Platelet-to-lymphocyte Ratio Values Research Articles

Relationship Between Systemic Inflammatory Response Exponents, Levels of ADAM10, ADAM17 Proteins and Selected Clinical Parameters in Patients with Colorectal Cancer: Original Research Study

Chronic inflammation is a confirmed risk factor for colorectal cancer (CRC). Indicators of systemic inflammatory response (SIR), such as neutrophil-to-lymphocyte ratio (NLR) or platelet-to-lymphocyte ratio (PLR), are easily accessible indicators of the generalized inflammatory response. At the molecular level, inflammation-related carcinogenesis involves proteins from the adamalysin family: ADAM10 and ADAM17. The aim of the study was to assess NLR and PLR and their relationship with selected clinical parameters in CRC patients, as well as the correlation between ADAM10 and ADAM17 in tumor tissue and matched surgical margins with NLR and PLR values. Tumor tissue material matched surgical margins, and blood was collected from 66 patients who underwent surgery because of CRC. The concentrations of ADAM10 and ADAM17 in the collected material were tested using the enzyme-linked immunosorbent assay (ELISA) method. SIR parameters (NLR, PLR) were also determined. The results were statistically analyzed and compared with selected clinical parameters. Results: The study showed that PLR was lower in patients with comorbid cardiovascular diseases (CVD). In patients who underwent preoperative treatment, both the NLR and PLR values were higher than in patients who underwent primary surgery. There was also a negative correlation between ADAM17 concentrations in the surgical margin and PLR values. In conclusion, the presence of additional diseases such as CVD or diabetes mellitus type 2 (DMT2) or the use of preoperative treatment should be taken into account when assessing SIR parameters in CRC patients. Moreover, no clear correlations have been found between ADAM10 and ADAM17 and SIR parameters.

Pre-treatment blood parameters as an economical predictive marker for predicting treatment response in locally advanced cervical cancer

Background Cervical cancer poses a significant public health challenge, particularly in low and middle-income countries. Despite advancements in treatment, the disease remains a leading cause of cancer-related deaths among women globally. Chemoradiation utilizing cisplatin has been the cornerstone therapy for locally advanced cervical cancer. Prognostic biomarkers, including hematological parameters, have emerged as valuable tools in guiding treatment decisions and predicting outcomes. Methodology Data from patients treated between January 2021 and June 2022 were analyzed. Demographic information, histopathology, pre-treatment blood parameters, treatment details, and response assessments were collected. The parameters assessed included hemoglobin levels, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), prognostic nutritional index (PNI), and eosinophil albumin ratio (EAR). Receiver operating characteristic (ROC) curve analysis was conducted to determine optimal cut-off values for these biomarkers. Results Of the 140 patients included, the majority had squamous cell carcinoma (92%) and were at stage II or III. Complete response to treatment was observed in 86.4% of patients. Non-responders demonstrated significantly higher levels of hemoglobin, NLR, and EAR, along with lower PNI levels compared to responders. ROC analysis revealed cut-off values for hemoglobin (< 9.5), NLR (< 2.98), PLR (> 289.26), PNI (< 37.67), and EAR (< 49.63) associated with treatment response. Conclusion The study highlights the potential utility of pre-treatment blood parameters as predictive markers for treatment response in locally advanced cervical cancer. Lower hemoglobin, higher NLR, and EAR, along with reduced PNI, were associated with poorer treatment outcomes. Integration of these biomarkers into clinical practice could aid in treatment planning and improve patient outcomes. Further validation and prospective studies are warranted to establish the role of these biomarkers in guiding personalized treatment strategies for cervical cancer patients.

The prognostic value of the platelet-to-lymphocyte ratio in multiple myeloma patients treated with a bortezomib-based regimen

Multiple myeloma (MM) is the second most common hematological malignancy. Previous studies have validated the prognostic significance of the platelet-to-lymphocyte ratio (PLR) in patients with certain solid tumors. However, the relationship between the PLR and prognosis in myeloma patients has not been clearly demonstrated. In our study, we included 122 newly diagnosed MM patients who were treated with bortezomib-based chemotherapy. These patients were divided into low-PLR and high-PLR groups based on their initial PLR values. We compared the clinical characteristics between the two groups and utilized restricted cubic splines (RCSs) in the regression model to estimate the nonlinear relationship between the initial PLR and overall survival (OS) in MM patients. The results showed that patients in the low-PLR group had significantly worse OS (P = 0.00031) and progression-free survival (PFS) (P < 0.0001) compared to those in the high-PLR group. Furthermore, within the higher-risk MM group, a low PLR was also associated with worse OS (P = 0.0037) and PFS (P = 0.0048). Therefore, a low PLR was identified as an independent predictor of poor OS in MM patients. The RCS curves further confirmed a significant nonlinear relationship between the PLR and OS in patients with MM. The PLR may serve as a significant independent prognostic indicator for MM patients undergoing bortezomib-based chemotherapy, and there exists a crucial nonlinear relationship between the PLR and OS in these patients.

Exploring the correlations between six serological inflammatory markers and different stages of type 2 diabetic retinopathy

To determine the correlations between six serological inflammatory markers, namely the systemic immune-inflammation index (SII), systemic inflammatory response index (SIRI), aggregate index of systemic inflammation (AISI), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and monocyte-to-lymphocyte ratio (MLR), and various stages of type 2 diabetic retinopathy (T2DR). Additionally, the diagnostic value of these markers in T2DR was evaluated. Clinical data were collected from a total of 397 patients with type 2 diabetes who visited the ophthalmology department at Mian Yang Central Hospital and the Affiliated Hospital of Southwest Medical University from January 2023 to December 2023. Based on the results of fundus photography, patients were categorized into a non-diabetic retinopathy group (NDR, n = 121), a non-proliferative diabetic retinopathy group (NPDR, n = 77), and a proliferative diabetic retinopathy group (PDR, n = 199). General patient information and systemic inflammatory markers, including the SII, SIRI, AIRI, NLR, PLR, and MLR, were compared among the groups, and their correlations with T2DR were analyzed. The SII values were found to be significantly higher in the PDR group compared to the NPDR group, which in turn were higher than those in the NDR group (P < 0.05). Similarly, the AISI values were significantly elevated in the PDR group compared to both the NPDR and NDR groups (P < 0.05). The SIRI and MLR values were significantly higher in the PDR group than in the NDR group (P < 0.05). Furthermore, the NLR and PLR values were significantly higher in the NPDR and PDR groups compared to the NDR group (P < 0.05). The Mantel‒Haenszel chi-square test revealed a significant linear trend between the SII and PLR and the incidence of PDR (P < 0.001), with the incidence of PDR increasing as the quartile levels of the SII and PLR increased. Multivariate logistic regression analysis indicated that, compared with NDR, a higher SII was found to be an independent risk factor for NPDR (ORSII = 1.002, p = 0.001) and PDR (ORSII = 1.002, P < 0.001). The ROC curve analysis suggested that the combined assessment of the six inflammatory indices had the highest accuracy in the evaluation of DR, with an area under the curve (AUC) of 0.69, a sensitivity of 54%, and a specificity of 75%. The results of this study indicate that the SII is an independent risk factor for T2DR. A close correlation was observed between the SII and PLR and the occurrence and progression of T2DR. The high accuracy of the combined diagnosis of T2DR via various serological inflammatory markers underscores their potential as early biological indicators for the diagnosis of T2DR.

Prognostic significance of neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and monocyte-to-lymphocyte ratio in uterine carcinosarcoma.

Uterine carcinosarcoma (UCS) and uterine sarcomas (US) are rare but aggressive cancer with poor prognoses. The prognostic value of systemic inflammatory response (SIR) indicators, including the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and monocyte-to-lymphocyte ratio (MLR), in predicting outcomes of UCS and US remains unclear. This study investigated the prognostic significance of SIR indicators for UCS and US. Clinicopathological data from 237 patients diagnosed with UCS or US across 14 hospitals from January 2008 to December 2017 were retrospectively analyzed. NLR, PLR, and MLR values were calculated from preoperative blood counts. Prognostic impact was evaluated using Kaplan-Meier survival analysis, Cox regression models, and receiver operating characteristic (ROC) curve analysis. Elevated NLR, PLR, and MLR were associated with poorer progression-free survival (PFS) in UCS. Additionally, a high NLR also indicated worse overall survival (OS) in UCS. In patients with US, only PLR was significantly associated with poorer PFS. Combining SIR indicators provided a stronger prognostic prediction for UCS compared to individual indicators. Multivariate analysis revealed that high levels of SIR indicators were an independent poor prognostic factor for both PFS and OS in UCS. SIR indicators, particularly when combined, are valuable prognostic markers in UCS, reflecting the inflammatory status and aiding in stratifying patients for tailored therapeutic strategies. These findings support the incorporation of SIR indicators into clinical practice for better management of patients with UCS.

The Predictive Significance of Platelet-to-Lymphocyte Ratio for Miscarriage: A Systematic Review and Meta-Analysis.

Miscarriage is a common complication of pregnancy, and its underlying pathophysiologic mechanisms remains unclear. The platelet-to-lymphocyte ratio (PLR), a prothrombotic and inflammatory marker, has been controversially discussed as a potential predictor of miscarriage. This systematic review and meta-analysis aimed to assess the predictive significance of the PLR in women with miscarriage compared to healthy pregnancies. Relevant studies were systematically searched in PubMed, Embase, Web of Sciencey, and Cochrane Library up to December 31, 2023. A systematic review and meta-analysis following PRISMA guidelines was conducted. Articles were identified, screened, and evaluated for quality to determine the predictive value of PLR for miscarriage. Fourteen eligible articles, comprising a total of 3745 patients, were included in the meta-analysis. The pooled analysis found comparable PLR levels between miscarriage and non-miscarriage groups (SMD = 0.25; 95% Confidence Interval (CI): -0.05 to 0.54). Subgroup analysis revealed significant differences in PLR levels in the missed miscarriage group (SMD = 0.29; 95% CI: 0.01-0.56). and in studies with sample sizes smaller than 200 (SMD = 0.31; 95% CI: 0.05-0.56). Other subgroups did not exhibit significant differences. Subgroup analysis of PLR levels and miscarriage risk demonstrated no significant differences across all subgroups. PLR is not a reliable predictor of miscarriage in general. However, for missed miscarriage cases, elevated PLR levels may serve as a practical and cost-effective marker for prediction.

Diagnostic Roles of Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio for Vertebral Fracture due to Tuberculosis and Malignancy

Background: Vertebral fracture is a serious complication that can occur due to various medical conditions, including bone tuberculosis and malignancy (eg, cancer metastasis to the vertebrae). This condition invariably causes an increase in the inflammatory process in the body, which can be identified through the Neutrophil-to-Lymphocyte Ratio (NLR) and Platelet-to-Lymphocyte Ratio (PLR). This study aims to investigate the differences in NLR and PLR values in patients with vertebral fractures due to TB or malignancy. Methods: A retrospective observational study was conducted on vertebral fracture patients who underwent surgery in the Orthopedic Surgery Department of Dr. Kariadi Hospital Semarang between January 1st, 2022, and December 31st, 2023. Data on demographics and laboratory test results were extracted from medical records. Statistical analysis was performed using univariate analysis and presented as percentage and frequency. T-test or Mann-Whitney test was used to determine the difference based on their normality distribution. The diagnostic value of NLR and PLR was also analyzed using the receiver operating characteristic (ROC) curve and Youden index. Results: The study included 54 vertebral fracture patients. The mean age of patients was 41.77 ± 16.00 years, and the majority were female patients (68.5%). The Neutrophil to Lymphocyte Ratio (NLR) value was significantly higher in vertebral fracture due to malignancy patients than TB (5.5 (IQR 3.92 – 13.39) vs 4.53 (IQR 2.91 – 6.96), p=0.020). In contrast, the Platelet to Lymphocyte Ratio (PLR) value was not significantly different (p&gt;0.05). The area under the curve for the NLR (0.69, 95% confidence interval [CI], 0.54 – 0.839) was greater than that of PLR (0.408, 95% CI, 0.246 – 0.571). Conclusion: NLR showed significantly different results in determining the cause of vertebral fractures, either tuberculosis or malignancy. NLR can be used as an important diagnostic marker to help differentiate between vertebral fractures caused by malignancy and those caused by infection.

Systemic immune-inflammatory index predict short-term outcome in recurrent/metastatic and locally advanced cervical cancer patients treated with PD-1 inhibitor

This study aims to assess the predictive value of certain markers of inflammation in patients with locally advanced or recurrent/metastatic cervical cancer who are undergoing treatment with anti-programmed death 1 (PD-1) therapy. A total of 105 patients with cervical cancer, who received treatment involving immunocheckpoint inhibitors (ICIs), were included in this retrospective study. We collected information on various peripheral blood indices, including the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), systemic immune-inflammation index (SII), and prognostic nutritional index (PNI). To determine the appropriate cutoff values for these inflammatory markers, we performed receiver operating characteristic curve (ROC) analysis. Progression-free survival (PFS) was estimated using the Kaplan-Meier method, and we conducted both univariate and multivariate Cox regression analyses to evaluate the prognostic value of these markers. Out of the 105 patients who received ICI treatment, the median progression-free survival (mPFS) was 19.0 months. We obtained the patients’ clinical characteristics, such as age, pathological type, therapy regimen, Figo stage, NLR, PLR, LMR, SII, and PNI from their medical records. The optimal cutoff values for NLR, PLR, LMR, SII, and PNI were determined as 3.76, 218.1, 3.34, 1147.7, 43.75, respectively. In the univariate analysis, age, pathological type, therapy regimen, Figo stage, and LMR were not found to be associated with PFS. However, high NLR(P=0.001), high PLR(P<0.001), high SII(P<0.001), and low PNI (P=0.003)were all associated with shorter PFS. Multivariate analysis indicated that SII (P=0.017) was an independent risk factor for PFS. This study highlights the potential use of SII as a predictor of progression-free survival in cervical cancer patients undergoing immunotherapy.

Prognostic Value of Systemic Inflammatory Markers in Elderly Patients with Tumor-associated Venous Thromboembolism.

Elderly tumor patients are more prone to venous thrombotic events than nontumor patients. To investigate the relationship between systemic inflammatory markers and overall survival (OS) in elderly patients with tumorassociated venous thromboembolism (TAVTE). And to evaluate the prognostic value of combined lymphocyte platelettolymphocyte ratio (PLR) with neoplasm metastasis in elderly patients. A prospective study was conducted. A total of 172 elderly patients with TAVTE admitted to the hospital from January 2017 to December 2019 were included in the study, which were followed up for 2 years. Clinical and laboratory data were collected. All-cause mortality within after discharge were followed up. The optimal cutoff values of neutrophiltolymphocyte ratio (NLR), PLR, systemic immuneinflammation index (SII), and monocyte to highdensity lipoprotein ratio (MHR) for predicting efficacy and prognosis were determined according to receiver operating characteristic (ROC) curve and the areas under the ROC curve (AUC). Kaplan-meier curves were used to analyze the survival time. Univariate and multivariate COX logistic regression analyses were used to analyze the independent predictors of OS in elderly patients with TAVTE. The cut-off values for NLR, PLR, SII, and MHR were 3.375, 274.63, 399.73 and 0.58, respectively. And the area under the curve (AUC) was 0.639(95%CI: 0.556-0.721), 0.628(95%CI:0.544-0.712), 0.595(95%CI:0.510-0.680) and 0.596(95%CI: 0.510-0.683). Survival analysis showed that OS was longer in the NLR≤3.375 group (181.07 weeks, 95% CI: 150.11 ~ 212.03) than in the NLR >3.375 group (108.95 weeks, 95%CI: 90.38 ~ 127.51) (P = 0.005). The OS of PLR≤274.63 group (160.40 weeks, 95%CI: 138.41 ~ 182.38) was longer than that of PLR >274.63 group (43.85 weeks, 95%CI: 34.08 ~ 53.63) (P < 0.001). The OS of SII≤399.73 group (176.62 weeks, 95%CI:147.26 ~ 205.97) was longer than that of SII>399.73 group (126.55 weeks,95%CI: 105.04 ~ 148.05) (P = 0.012). The OS was longer in the MHR≤0.58 group (156.24 weeks, 95% CI: 127.05-185.43) than in the MHR>0.58 group (108.11 weeks, 95%CI:86.85-129.38) (P = 0.011). Univariate and multivariate Cox analysis showed that tumor metastasis and PLR>274.63 were independent predictors of the lower OS in elderly patients with TAVTE (P < 0.001). According to the tumor metastasis and the cut-off value of PLR, a combined scoring system MPS (Metastasis and PLR System) was designed. The OS of the 0, 1 and 2 score groups was 184.08 weeks (95%CI:158.11-210.05), 82.60 weeks (95%CI:61.57-103.64), and 23.83 weeks (95%CI: 9.575-38.09) (P < 0.001), respectively. Our findings suggest that the systemic inflammatory markers (NLR, PLR, SII, MHR) may have predictive value for all-cause mortality in elderly patients with TAVTE. PLR combined with tumor metastasis may be an effective index to predict the prognosis of elderly patients with TAVTE.

Prognostic Significance of Preoperative Neutrophil-to-lymphocyte Ratio and Platelet-to-lymphocyte Ratio in Patients with Ruptured Abdominal Aortic Aneurysm Undergoing Endovascular Aneurysm Repair

BackgroundRuptured abdominal aortic aneurysm (RAAA) is a fatal disease. This study aimed to assess the prognostic value of the preoperative neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) in patients with RAAA undergoing endovascular aneurysm repair (EVAR).Materials and methodsThis retrospective study included patients with RAAA who underwent EVAR from 2012 to 2022. NLR and PLR were measured when patients were first admitted to the hospital before receiving any treatment. Risk factors associated with overall survival in this patient group were identified through univariate and multivariate analyses. Nomograms and artificial neural networks were developed to evaluate the prognosis of these patients.ResultsA total of 50 patients were included in this study. The optimal cut-off points for predicting overall survival were an NLR of 19.6 and a PLR of 190.5. Univariate and multivariate analyses revealed that NLR (hazard ratio 0.271, p = 0.024) and PLR (hazard ratio 0.272, p = 0.041). Were independent risk factors for overall survival. Nomograms and artificial neural networks also showed the prognostic value of preoperative NLR and PLR in this patient group.ConclusionPreoperative NLR and PLR are independent and valid predictors of prognosis in patients with RAAA undergoing EVAR. The higher the preoperative NLR and PLR of the patients, the worse their prognosis.

Neutrophil-to-Lymphocyte Ratio and Other Complete Blood Count Parameters in the Diagnosis of Serious Bacterial Infections in Febrile Infants Under Three Months.

The incidence of serious bacterial infections (SBI) in febrile infants under three months is high. Complete blood count parameters, an easily accessible and low-cost test, may have diagnostic potential for SBI. This study evaluated the efficacy of absolute neutrophil count (ANC), neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), platelet-to-lymphocyte ratio (PLR), platelet-to-mean platelet volume ratio (PLT/MPV), red cell distribution width (RDW), and C-reactive protein (CRP) in distinguishing febrile infants under three months with SBI. A random sample of an eight-year registry-based retrospective cohort study included infants aged under three months who were hospitalized with fever. Patients were divided into those with and without SBI. Complete blood count parameters and CRP levels at admission, 24-48 hours, and discharge were compared between the groups. In total, 224 infants were included. At admission, infants with SBI (n=112) had higher median values (p=0.001) of CRP, ANC, and PLR and lower LMR (p=0.001) than those with negative cultures. CRP at admission was the best diagnostic marker for SBI (AUC: 0.857, 95% CI: 0.808-0.907), followed by ANC (AUC: 0.825, 95% CI: 0.772-0.879), NLR (AUC: 0.797, 95% CI: 0.738-0.855), and LMR (AUC: 0.642, 95% CI: 0.570-0.714). The combination of CRP with ANC, NLR, and LMR was found to be superior to any of the single markers (AUC: 0.918, 95% CI: 0.88 to 0.95). The combination of ANC and NLR proved to be a better discriminator compared to each parameter individually (AUC: 0.842, 95% CI: 0.79 to 0.90). At 24-48 hours, CRP continued to perform better, followed by ANC and NLR. At discharge, infants with SBI had higher PLT/MPV compared to those with negative cultures (p=0.009), but no significant differences in other parameters were observed. The strongest predictor of SBI in febrile infants aged under three months was CRP, while ANC, NLR, and LMR also showed diagnostic potential. The combination of these parameters demonstrates the highest diagnostic value overall.

Prognostic value of immunotherapy in advanced NSCLC based on baseline and dynamic changes in HALP.

Immune checkpoint inhibitors (ICIs) enhance the tumor-killing ability of T-cells in non-small cell lung cancer (NSCLC), improving overall survival (OS) and revolutionizing treatment for advanced stages. However, challenges remain, such as low response rates and the lack of effective markers for selecting candidates. This study evaluated the impact of hemoglobin, albumin, and platelet (HALP), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) on the efficacy of immunotherapy and survival outcomes in advanced NSCLC. Additionally, it aimed to develop a nomogram based on these parameters. Clinical and hematological data from NSCLC patients who received immunotherapy were analyzed. Efficacy was assessed using the immune Response Evaluation Criteria in Solid Tumors (iRECIST), and progression-free survival (PFS) and OS were evaluated. Prediction models incorporated baseline and post-treatment HALP, NLR, and PLR values. The 203 patients had a median follow-up of 16 months, a median PFS (mPFS) of seven months (6.0-8.0), while the median OS (mOS) was not reached (24.0-not available). Pretreatment PLR (PLR0) was associated with a higher disease control rate (DCR) (odds ratio [OR] = 0.258), while initial immunotherapy and NLR after four treatment cycles (NLR4C) significantly improved the objective response rate (ORR). Cox regression analysis showed that pretreatment HALP (HALP0), HALP after four cycles of treatment (HALP4C), and pretreatment NLR (NLR0) significantly impacted PFS. Additionally, HALP0, NLR0, and PLR after four treatment cycles (PLR4C) were associated with OS. The C-indices for PFS and OS were 0.823 and 0.878, respectively, indicating good predictive accuracy. HALP, NLR, and PLR at various time points effectively predicted immunotherapy response in advanced NSCLC patients, with low HALP combined with high NLR and PLR indicating a poor prognosis. These findings could serve as the basis for stratified randomized controlled trials (RCTs) in the future.

The role of inflammatory markers and βhCG levels in predicting the success of single-dose methotrexate treatment in tubal ectopic pregnancy.

To evaluate the predictive ability of serum beta human chorionic gonadotropin (βhCG) levels and inflammatory markers derived from hemogram parameters in the success of methotrexate (MTX) treatment for tubal ectopic pregnancy. This retrospective study involved the examination of patients diagnosed with tubal ectopic pregnancy and treated with a single dose of MTX at our clinic between 2018 and 2023. The monocyte-to-lymphocyte ratio (MLR), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and systemic immune-inflammation index (SII) were calculated from blood samples taken at the time of presentation. βhCG levels were recorded on days 1, 4, and 7 of treatment. The patients were categorized into successful and unsuccessful treatment groups based on their response to MTX. No statistically significant differences were found between the two groups regarding MLR, NLR, PLR, or SII values (P = 0.284, P = 0.097, P = 0.455, and P = 0.061, respectively). In the receiver operating characteristic analysis of serum βhCG from day 1 to day 4, the area under the curve value was calculated as 0.832. The cutoff value for the serum βhCG change from days 1 to 4 was -0.093 (-9.3%), with a sensitivity of 85.53% and specificity of 74.14%, and a positive predictive value (PPV) of 87.5%. There were no significant differences in inflammatory markers (MLR, NLR, PLR, and SII) between the successful and unsuccessful MTX treatment groups. The change in serum βhCG levels between days 1 and 4 can be used as an early predictor of MTX treatment success in tubal ectopic pregnancy.

The Relationship between Aortic Clamping Time and Platelet-lymphocyte Ratio in Isolated Coronary Artery Bypass Surgery

Objectives: This study aims to evaluate the relationship between aortic clamp duration acute coronary syndrome (ACS) and platelet-to-lymphocyte ratio (PLR) in patients undergoing isolated coronary artery bypass grafting (CABG) with cardiopulmonary bypass (CPB). Methods: This retrospective study included 96 patients who underwent elective isolated CABG at a single center between June 2021 and September 2023. Patients were divided into two groups according to median ACS: Group I (ACS &lt;66.2 min, n=54) and Group II (ACS &gt;66.2 min, n=42). Demographic data, pre-operative and 24-h post-operative platelet and lymphocyte counts, and operative details were recorded. PLR was calculated using the platelet/ lymphocyte formula. Statistical analyses were performed using IBM Statistical Packages for the Social Sciences 25.0. Results: The mean ages of Group I and Group II were 63.6±8.8 and 66±8.9 years, respectively (p&gt;0.05). There was no significant difference in pre- and post-operative PLR values between the groups (p&gt;0.05). There was no correlation between post-operative PLR and the duration of CPB and ACS (p&gt;0.05). However, there was a strong positive correlation between CPB and ACS durations (p&lt;0.001). Conclusion: The study revealed that there was no significant correlation between post-operative PLR and perioperative ACS and CPB durations. While post-operative PLR increased significantly in both groups, this increase was not associated with the duration of ACS or CPB. PLR may be a useful biomarker in determining inflammation and adverse outcomes in CABG, but larger-scale, randomized, prospective studies are needed to confirm these findings.

Platelet to Lymphocyte Ratio (PLR) Value in Normotency, Preeclampsia and Severe Preeclampsia

BACKGROUND : Hyperactivation of the inflammatory response in preeclampsia causes a significant increase in the number of leukocytes. Platelet to Lymphocyte Ratio (PLR) has been known as a marker of systemic inflammatory response. In preeclampsia, the role of PLR markers is still uncertain regarding the ability of clinical evaluation, differential diagnosis and evaluation of patient prognosis. AIMS : To analyze differences in platelet to lymphocyte ratio (PLR) values in normotensive, preeclampsia, and severe preeclampsia pregnancies METHOD : Analytical observational study with cross sectional design with 90 samples consisting of 30 normotensive pregnancies, 30 preeclampsia and 30 severe preeclampsia. Evaluation is carried out on the platelet to lymphocyte ratio (PLR) value. Analysis was carried out using the SPSS 32 edition application. Results are significant if p&lt;0.05. RESULT : Comparison between the normotensive group versus preeclampsia versus severe preeclampsia showed that platelet levels decreased but not significantly (p=0.081), lymphocyte levels increased significantly (p&lt;0.001) and PLR values decreased significantly (p&lt;0.001) as the degree of severity increased preeclampsia. In the severe preeclampsia group, the lowest platelet levels, the highest lymphocyte levels and the lowest PLR values were obtained. Patients with a PLR value &lt; 104.62 have an 8.43x (OR 8.43; CI95% 3.12-22.78) higher risk of experiencing severe preeclampsia compared to subjects with a PLR value &gt; 104.62. CONCLUSION : The PLR value was significantly lowest in the severe preeclampsia group.

Evaluating the prognostic impact of inflammatory markers on treatment outcomes in patients with intrahepatic cholangiocarcinoma undergoing radioembolization.

Intrahepatic cholangiocarcinoma (iCCA) is a rare and aggressive malignancy with limited treatment options, often diagnosed at advanced stages. Radioembolization has emerged as a promising therapy, but its efficacy varies among patients, necessitating reliable biomarkers to predict treatment response. This study evaluates the prognostic impact of systemic inflammatory response markers on treatment outcomes in patients with iCCA undergoing radioembolization. This retrospective study included 70 patients with iCCA treated with radioembolization between January 2016 and December 2023. Inflammatory markers, including the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and systemic immune-inflammation index (SII), were measured from peripheral blood samples. Treatment response was assessed using the modified RECIST criteria, and survival analyses were performed using the Kaplan-Meier method and Cox proportional hazards regression. Patients with lower NLR, PLR, and SII values exhibited significantly higher objective response rates (P = 0.032, P = 0.016, and P = 0.001, respectively). High levels of NLR, PLR, and SII were associated with shorter overall survival (12 vs. 16 months, P = 0.007; 12 vs. 16 months, P = 0.004; and 10 vs. 22 months, P < 0.001, respectively) and progression-free survival (3 vs. 7 months, P = 0.046 for SII). Multivariate analysis identified high SII (P = 0.040), lymph node metastasis (P = 0.042), and high serum total bilirubin (P = 0.013) as significant independent prognostic factors. Systemic inflammatory markers such as NLR, PLR, and SII are valuable prognostic indicators for patients with iCCA undergoing radioembolization. These markers can aid in identifying patients likely to benefit from personalized treatment strategies, potentially improving clinical outcomes. The clinical significance of this study lies in its demonstration that systemic inflammatory markers (NLR, PLR, and SII) serve as valuable prognostic indicators for predicting treatment outcomes in patients with iCCA undergoing radioembolization, thus aiding in the identification of patients who may benefit from personalized treatment strategies and potentially improving clinical outcomes.

The Serum Biomarkers in Ulcerative Colitis.

In this study, the aim was to evaluate the diagnostic effectiveness of more easily applicable and cost-effective serum biomarkers, such as neutrophil-to-lymphocyte ratio (NLR), platelet-tolymphocyte ratio (PLR), C-reactive protein (CRP) to albumin ratio (CAR), and CRP-to-lymphocyte ratio (CLR), instead of the endoscopic activity index (EAI) used to determine disease activation in ulcerative colitis (UC) patients. Blood tests performed during the same period as colonoscopy were reviewed, and NLR, PLR, CAR, and CLR values were calculated. Based on the EAI score, patients with a score <4 were classified as having UC in remission, those with a score ≥4 as having active UC, and those with normal colonoscopy results as the control group. The study included 66 patients with active UC, 31 with UC in remission, and 99 controls. The CLR and CAR values of active and remission UC patients were found to be higher compared with the control group (p<0.001), while no significant difference was found between the groups in terms of PLR and NLR values (p>0.05). The AUC calculated for CLR in diagnosing active UC was significant (p<0.001), and the best cut-off value was determined as >1,75. For CAR, the best cut-off value was calculated as >0.11. This study demonstrated that the CLR and CAR had high sensitivity and specificity for detecting UC activity, whereas the PLR and NLR had low diagnostic value.

The role of neutrophil to lymphocyte ratio and platelet to lymphocyte ratio in determining the severity of pre-eclampsia in antenatal women: A case control study

Pre-eclampsia (PE) remains a significant global health concern, affecting 2-8% of pregnancies and contributing to maternal and perinatal morbidity and mortality. Characterized by hypertension and proteinuria after 20 weeks of gestation, PE often involves systemic inflammation and endothelial dysfunction. Its exact etiology is multifactorial, involving immune dysregulation and vascular abnormalities. Early identification of high-risk pregnant women is crucial to mitigate adverse outcomes. In India, PE affects 8-10% of pregnancies.Inflammatory markers such as the Neutrophil-to-Lymphocyte Ratio (NLR) and Platelet-to-Lymphocyte Ratio (PLR) have emerged as potential indicators of systemic inflammation. Elevated NLR and PLR levels in PE suggest a role in the disorder's pathophysiology, reflecting immune responses to placental ischemia and pro-inflammatory cytokine release.This study aims to compare NLR and PLR levels between PE patients and normotensive pregnant women, evaluate their association with PE severity, and discuss their potential as predictive biomarkers. A case-control study was conducted with 84 participants, following eligibility criteria via convenient sampling. Demographic characteristics, obstetric history, and CBC-derived biomarkers were assessed.Among 84 pregnant women, 42 had preeclampsia (PE) and 42 were normotensive. The PE group had significantly higher Neutrophil-to-Lymphocyte Ratios (5.11 ± 2.88 vs. 2.74 ± 0.78) and Platelet-to-Lymphocyte Ratios (108 ± 46.7 vs. 85.4 ± 29.4) compared to controls. PE incidence peaked between 34-38 weeks. Higher PLR and NLR values were linked to severe PE. ANC booking was lower in the PE group. Obesity trends were not statistically significant.Significant associations were found between elevated NLR and PLR and PE severity, highlighting their potential clinical utility.Our findings indicate NLR and PLR as valuable biomarkers for predicting and managing PE. Integration of these markers into routine prenatal care could enhance clinical management and improve maternal and fetal outcomes.

The Impact of Systemic Inflammation on Recurrence in Patients with Congenital Nasolacrimal Duct Obstruction.

Background/Objective: Congenital nasolacrimal duct obstruction (CNLDO) is commonly treated by probing, but recurrence remains a clinical issue. This study investigates the potential role of inflammatory biomarkers, such as the neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), and platelet-to-lymphocyte ratio (PLR), in predicting recurrence after probing in children with CNLDO. Methods: This retrospective cohort study included 172 patients who underwent initial probing for unilateral CNLDO. The patients were then categorized into two groups: those who experienced the complete resolution of symptoms after primary probing, and those who required Ritleng tube intubation due to recurrence following primary probing. Blood samples for calculating inflammatory biomarkers in all subjects were collected during general anesthesia preparation prior to initial probing. NLR, MLR, and PLR values were compared between the groups using the independent samples t-test. The predictive performance of the inflammatory biomarkers for recurrence was assessed using Receiver Operating Characteristic (ROC) curve analysis. Results: A total of 110 patients were included in the probing group, while 62 patients were in the recurrence group. The mean age at the time of the initial probing procedure was 15 ± 4.06 months in the probing group and 15.83 ± 4.02 months in the recurrence group. There was no difference in the duration of the probing procedure between the groups. The mean age at the time of Ritleng tube intubation in the recurrence group was 37.80 ± 13.34 months. The recurrence group exhibited significantly higher values in all analyzed inflammatory markers compared to the probing group, including the NLR (1.12 ± 0.56 vs. 0.86 ± 0.39, p = 0.002), MLR (0.16 ± 0.06 vs. 0.14 ± 0.06, p = 0.005), and PLR (95.13 ± 24.34 vs. 82.23 ± 22.77, p < 0.001). ROC curve analysis indicated that these inflammatory biomarkers demonstrated moderate performance in predicting recurrence. Conclusions: Recurrence following probing in children with CNLDO was associated with complete blood cell count-derived inflammatory biomarkers. The preoperative assessment of these biomarkers may aid in the individualization of disease management and inform the development of new therapeutic strategies.

Novel predictor of thrombosis after left atrial appendage closure -Neutrophil to Lymphocyte Ratio (NLR), platelet to LymPhocyte Ratio (PLR), and Lymphocyte to Monocyte Ratio (LMR)-

Abstract Background Cardiogenic embolism by left atrial thrombi is one of the most important atrial fibrillation (AF)-related clinical problems. In a previous survey, 91% of nonrheumatic AF-related left atrial thrombi was originated in the left atrial appendage (LAA). The WATCHMAN device was developed as a permanent implantable device to seal off the LAA to prevent cardiogenic embolism. It has been used in Japan since September 2019. The WATCHMAN family is the only left atrial appendage closure (LAAC) device in Japan. After percutaneous left atrial appendage closure (LAAC), DRT is an important issue in some cases. Neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), and lymphocyte to monocyte ratio (LMR) are known as cancer prognostic factors and indicators of immune status. There are few reports on the predictor for device related thrombosis (DRT), transient ischemic attack (TIA), and ischemic stroke. Finding novel biomarkers could help clinical decision in antithrombotic therapy post LAAC and follow-up intervals. Purpose To investigate the association of NLR, PLR, and LMR with device related thrombosis, transient ischemic attack, and ischemic stroke in patients with LAAC. Methods Our database of LAAC was respectively analyzed. All LAAC cases were performed between January 2020 and September 2023. Blood cell counts were sampled in three days before LAAC. Postoperative antithrombotic therapy was individualized based on the patient’s background. We examined their background and clinical events. Results A total of 116 consecutive patients underwent LAAC in our institution excepting for one case that could not be performed due to a huge LAA (follow-up period, 610±37 days; age, 75±1 years; male sex, 73%; left ventricular ejection fraction, 58±1%; CHAD2S2-VASc, 4.6±0.1; HAS-BLED, 3.4±0.1). The results are shown in the Figure. Receiver-operating characteristic curve analysis confirmed the best cut-off value of NLR, PLR, and LMR for composite of DRT, TIA, and ischemic stroke (AUC = 0.69; 0.70; 0.67). In the univariate analysis, NLR&amp;lt;1.88, PLR&amp;lt;144, and LMR&amp;gt;3.40 are the independent predictor for the combination of DRT, TIA, and ischemic stroke (p-value = 0.02; 0.04; 0.05, respectively). Conclusion Low NLR, low PLR, and high LMR are the independent predictor for the combination of DRT, TIA, and ischemic stroke. These parameters can be useful in routine use because they can be easily calculated without additional costs.