation is associated with adverse outcomes in hemodialysis patients.Methods: A cross sectional study was designed on 100 maintenance hemodialysis Patients in atertiary care hospital in Eastern India after IRB permission and informed consent. 88 completeresults became available. Complete blood count (CBC), routine PTH and biochemistry analysis wereperformed. KDIGO 2009 cut offs were used to classify patients by PTH levels (PTH&lt;2ULN, PTH 2-9ULN &amp; PTH&gt;9 ULN). NLR was calculated and NLR of 3.5 was used as high inflammation cut off.Results: In Analysis of 88 samples, significant Pearson Correlation with NLR was shown by Albumin,Hemoglobin, PTH, Gender, Age, and Sugar, but involved collinearities. Multiple Linear Regressionwith Robust estimation of Standard Errors retained only PTH as a significant predictor (Beta=-0.273, P=0.033) of NLR and Albumin as a borderline significant predictor (Beta= -0.501, P=0.061). The population was partitioned into 3 sets based on PTH as per KDIGO guideline.Conclusion: Our study suggests that PTH is a significant predictor of inflammation as measured byNLR, independent of the other parameters, and it has an overall weak negative association withinflammation especially in the mid-range (PTH 2-9 ULN) subgroup, which largely corroborates withavailable but scant literature.

The relationship between hematological parameters and disease activity in İnflammatory bowel disease

Objective: Serum biomarkers are frequently used to assess disease activities in Ulcerative Colitis (UC) and Crohn disease (CD). But none of them are specific for intestinal inflammation. There are studies showing that hematological parameters predict inflammation in the body. Although previous studies have shown that the neutrophil / lymphocyte ratio (NLR) is associated with disease activity in UC, this relationship has not been shown in CD. In our study, the relationship of NLR and other hematological parameters to disease activity in UC and CD was evaluated. Material and Method: A total of 197 UC (107 active, 90 remissions), 97 CD (50 active, 47 remissions) and 26 age and sex matched healthy control groups were included in the study. The disease activity and CRP, ESR, hemogram parameters were recorded. NLR, Platelet/lymphocyte (PLR), MPV/platelet and RDW/platelet ratios were calculated. Parameters were compared between UC, CD and control groups according to activity status. Results: In UC, leukocyte, neutrophil, monocyte, platelet, platecrit (Pct), PLR, ESR, CRP values were found to increase significantly in the control, remission and active groups with a certain trend, respectively. Hemoglobin (Hb), hematocrit (HCT) and RDW/platelet were shown to decrease respectively. NLR and MPV/platelets were significantly different between the groups of active UC, UC in remission and control. Other parameters were not statistically significant. In CH, ESR, CRP, platelet, Pct, PLR were found to increase significantly with a certain trend in control, remission and active groups, respectively. Hb, HCT, MCV, MCH and RDW/platelets were found to decrease with a certain trend. Leukocyte, neutrophil, lymphocyte, monocyte count, MCHC, NLR and MPV/platelet were significantly different between the CD and control groups. In CD, eosinophil count and RDW were not statistically significant. ESR, CRP, NLR and PLR had acceptable sensitivity-specificity in predicting active patients in CD and UC. ESR, CRP, WBC, neutrophil, monocyte, platelet, Pct, NLR, PLR, MPV/platelet and RDW/platelet parameters were significant factors in predicting active disease in UC and CD. Conclusion: Many hemogram parameters change with activity in IBD. Although not specific for IBD, NLR and PLR are as effective as CRP and ESR in detecting active patients in IBD and can be used as markers to demonstrate activity.

The Relationship of Neutrophil-Lymphocyte Ratio and Platelet-Lymphocyte Ratio with Bone Mineral Density in Korean Postmenopausal Women.

The neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) are known to be markers of the systemic inflammatory response. However, the few studies that have been done on the relationship between the NLR and PLR and osteoporosis have yielded inconsistent results. Therefore, we assessed the relationship between the NLR and PLR and bone mineral density (BMD). This study was conducted with postmenopausal patients admitted to an orthopaedic hospital. Data including BMD, NLR, PLR and covariates were obtained from the subjects' medical records. In total, 407 postmenopausal patients were enrolled in this study. Analysis of covariance was performed to identify significant differences in BMD according to NLR and PLR. After adjusting for other covariates, a quartile of NLR was negatively associated with the mean value of lumbar BMD (p=0.040, p for trend=0.005) but not with the mean value of femur neck BMD. However, there were no significant associations among the PLR, the BMD of the lumbar and the femur neck. In conclusion, the quartile of NLR was negatively associated with the mean value of lumbar BMD in Korean postmenopausal patients.

Evaluation of neutrophil/lymphocyte ratio and platelet/lymphocyte ratio in recurrent epistaxis in childhood: case controlled study.

Introductionthe aim of this study was to investigate the possible relationship of neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) and routine hematological parameters with recurrent epistaxis in children.Methodsİn this retrospective case-controlled study, 294 patients aged between 2 and 18 years who applied to the Tokat State Hopital Ear Nose Throat Clinic due to recurrent epistaxis between January 1st 2013 and December 31st December 2017 and 329 sex-and age-matched controls were investigated.ResultsNLR was 1.45±0.75 in the study group and the 1.35±0.7 in the control group. There was no significant difference between the groups (p>0.05). PLR values were found significantly (p<0.05) higher in the study group than in the control group (103,21±29.57 vs. 97,3±30.38). Red Blood Cell Distribution Width (RDW) values were found significantly (p<0.05) lower in the study group than in the control group (39,56±2,87 and 38,92±2,46).Conclusionthe increase of PLR, an inflammatory marker, in epistaxis supports the effect of inflammatory factors in the etiology of epistaxis. However, more study in future is needed to support this.

Correlation Between Neutrofil-Limphocyte Ratio Before Chemoteraphy and Objective Response Platinum based Chemoteraphy on Lung Cancer Patient

Background: Lung cancer is the leading cause of death from cancer. One type of cancer is non-small cell lung cancer (NSCLC). The body fights against cancer cells by immune surveillance mechanisms involving the role of neutrophils and lymphocytes. Chemotherapy is a modality that is usually used as a therapy in patients’ NSCLC. To assess chemotherapy’s prognostic, research needs to be done to find the relationship between the neutrophil-lymphocytes ratio before chemotherapy with objective response after chemotherapy in patients with NSCLC&#x0D; Methods: This study was an observational study of retrospective cohort analytics which samples are secondary data from medical records of NSCLC patients in RSUD Dr. Soetomo who received chemotherapy by linking the neutrophils-lymphocytes ratio before chemotherapy with objective response after chemotherapy based on RECIST’s criteria and analyzed by spearman correlation test method and RNL cut off value with ROC curve and kappa test&#x0D; Results: Sixty-four subjects were analyzed in this study, the relationship of neutrophil-lymphocyte ratio with chemotherapy objective response after 2 cycles with P=0.354 (

Effect of highly active antiretroviral therapy on neutrophil/lymphocyte ratio using white rabbit

Background: There is an increasing reliance on neutrophil/lymphocyte ratio (NLR) as a prognostic marker in certain diseases. Observations have suggested the effects of administering highly active antiretroviral therapy (HAART) to human immunodeficiency virus (HIV) patients to be beneficial as well as having its side effects. Hence, this study is designed to examine the relationship of NLR of HAART in the management and disease progression of HIV infection. Materials and Methods: Twenty male white rabbits weighting between 0.8 and 1.8 kg were randomly assigned to five Groups A, B, C, D, and E with four animals per group. Two milliliters of venous blood was aseptically collected before HAART administration and on days 5, 10, 15, and 20 of treatment. Groups B, C, D, and E received graded doses of 15, 20, 25, and 34 mg/kg body weight of the drug combinations (efavirenz, lamivudine, and tenofovir disoproxil fumarate tablets once daily for 20 days). Neutrophil/lymphocyte counts were determined using hematology autoanalyzer. Results: Showed a significant reduction (P< 0.05) in NLR before HAART administration (controls) when compared to administration of HAART at 15, 20, 25, and 35 mg/kg 5 days after drug administration. The same trend was observed in the various groups at 10, 15, and 20 days after drug administration. Conclusion: Administration of HAART has a significant association on NLR.

Association of neutrophil-lymphocyte ratio with metabolic syndrome and its components in Asian Indians (CURES-143)

BackgroundMetabolic syndrome (MS) is the state of chronic low grade inflammation. This study looks at the relationship of neutrophil-lymphocyte ratio (NLR) in subjects with and without MS in Asian Indians. MethodsStudy subjects (n=754) were recruited from the Chennai Urban Rural Epidemiology Study. MS was defined using the National Cholesterol Education Program-Adult Treatment Panel (NCEP-ATP) III criteria modified for waist according to World Health Organization Asia Pacific guidelines. A complete hemogram was done in all subjects using a five-part hematology analyzer (model SF-3000; Sysmex, Kobe, Japan). The NLR was calculated as the ratio between counts for neutrophils and total lymphocytes in subjects with (n=422) and without (n332) MS and correlated with number of metabolic abnormalities in those with MS. ResultsSubjects with five metabolic abnormalities had the highest NLR, and with decreasing number of metabolic abnormalities, the NLR decreased linearly (p for trend <0.001). Logistic regression analysis revealed that even after adjusting for age, gender and body mass index, MS was strongly associated with NLR (p<0.001). ConclusionAmong Asian Indians, NLR is correlated with MS and also with the number of metabolic abnormalities.

Abstract P6-08-48: Neutrophil/lymphocyte ratio (NLR) can be one of the useful predictive prognostic markers for the metastatic breast cancer (MBC)

Abstract Introduction: The possibility of tumor infiltlating lymphocytes as a predictive marker of the neoadjuvant chemotherapy for breast cancer was discussed at SABCS 2013. Cancer microenvironment formed by the immune and inflammatory cells is noticed to be one of the factors for tumor growth, invasion or metastasis. To figure out the macro inflammatory environment as an extension of the microenvironment, the neutrophil / lymphocyte ratio (NLR) is a useful method and a simple indicator of systemic inflammatory state. We have some reports that NLR can predict the prognosis in gastric cancer and colorectal cancer. But in breast cancer, few reports can be seen. We examined the relationship of NLR and the risk of recurrence in curable breast cancer in our hospital, and could not detect the specific relations. We hypothesized one of the reasons that resectable breast cancers are not in systemic phase in the view of inflammatory or immune reaction. Therefore, the next, in metastatic breast cancer (MBC), absolutely systemic disease, we tried to reveal the relationship of the NLR at the recurrence and the prognosis. Purpose: To evaluate the NLR affects the Overall Survival (OS) of the patients of MBC or not. Patients: From 2003 to 2013, we have 300 MBC patients in our hospital included 53 Stage4 patients at the first visit. Median Disease free survival (DFS) is 911-day, the median OS after the recurrence is 1196-day. Average value of the NLR is 2.85. The reasons of MBC are bone metastases, pleural and pulmonary metastases, liver metastasis, lymph node metastasis, central nervous system (CNS) metastasis, unresectable metastatic chest wall recurrence, or other. Result: By univariate analysis, NLR ≥3.7(p&amp;lt;0.01), DFS &amp;gt;1000 days, (p&amp;lt;0.01), liver metastases, (p&amp;lt;0.05), CNS metastasis (p&amp;lt;0.01), and 2 or more organs metastasis (p&amp;lt;0.05) made a contribution to poor OS. Between these 5 factors, special relations were not seen. Other factors, stage4, organ metastasis except for liver and CNS, tumor subtype and the age at recurrence had no significant effects for OS. Out of these 5, not only DFS &amp;gt;1000(p&amp;lt;0.01) or CNS metastasis (p&amp;lt;0.01) but also NLR ≥3.7 (p&amp;lt;0.05) were the independent prognostic factors by using multivariate analysis. Discussion: The NLR was one of the prognostic factors which we can easily and simply examine by blood sample. The reason of this fact, we suggest, is that the whole body micro-environment caused by the immune or inflammatory cells at MBC occurred contributes to tumor growth. For hormone receptor positive MBC without life threading organ metastasis, we select hormonal therapy first, usually. But, high NLR MBC patient have a possibility of selection for up-front chemotherapy even if without life threading metastasis. High Ki67-index as well as high NLR may be useful for the prognostic biomarker, however, make no decision for the chemotherapy agents. First, we need to accumulate further retrospective cases and plan the prospective study to make sure of the adequate treatment divided by NLR. Conclusion: The NLR ≥3.7 is one of the independent predictive prognostic factors for MBC as well as DFS &amp;gt;1000 days and CNS metastasis. Citation Format: Takeshi Miyamoto, Tomomi Fujisawa, Akiko Morishita, Yasuhiro Yanagita. Neutrophil/lymphocyte ratio (NLR) can be one of the useful predictive prognostic markers for the metastatic breast cancer (MBC) [abstract]. In: Proceedings of the Thirty-Seventh Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2014 Dec 9-13; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2015;75(9 Suppl):Abstract nr P6-08-48.

Relation of admission neutrophil/lymphocyte ratio to angiographic no-reflow phenomenon in patients with ST-elevated myocardial infarction undergoing primary coronary intervention

To investigate the relationship of the neutrophil/lymphocyte ratio (NLR) on admission and angiographic no-reflow phenomenon in patients with ST-segment elevation myocardial infarction (STEMI) who had undergone primary percutaneous coronary intervention (PCI). 232 patients who had undergone PCI between 2010 and 2013, were included and divided into two groups based upon the thrombolysis in myocardial infarction (TIMI) flow gradings. No-reflow was defined as post-PCI TIMI Grade 0, 1 and 2 flows (group I). Normal-flow was defined as TIMI 3 flow (group II). Receiver operating characteristic curve (ROC) analysis was used to identify the predictive effect of NLR on no-reflow phenomenon. Relationship of NLR and no-reflow was assessed by multivariate logistic regression. All statistical calculations and analyses were performed using SPSS 11.0. NLR was significantly higher in group I (n = 45) compared with group II (n = 187) [4.1(2.4-6.5) vs. 2.4 (1.7-3.8), P = 0.001]. In ROC analysis, NLR>3.2 predicted no reflow with 80% sensitivity and 73% specificity. Patients with elevated NLR had a higher incidence of no-reflow phenomenon than those with non-elevated NLR (34.8% vs. 9.3%, P < 0.001). Also, NLR (>3.2) was an independent predictor of no-reflow development [odds ratio 3.70, 95% confidence interval(1.39-9.80), P = 0.009]. NLR was an independent predicator for no-reflow development in STEMI patients who had undergone PCI. This simple and low-cost parameter could provide useful information for the early risk evaluation on these patients.

Assessment of neutrophil-lymphocyte ratio in ulcerative colitis: A promising marker in predicting disease severity

In order to diagnosis and monitor the disease activity of ulcerative colitis (UC), serum biomarkers are generally used, but none of them are specific for intestinal inflammation. It is therefore desirable in clinical practice to be able to assess disease activity with simple, inexpensive and objective tools. The objective of the present study was to assess whether the neutrophil-lymphocyte ratio (NLR) would be useful in predicting disease severity in UC patients who had not received corticosteroid or immunosuppressive drugs within a defined period of time. Additionally, a possible relationship of NLR with other inflammatory markers in UC patients was also investigated. We designed a retrospective study examining the utility of NLR in estimating disease severity in UC patients admitted to our hospital between 2008 and 2011. In total, 119 patients with active UC and 77 patients with inactive UC were enrolled in the study group, and 59 age and gender matched healthy subjects were included as the control group. Disease activity was assessed using Truelove and Witts criteria. In the active UC group, NLR values were found to be elevated compared to inactive UC patients and controls (3.22 ± 1.29, 1.84 ± 0.69 and 2.01 ± 0.64, respectively). Using ROC statistics, a cut-off value of 2.16 indicated the presence of active disease with a sensitivity of 81.8% and a specificity of 80.5% (positive predictive value [PPV] 86.8%, negative predictive value [NPV] 73.8%). NLR values were found to be correlated with WBC and ESR levels. The present study revealed that NLR is increased in active UC. Peripheral blood NLR can reflect disease activity and can be used as an additional marker for estimating intestinal inflammation.