Value Of Lymphocyte-monocyte Ratio Research Articles

Evaluation of inflammatory biomarkers and the ratio of hemoglobin-red cell distribution width in patients with rheumatoid arthritis treated with tumor necrosis factor-alpha inhibitors.

The aim of this study was to examine pre-treatment and post-treatment hemogram-derived inflammatory biomarkers in patients with rheumatoid arthritis (RA) who received anti-tumor necrosis factor (TNF)-α treatment. The data of 1182 patients with RA were screened. Among them, 207 patients who met the eligibility criteria were included in the retrospective study. Demographic parameters, disease activity, and blood cell-derived indexes were evaluated. The neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), lymphocyte-monocyte ratio (LMR), and hemoglobin-red cell distribution width (Hb/RDW) rates were evaluated before treatment and at the third month of treatment in patients with RA who received anti-TNF-α treatment. According to the EULAR response criteria, 12.6% of the 207 patients responded to anti-TNF-α treatment as none, 21.3% as good, and 66.2% as moderate, respectively. Post-treatment NLR and PLR values were significantly lower than pre-treatment values (p < 0.001), whereas post-treatment LMR and Hb/RDW values were significantly higher than pre-treatment values (respectively, p = 0.001 and p = 0.012). The difference between pre-treatment and post-treatment values of LMR and Hb/RDW was significantly higher when compared to the moderate + good response groups than the none-response group (p = 0.002 and p = 0.014, respectively). However, in the receiver operating characteristic curve analysis, these parameters were not found to be significant in predicting treatment response. Significant changes were detected in hemogram-derived inflammatory markers of the groups responding to anti-TNF-α treatment. They can be used as a guide during treatment follow-up. Yet, they do not predict treatment response. Key Points • RA may manifest with periods of remission and activation, and regular follow-up is essential. • There is a demand for readily available, reproducible, and cost-effective parameters to assess treatment response. • Hemogram-derived inflammatory markers differ in relation to anti-TNF-α treatment response in RA. • None of those markers demonstrate an acceptable predictive performance in distinguishing patients based on their response to TNF-α inhibitors.

Comparison of Lymphocyte/Monocyte ratio (LMR) with Child-Pugh Score and MELD Score in the Determination of Hepatic Dysfunction Severity and Outcome in Cirrhotic Patient

Background: Lymphocyte/monocyte ratio (LMR) is a simple and effective marker that has the potential to predict the severity of hepatic dysfunction in a cirrhotic patient, like the Model for End-Stage Liver Disease (MELD) score and the Child- Pugh (CP) score. However, the usefulness of this newer tool has not yet been tested. Objectives: Comparison of Lymphocyte/Monocyte ratio with Child-Pugh Score and MELD Score in the determination of hepatic dysfunction severity in patients with cirrhosis was the objective of the study. Materials and Methods: This cross-sectional analytical study was conducted on cases of cirrhotic patients in the Department of Gastroenterology, Bangabandhu Sheikh Mujib Medical University, dated from September 2018 to August 2019. A total of 40 compensated cases and 82 decompensated cases were included in the process of obtaining informed written consent. Information about clinical profile, laboratory parameters (complete blood count including ESR, serum total bilirubin, serum albumin, ALT, AST, serum creatinine, prothrombin time, INR, etc.) were collected. LMR, MELD score, and CP score were calculated both in compensated and decompensated cirrhotic patients to assess the relationship with the severity of hepatic dysfunction. The correlation between LMR and the CP/MELD score was established by the Pearson correlation test. The receiver operating characteristic (ROC) curve and cut-off values of LMR were obtained, and areas under the ROC (AUROC) curve were calculated to identify the best LMR and/or the MELD score or CPS for predicting hepatic decompensation. The Bland-Altman plot and the Heliey- MacNeil test were used for comparison of measurement techniques. The data were analyzed with the help of SPSS version 20. Observation and Results: The mean age of the decompensated group was higher than that of the compensated group (p&lt;0.05). The mean values for LMR and MELD and CP scores were 7.93±3.08, 5.25±0.43 &amp; 7.10 ±1.19, respectively. Average LMR was significantly higher in compensated cirrhosis patients while CP and MELD Score was lower in that group (p&lt;0.001). MELD and CP were positively correlated with each other (p&lt;0.001). LMR was negatively correlated to both MELD and CP scores (p&lt;0.001). Of all patients, only 4 died (3.3%) and rest 118 (96.7%) survived. The cut off value of LMR, CP and MELD were LMR ≤ 2.18 (sensitivity: 75%, specificity: 87.3%), CPS ≥13.5 (sensitivity: 75%, specificity: 98.3%) &amp; MELD ≥30.5 (sensitivity: 75%, specificity: 94.9%) respectively. Pairwise comparison showed that the difference between the AUCs of MELD and LMR was not statistically significant (0.953 vs 0.887; p=0.081). Patients in the low LMR group showed decreased survival than those in the high LMR group (p=0.000). The no survived group had lower LMR and higher MELD and CP scores than those of the survived group (p&lt;0.001). Conclusion: In comparison with Child-Pugh Score and MELD Score in the determination of hepatic dysfunction severity in cirrhotic patients, Lymphocyte/ Monocyte ratio is a useful tool.

The predictive value of systemic inflammatory markers in 902 patients with tunneled hemodialysis catheter

AimThis study aimed to assess the predictive role of neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, lymphocyte-to-monocyte ratio, and mean platelet volume, on catheter survival in chronic hemodialysis patients, analyzing both infectious and non-infectious complications.MethodsA retrospective analysis encompassed 1279 tunneled catheter insertion procedures involving 902 patients between March 2014 and October 2018. Patients were categorized into two main groups: (i) initial placement and (ii) exchange. The exchange group was further stratified into four subgroups: infection, dysfunction, displacement, and transitioning temporary hemodialysis catheters to long-term ones. Hematologic ratios were calculated from baseline hemogram data, including neutrophil, lymphocyte, monocyte, and platelet counts, while mean platelet volume was derived from the same hemogram.ResultsThe patients in the exchange group displayed significantly higher lymphocyte and monocyte values (p < 0.001), while lower values were noted for neutrophil–lymphocyte ratio and platelet-lymphocyte ratio (p < 0.001). The transition group displayed higher monocyte values and lower mean platelet volume and lymphocyte-monocyte ratio values (p < 0.05). In the infection-related exchange subgroup, higher neutrophil count, mean platelet volume, neutrophil–lymphocyte ratio, and platelet-lymphocyte ratio values were observed compared to other groups (p < 0.05). Cases related to catheter dysfunction exhibited increased lymphocyte-monocyte ratio but lower neutrophil, monocyte, neutrophil–lymphocyte ratio, and platelet-lymphocyte ratio values (p < 0.05).ConclusionThis study highlights the interest of specific inflammatory markers, particularly monocytes, neutrophil–lymphocyte ratio, and platelet-lymphocyte ratio, in the management of tunneled catheters, notably in patients undergoing exchanges. However, cut-off values, essential for constructing management algorithms, are currently lacking, and prospective multicenter studies are needed for further elucidation.Graphical abstract

The Prognostic Value of the Combination of the Prognostic Nutritional Index and the Lymphocyte:Monocyte Ratio for the Prediction of Patients with Muscle-Invasive Bladder Cancer.

To explore the efficacy of combining the prognostic nutritional index (PNI) and the lymphocyte:monocyte ratio (LMR) for patients with muscle-invasive bladder cancer (MIBC). Of 172 patients who were diagnosed with MIBC in our hospital, 94 were eligible for the study. The clinical data of the 94 patients with MIBC were collected. The patients were divided according to the optimal cut-off values for the preoperative PNI and LMR into a low-PNI subgroup (PNI <44.15, 52 patients), a high-PNI subgroup (PNI ≥44.15, 42 patients), a low-LMR subgroup (LMR <2.98, 50 patients) and a high-LMR subgroup (LMR ≥2.98, 44 patients). The area under the receiver operating characteristic (ROC) curve (AUC) was used to analyse the efficacy of the PNI and the LMR in predicting the prognosis of patients with MIBC. Univariate and multivariate logistic regression analyses were performed to evaluate prognostic factors for patients with MIBC. Kaplan-Meier (K‒M) survival analysis was used for overall survival (OS) analysis to explore the ability of the PNI combined with the LMR to predict the prognosis of patients with MIBC. The optimal cut-off values for the preoperative PNI and the preoperative LMR were 44.15 and 2.98, respectively, on the basis of ROC curves. ROC curve analysis revealed that the PNI (AUC = 0.720, sensitivity 65.9%, specificity 74.50%, Youden index 0.399) and the LMR (AUC = 0.724, sensitivity 65.9%, specificity 70.0%, Youden index 0.395) both had good prognostic efficacy for patients with MIBC. The results of univariate and multivariate logistic regression analyses showed that preoperative PNI <44.15 was an independent risk factor for OS in patients with MIBC (p = 0.027). Based on K‒M survival curve analysis, patients with PNI <44.15 and LMR <2.98 had the shortest OS (p = 0.00002). Low preoperative PNI and LMR values are indicative of poor prognosis in patients with MIBC. The efficacy of their combination was better than that of the factors independently.

Pediatric chronic kidney disease: blood cell count indexes as inflammation markers.

Chronic kidney disease (CKD) is defined as a progressive decline of kidney functions. In childhood, the main triggering factors are congenital anomalies of the kidneys and urinary tract (CAKUT) and glomerulopathies. Inflammatory responses present challenges for diagnosis and staging, which justifies studies on biomarkers/indexes. To define blood cell count indexes and verify their association with pediatric CKD etiology and staging. The included indexes were: Neutrophil-Lymphocyte Ratio (NLR), Derived Neutrophil-Lymphocyte Ratio (dNLR), Lymphocyte-Monocyte Ratio (LMR), Systemic Inflammation Response Index (SIRI), Aggregate Index of Systemic Inflammation (AISI), and Systemic Immune-Inflammation Index (SII). We determined the indexes in 52 pediatric CKD patients and 33 healthy controls by mathematical calculation. CKD patients were separated in five groups based on the etiology and staging: Group IA: glomerulopathies at stage 1 or 2; IB: glomerulopathies at stage 3 or 4; IIA: CAKUT at stage 1 or 2; IIB: CAKUT at stage 3 or 4; and III: stages 3 or 4 of other etiologies. In addition, we combined all patients with CKD in one group (IV). Group V was a healthy control group. Lower values of LMR were observed for groups IB and IIB compared to group V (p = 0.047, p = 0.031, respectively). Increased values of SIRI were found for group III versus group V (p = 0.030). There was no difference for other indexes when the groups were compared two by two. The LMR and SIRI indexes showed promising results in the evaluation of inflammation, as they correlated with CKD etiologies and specially staging in these patients.

The value of lymphocyte to monocyte ratio in the prognosis of head and neck squamous cell carcinoma: a meta-analysis.

Although lymphocyte-monocyte ratio (LMR) is a potential prognostic biomarker in many tumor indications, a doubt occurs around its association with head and neck squamous cell carcinoma (HNSCC). We aimed to evaluate the predictive value of LMR in patients with HNSCC. We searched PubMed, Web of Science, EMBASE, and the Cochrane database from inception to May 8, 2023 for systematic review and meta-analysis on LMR and outcomes related to HNSCC development. STATA software was used to estimate the correlation between LMR and prognosis. The risk ratio (hazard ratio, HR) and 95% confidence interval l (CI) for overall survival (OS), disease-free survival (DFS), cancer-specific survival (CSS), and progression-free survival (PFS) were calculated, and the association between LMR and OS was further validated by subgroup analysis. The source of heterogeneity with the results of subgroup analysis was analyzed by meta-regression analysis. This meta-analysis was registered at PROSPERO (CRD42023418766). After a comprehensive exploration, the results of 16 selected articles containing 5,234 subjects were evaluated. A raised LMR was connected to improved OS (HR = 1.36% CI [1.14-1.62] P = 0.018), DFS (HR = 0.942, 95% CI [0.631-1.382], P = 0.02), and PFS (HR = 0.932, 95% CI [0.527-1.589], P < 0.022). Subgroup analysis indicated that patients with a low LMR level had a poor prognosis with a critical value of ≥4. The LMR was found to be prognostic for cases with an LMR of <4. The meta-regression analysis showed that the cut-off values and treatment methods were the primary sources of high heterogeneity in patients with HNSCC. Our study suggested that an elevated LMR is a potential prognostic biomarker in patients with HNSCC and could be used to predict patient outcomes.

Neutrophil-to-monocyte ratio is the better new inflammatory marker associated with rheumatoid arthritis activity.

Rheumatoid arthritis (RA) is a systemic autoimmune disease that chronically affects patients with episodes of inflammation. New inflammatory hematological markers were investigated for follow-up, such as the neutrophil-monocyte ratio (NMR), lymphocyte monocyte ratio (LMR), and neutrophil-lymphocyte ratio (NLR). This study was conducted to determine the most useful marker based on studies of association with RA disease activity and correlation with the classical markers C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and rheumatoid factor (RF). This case-control study included 62 chronic RA patients who had previously been diagnosed and experienced episodes of symptoms while attending a variety of public and private rheumatology clinics in Ibb City, Republic of Yemen, for the period of September 1 to November 30, 2021. Twenty healthy volunteers were included in this study. Complete blood count, CRP, ESR, and RF levels were measured in all participants. The total leukocyte count, neutrophil count, platelet count, NMR, LMR, and NLR were positively correlated with CRP and ESR, but the monocyte count was reversed. The area under the curve (AUC = 0.861, 95% confidence interval [CI] = 0.769-0.948) for the NMR cutoff value of 4.7 was equal to that of CRP and close to that of ESR. This NMR cutoff value had 87% sensitivity and 80% specificity. LMR and NLR cutoff values of 4.35 and 1.35, respectively, resulted in AUCs of (AUC = 0.807, 95% CI, 0.708-0.905) and (AUC = 0.699, 95% CI, 0.571-0.819); their sensitivity and specificity were 62.3%, 90%, 57.4%, and 80%, respectively. As a convenient and low-cost inflammatory marker of RA activity, NMR outperformed LMR and NLR.

Platelet-lymphocyte ratio and lymphocyte-monocyte ratio in inflammatory bowel disease and disease activity: A systematic review and meta-analysis.

This review aimed to examine if the platelet-lymphocyte ratio and lymphocyte-monocyte ratio can be useful in determining disease activity in patients with inflammatory bowel disease. PubMed, CENTRAL, Scopus, Embase, and Web of Science were searched for studies published up to 9 January 2023. Platelet-lymphocyte ratio and lymphocyte-monocyte ratio values from active and remission inflammatory bowel disease cases were compared to generate a mean difference (MD). Nine studies were included. Meta-analysis showed that inflammatory bowel disease patients with active disease had significantly higher values of platelet-lymphocyte ratio as compared to those in remission (MD: 63.46 95% CI: 35.74, 91.17, I2 = 89%). The values of platelet-lymphocyte ratio were significantly higher in both active ulcerative colitis and Crohn's disease patients. Meta-analysis also showed that lymphocyte-monocyte ratio values were significantly lower in active inflammatory bowel disease patients as compared to those under remission (MD: -1.28 95% CI: -1.42, -1.14, I2 = 4%). Lymphocyte-monocyte ratio values were significantly lower in both ulcerative colitis and Crohn's disease patients with active disease. Platelet-lymphocyte ratio and lymphocyte-monocyte ratio can be useful blood-based markers in differentiating active disease in inflammatory bowel disease patients. Active cases of ulcerative colitis and Crohn's disease have high platelet-lymphocyte ratio and low lymphocyte-monocyte ratio as compared to those in remission. Further studies with a larger sample size are needed to strengthen conclusions.

Association of pre-treatment lymphocyte-monocyte ratio with survival outcome in patients with head and neck cancer treated with chemoradiation

BackgroundGiven the role of systematic inflammation in cancer progression, lymphocyte-monocyte ratio (LMR) from peripheral blood has been suggested as a biomarker to assess the extent of inflammation in several solid malignancies. However, the role of LMR as a prognostic factor in head and neck cancer was unclear in several meta-analyses, and there is a paucity of literature including patients in North America. We performed an observational cohort study to evaluate the association of LMR with survival outcomes in North American patients with head and neck cancer.MethodsA single-institution, retrospective database was queried for patients with non-metastatic head and neck cancer who underwent definitive chemoradiation from June 2007 to April 2021 at the Roswell Park Comprehensive Cancer Center. Primary endpoints were overall survival (OS) and cancer-specific survival (CSS). The association of LMR with OS and CSS was examined using nonlinear Cox proportional hazard model using restricted cubic splines (RCS). Cox multivariable analysis (MVA) and Kaplan–Meier method were used to analyze OS and CSS. Pre-radiation LMR was then stratified into high and low based on its median value. Propensity scored matching was used to reduce the selection bias.ResultsA total of 476 patients met our criteria. Median follow up was 45.3 months (interquartile range 22.8–74.0). The nonlinear Cox regression model showed that low LMR was associated with worse OS and CSS in a continuous fashion without plateau for both OS and CSS. On Cox MVA, higher LMR as a continuous variable was associated with improved OS (adjusted hazard ratio [aHR] 0,90, 95% confidence interval [CI] 0.82–0.99, p = 0.03) and CSS (aHR 0.83, 95% CI 0.72–0.95, p = 0.009). The median value of LMR was 3.8. After propensity score matching, a total of 186 pairs were matched. Lower LMR than 3.8 remained to be associated with worse OS (HR 1.59, 95% CI 1.12–2.26, p = 0.009) and CSS (HR 1.68, 95% CI 1.08–2.63, p = 0.02).ConclusionLow LMR, both as a continuous variable and dichotomized variable, was associated with worse OS and CSS. Further studies would be warranted to evaluate the role of such prognostic marker to tailor interventions.

Pretreatment lymphocyte-monocyte ratio (LMR) as a superior predictor of short-term progression outcomes in patients with gastric cancer receiving second- and later-line apatinib regimens.

Lymphocyte-monocyte ratio (LMR) has previously been used as a prognostic predictor in various solid tumors. This research aims in comparing the prognostic predictive Please check and conability of several inflammatory parameters and clinical parameters to validate further the excellent prognostic value of LMR in patients with gastric cancer treated with apatinib. Monitor inflammatory, nutritional parameters and tumor markers. Cutoff values of the parameters concerned were identified with the X-tile program. Subgroup analysis was made via Kaplan-Meier curves, and univariate and multivariate Cox regression analyses were used to find independent prognostic factors. The nomogram of logistic regression models was constructed according to the results. A total of 192 patients (115 divided into training group and 77 into validation group) who received the second- or later-line regimen of apatinib were retrospectively analyzed. The optimal cutoff value for LMR was 1.33. Patients with high LMR (LMR-H) were significantly longer than those with low LMR (LMR-L) in progression-free survival (median 121.0days vs. median 44.5days, P < 0.001). The predictive value of LMR was generally uniform across subgroups. Meanwhile, LMR and CA19-9 were the only hematological parameters with significant prognostic value in multivariate analysis. The area under the LMR curve (0.60) was greatest for all inflammatory indices. Adding LMR to the base model significantly enhanced the predictive power of the 6-month probability of disease progression (PD). The LMR-based nomogram showed good predictive power and discrimination in external validation. LMR is a simple but effective predictor of prognosis for patients treated with apatinib.

Evaluation of neutrophil-lymphocyte ratio, lymphocyte-monocyte, and monocyte-high density lipoprotein ratios in patients with fibromyalgia and determination of their relationship with disease activity, pain, and depression levels.

This study aimed to evaluate neutrophil-lymphocyte ratio, lymphocyte-monocyte, and monocyte high-density lipoprotein ratios in patients with fibromyalgia and determine their relationship with disease activity, pain, and depression levels.This study was conducted with 40 healthy controls and 87 newly fibromyalgia (FM) diagnosed patients. Demographic characteristics, duration of pain, body mass index (BMI), and laboratory test results were recorded. The hematological indices and ratios were determined with a hemogram test. Disease activity was evaluated with a fibromyalgia impact questionnaire (FIQ). Depression status was evaluated with the beck depression inventory (BDI).A total of 127 participants, 40 in the control group and 87 in the patient group, were included in the study. BMI values of the patient group were statistically higher than the control group (p=0.025). The white blood cell count of the patient group was statistically higher than the control group (p=0.007). Monocyte values were statistically higher in the patient group (p<0.001). Monocyte to high-density lipoprotein-cholesterol ratio (MHR) values in the patient group were statistically higher than the control group (p<0.001). Lymphocyte-monocyte-ratio (LMR) values of the control group were statistically higher than the patient group (p<0.001).This study shows that in fibromyalgia patients, monocyte level and MHR were higher than in healthy subjects. Also, high-density lipoprotein-cholesterol (HDL-C) level was found lower, and the total cholesterol level was found higher in patients with FM. Increased LMR and HDL-C values were found as responsible for decreasing the risk of developing FM and increased glucose and total cholesterol values were responsible for increasing the risk of FM developing.

Association of pretreatment lymphocyte-monocyte ratio with survival outcome in patients with head and neck cancer treated with chemoradiation.

6052 Background: Lymphocyte-monocyte ratio (LMR) from peripheral blood has been suggested as a biomarker to assess the extent of inflammation in several solid malignancies. However, the role of LMR as a prognostic factor in head and neck cancer (HNC) was unclear in several meta-analyses, and there is a paucity of literature including patients in North America. We performed an observational cohort study to evaluate the association of pre-radiation LMR with survival outcomes in North American patients with HNC. Methods: A single-institution database was queried for patients with non-metastatic HNC who underwent curative-intent definitive chemoradiation from 6/2007 to 4/2021 at the Roswell Park Comprehensive Cancer Center. Patients were excluded if they underwent induction chemotherapy or postoperative radiation. Primary endpoints were overall survival (OS) and cancer-specific survival (CSS). The association of LMR with OS and CSS was examined using nonlinear Cox proportional hazard model using restricted cubic splines (RCS), Cox multivariable analysis (MVA), and Kaplan-Meier method. LMR was stratified into high and low based on its median. Logistic MVA was performed to identify variables associated with low LMR. Propensity scored matching was used to reduce selection bias. Subgroup analyses were performed among those with available human papillomavirus (HPV) status. Results: A total of 476 patients (391 male [82.1%], median [interquartile range] age, 61 [55-67] years) met our criteria. Median follow up was 45.3 months (interquartile range 22.8-74.0). The nonlinear Cox regression model using RCS showed that low LMR was associated with worse OS and CSS in a continuous fashion without plateau and crossed the hazard ratio of 1 at LMR 3.4 for both OS and CSS. On Cox MVA, higher LMR as a continuous variable was associated with improved OS (adjusted hazard ratio [aHR] 0.90, 95% confidence interval [CI] 0.82-1.00, p = 0.04) and CSS (aHR 0.81, 95% CI 0.70-0.94, p = 0.005). The median value of LMR was 3.8. On logistic MVA, patients with other racial background (adjusted odds ratio [aOR] 0.85, 95% CI 0.74-0.97, p = 0.02) and positive HPV status (aOR 0.82, 95% CI 0.72-0.94, p = 0.005) were less likely to have low LMR. Higher T staging was associated with low LMR (aOR 1.15, 95% CI 1.04-1.27, p = 0.005). A total of 186 pairs were matched with well balanced baseline characteristics. LMR lower than 3.8 remained associated with worse OS (HR 1.60, 95% CI 1.13-2.28, p = 0.009) and CSS (HR 1.69, 95% CI 1.07-2.67, p = 0.03). In the subgroup of 319 patients (67.0%) with available HPV data, LMR status was not associated with both OS and CSS regardless of HPV status. Conclusions: Low LMR was associated with worse OS and CSS. Low LMR was also associated with higher T staging, negative HPV status, and White race. Further studies are warranted to evaluate the role of such prognostic marker to tailor interventions.

Comparing Prognostic Scores and Inflammatory Markers in Predicting the Severity and Mortality of Acute Pancreatitis.

Acute pancreatitis is an emergency gastrointestinal condition for which severity prediction is crucial during hospitalization. This study aimed to compare the diagnostic accuracy of inflammatory markers with gold standard scoring systems in predicting pancreatitis severity. A prospective, hospital-based, cohort study was conducted, including 249 patients diagnosed with acute pancreatitis via clinical examination. Laboratory investigations and radiological investigations were conducted. The diagnostic accuracy of the inflammatory markers neutrophil/lymphocyte ratio (NLR), lymphocyte/monocyte ratio (LMR), red cell distribution width (RDW), and prognostic nutritional index (PNI) was compared with gold standard prognostic scores, namely, the Acute Physiology and Chronic Health Evaluation II (APACHE II), Simplified Acute Physiology Score II (SAPS II), Bedside Index of Severity in Acute Pancreatitis (BISAP), and Systemic Inflammatory Response Syndrome (SIRS), in predicting primary and secondary outcomes. All values were analyzed using mean and standard deviation (SD). Sensitivity, specificity, positive predictive value, negative predictive value, and area under the receiver operating characteristic curve for mortality prediction were calculated for NLR, LMR, RDW, and PNI. Of 249 patients with acute pancreatitis (mean age: 39-43 years), 94 were classified as mild acute, 74 as moderately severe acute, and 81 as severe acute. The most common etiology was alcohol use (40.2%), followed by gallstones (29.7%), hypertriglyceridemia (6.4%), steroid use (4%), diabetic ketoacidosis (2.8%), hypercalcemia (2.8%), and complication of endoscopic retrograde cholangiopancreatography (2%). On day 1, mean values of NLR, LMR, RDW, and PNI were 8.23±5.11, 2.63±1.76, 15.93±3.64, and 32.84±8.13, respectively. Compared to APACHE II, SAPS II, BISAP, and SIRS on day 1, day 3, day 7, and day 14, the cutoff values for NLR were 4.06, 10.75, 8.75, and 13.75, respectively. Similarly, on day 1, the cutoff value of LMR was 1.95, and on day 1 and day 3, the cutoff values of RDW were 14.75% and 15%, respectively. The results indicate that inflammatory biomarkers NLR, LMR, RDW, and PNI are comparable with gold standard scoring systems for predicting the severity and mortality of acute pancreatitis. NLR on day 7 was significantly associated with higher severity of illness. NLR on days 3, 7, and 14, LMR on day 1, and RDW on days 1 and 3 were significantly associated with mortality.

Association of systemic inflammatory markers with prognosis in erlotinib-treated EGFR-mutant non-small cell lung cancer.

To evaluate the relationship of overall survival (OS) and progression-free survival (PFS) with the derived neutrophil-lymphocyte ratio (dNLR), neutrophil-lymphocyte ratio (NLR), lymphocyte-monocyte ratio (LMR), and platelet-lymphocyte ratio (PLR) in patients with epidermal growth factor receptor (EGFR)-mutant non-small cell lung cancer (NSCLC). The study included 43 patients with EGFR-mutant metastatic NSCLC. The dNLR, NLR, LMR, and PLR values were calculated using the baseline complete blood counts before and after treatment with erlotinib. The NLR value had the best diagnostic test performance with a sensitivity of 91.3%. dNLR, NLR, LMR, and PLR were found to be significant for the prediction of OS and PFS. While the delta dNLR and NLR values were significant for OS, only the delta NLR value was significant for PFS. The dNLR, NLR, LMR, and PLR values were found to be significant in the prediction of OS and PFS in erlotinib-treated metastatic NSCLC. Further clinical studies are needed to determine the ideal target-specific tyrosine kinase inhibitor in cases of metastatic NSCLC presenting with the EGFR-activating mutation.

Inflammatory biomarkers may predict response to phosphodiesterase type 5 inhibitor treatment in patients with erectile dysfunction.

In this study, we aimed to evaluate the clinical utility of the neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), lymphocyte/monocyte ratio (LMR), and monocyte/high-density lipoprotein cholesterol ratio (MHR) in predicting response to a phosphodiesterase type 5 inhibitor (PDE5i) when used as the first-line medical treatment of erectile dysfunction (ED). This study prospectively included 185 patients who were diagnosed with ED and started PDE5i treatment. After PDE5i treatment, 107 (57.8%) patients with an International Index of Erectile Function-5 (IIEF-5) score below 22 were assigned to Group 1, and 78 (42.2%) patients with an IIEF-5 score of 22 or above were assigned to Group 2. The outcome measures of the study were demographic characteristics and inflammation markers between the groups. The mean IIEF-5 change after PDE5i treatment was 6.1±4.2 points in Group 1 and 11.5±3.2 points in Group 2 (p=0.001). The mean age was 54.6±9.2 years in Group 1 and 47.8±10.3 years in Group 2 (p<0.001), and the median fasting blood glucose values of Groups 1 and 2 were 105 (36) mg/dL and 97 (23) mg/dL, respectively (p=0.010). The LMR and MHR values were 2.39±0.23 and 13.8±7, respectively, for Group 1, and 2.03±0.22 and 17±6.6, respectively, for Group 2 (p=0.044 and p=0.002, respectively). On multivariable analysis, younger age and increased MHR were independent predictors of benefit from PDE5i treatment. This study showed that only MHR as an inflammatory biomarker was an independent predictor for response to PDE5i in the treatment of ED. Also, several factors were predictive of treatment failure.

Evaluation of systemic inflammatory and nutritional indexes in locally advanced gastric cancer treated with adjuvant chemoradiotherapy after D2 dissection.

Many studies have shown that the peripheral blood inflammatory index and nutritional index, such as the platelet lymphocyte ratio (PLR), neutrophil lymphocyte ratio (NLR), lymphocyte monocyte ratio (LMR), systemic inflammation response index (SIRI), pan-immune-inflammation value (PIV), systemic immune-inflammation index (SII), and prognostic nutrition index (PNI), are independent prognostic factors for tumors. The present study aimed to investigate the prognostic role of these peripheral blood indexes before treatment in locally advanced gastric cancer (LAGC) treated with adjuvant chemoradiotherapy after D2 dissection. A total of 89 patients with LAGC who underwent D2 gastrectomy and adjuvant chemoradiotherapy at our hospital from 2010-2018 were eligible. Systemic inflammatory indicators before treatment were evaluated. Receiver operating characteristic curve (ROC), Kaplan-Meier analysis, and Cox regression were utilized for prognosis evaluation. The median follow-up time was 29.1 (4.1-115.8) months. The overall survival at 3 years (OS) and the disease-free survival (DFS) were 78.9% and 59.1%, respectively. According to the ROC curve for 3-year DFS, the best cut-off values of pre-treatment NLR, PLR, LMR, SII, SIRI, PIV and PNI were 1.7, 109.3, 2.9, 369.2, 0.58, 218.7, and 48, respectively. Multivariate Cox regression analysis showed that NLR was an independent prognostic factor for DFS (HR 2.991, 95%CI 1.085-8.248, P = 0.034). Kaplan-Meier analysis showed that a higher NLR (>1.70) was significantly associated with a poorer OS (3-year OS: 68.8% vs 92.9%, P = 0.045) and DFS (3-year DFS: 47.5% vs 80.9%, P = 0.005). In terms of the free locoregional recurrence rate (LRR), the prognosis of patients with high NLR was also significantly worse than those with low NLR (70.2% vs 96.0%, P = 0.017). Paraaortic lymph nodes were the most common site of LRR (7/14 patients). The seven cases of paraaortic lymph node metastasis occurred in patients with high NLR. In our retrospective analysis, we found that pretreatment NLR could serve as a prognostic factor for survival in LAGC treated with adjuvant chemoradiotherapy after D2 dissection, especially for the prediction of LRR and paraaortic lymph node metastasis. Prospective studies are needed to confirm our findings.

Potential diagnostic value of the hematological parameters lymphocyte-monocyte ratio and hemoglobin-platelet ratio for detecting colon cancer.

ObjectiveTo evaluate the efficacy of using the lymphocyte–monocyte ratio (LMR), hemoglobin–platelet ratio (HPR), and carcinoembryonic antigen (CEA) levels alone or in combination for diagnosing colon cancer.MethodsWe assessed 124 consecutive patients who were pathologically diagnosed with colon cancer and 131 patients who were diagnosed with benign colon tumors in this retrospective study. We then analyzed correlations between LMR, HPR, and clinicopathological findings. The diagnostic values of LMR, HPR, and CEA alone or in combination in colon cancer patients were evaluated by receiver operating characteristic curves.ResultsThe median LMR, HPR, and CEA values in colon cancer patients showed significant correlation with the depth of tumor invasion, lymph node metastasis, and TNM stage. Moreover, there was a significant difference in HPR between patients with tumor size ≥5 cm and those with tumor size <5 cm. Compared with LMR, HPR, or CEA alone, combinations of CEA with LMR, CEA with HPR, and HPR with LMR all had higher area under the curve values, among which the combination of all three (LMR, HPR, and CEA) had the highest area under the curve.ConclusionThe combination of LMR, HPR, and CEA may be a valuable indicator for monitoring colon cancer.

The effects of testosterone on transgender males on carotid intima-media thickness and serum inflammatory markers compared within patients with polycystic ovary syndrome

Objective: To evaluate the effects of testosterone on carotid intima-media thickness (CIMT) and serum inflammatory markers compared within transgender males (TGM-Former called female-to-male) and polycystic ovary syndrome (PCOS). Methods: The prospective observational study included 30 TGM, 30 patients with PCOS, and 30 healthy women. Groups were compared for CIMT and hematologic inflammatory markers white blood cell (WBC), lymphocyte/monocyte ratio (LMR), neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), and mean platelet volume (MPV). Results: The CIMT of the TGM group was 0.48 ± 0.09 mm was significantly higher than PCOS (0.41 ± 0.09 mm, p = .005) and the control group (0.38 ± 0.7 mm, p = .001). The mean NLR, LMR, and MPV values were similar (p > .05). TGM had higher WBC levels compared to control women (p = .029). TGM had significantly lower PLR compared to PCOS and the control group (p = .001). CIMT were related to age (r = .390, p = .04) and body mass index (BMI) (r = .392, p = .03) in TGM. Conclusion: Increased CIMT in TGM individuals is not associated with inflammation; it seems to be a deleterious effect of exogenous testosterone exposure. Since increased CIMT may be a sign of serious cardiovascular problems developing in the future, it is suggested that it will be beneficial for these individuals should undergo clinical and radiological evaluation at regular intervals.

Complete blood count during the first trimester predicting spontaneous preterm birth.

This work aimed at assessing the peripheral complete blood count during the first trimester of pregnancy in women with spontaneous preterm birth (sPTB) compared with age-matched controls who are women with healthy pregnancies. This was a cross-sectional case-control study, with 175 sPTB and 175 age-matched healthy controls, carried out between January 2019 and December 2019. Baseline data and the complete blood count parameters examined during the first trimester of all the participants were recorded. The receiver operator characteristic curve (ROC) was used to evaluate cut-off point and diagnostic characteristics and area under the curve predicting sPTB. White blood count, platelet, lymphocyte, monocyte, and lymphocyte-monocyte ratio values were significantly higher, and platelet-lymphocyte ratio and neutrophil-lymphocyte ratio values were lower in sPTB group than healthy control group in the first trimester of pregnancy. Receiver-operator curve analysis suggested that lymphocyte, white blood count, platelet-lymphocyte ratio, neutrophil-lymphocyte ratio, lymphocyte-monocyte ratio, monocyte, and platelet in the first trimester of pregnancy had predictive value for sPTB. The greatest predictive was lymphocyte, and the areas under the receiver operator characteristic curve (AUROCs) reached 0.853. Lymphocyte values during the first trimester of pregnancy were the most predictive spontaneous preterm delivery. Therefore, in the management of the higher risk of preterm delivery, lymphocyte values could be a more cost-effective method during the first trimester of pregnancy because it does not need any kit.

Prognostic value of neutrophil/lymphocyte, platelet/lymphocyte, lymphocyte/monocyte ratios and Glasgow prognostic score in osteosarcoma: A meta-analysis.

BACKGROUNDSome studies investigated the prognostic role of several blood biomarkers, including the neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), lymphocyte/monocyte ratio (LMR) and Glasgow prognostic score (GPS), in osteosarcoma, but their results were inconsistent with each other.AIMTo identify the prognostic value of NLR, PLR, LMR and GPS in osteosarcoma patients through reviewing relevant studies.METHODSThe PubMed, EMBASE, Web of Science and CNKI databases were searched up to October 2, 2021. The primary and second outcomes were overall survival (OS) and disease-free survival (DFS), respectively. The hazard ratios (HRs) with 95% confidence intervals (CIs) were combined to assess the association between these indicators and prognosis of osteosarcoma patients. RESULTSA total of 13 studies involving 2087 patients were eventually included. The pooled results demonstrated that higher NLR and GPS were significantly associated with poorer OS (HR = 1.88, 95%CI: 1.38-2.55, P < 0.001; HR = 2.19, 95%CI: 1.64-2.94, P < 0.001) and DFS (HR = 1.67, 95%CI: 1.37-2.04, P < 0.001; HR = 2.50, 95%CI: 1.39-4.48, P < 0.001). However, no significant relationship of PLR and LMR and OS (P = 0.085; P = 0.338) and DFS (P = 0.396; P = 0.124) was observed.CONCLUSIONHigher NLR and GPS were related with worse prognosis and might serve as novel prognostic indicators for osteosarcoma patients.