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ObjectiveTo investigate the value of neutrophil-lymphocyte ratio (NLR) combined with apolipoprotein A-I (ApoA-I) level in predicting the severity of acute pancreatitis (AP). MethodsA retrospective analysis was performed for 460 patients with AP who were admitted to The Affiliated Hospital of Southwest Medical University from January 2015 to December 2019, among whom 250 had mild acute pancreatitis (MAP), 166 had moderate-severe acute pancreatitis, and 44 had severe acute pancreatitis (SAP). Related clinical data were collected, including basic information, laboratory markers (neutrophil count, lymphocyte count, serum triglyceride, serum total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, ApoA-I, and apolipoprotein B), and scores (Ranson, BISAP, and MCTSI). A one-way analysis of variance or the Kruskal-Wallis H test was used for comparison of continuous data between multiple groups; a logistic regression analysis was performed for the variables with statistical significance in univariate analysis; a Spearman correlation analysis was performed to investigate the correlation between data. The receiver operating characteristic (ROC) curve was used to evaluate the diagnostic efficiency of indices, and MedCalc software was used to investigate whether there was a significant difference in diagnostic efficiency. ResultsThere were significant differences in NLR and ApoA-I level between the groups with different severities of AP (χ2= 64.124, F=40.277, P＜0.001). On admission, NLR was positively correlated with Atlanta grading, Ranson score, MCTSI score, and BISAP score (r=0.370, 0.129, 0.260, and 0.122, all P＜0.05), and ApoA-I level was negatively correlated with Atlanta grading, Ranson score, MCTSI score, and BISAP score (r=-0.358, -0.220, -0.297, and -0.251, all P＜0.05). NLR was an independent risk factor for non-MAP (odds ratio ［OR］=1.104, 95% confidence interval ［CI］: 1.070-1.140, P＜0.001), while ApoA-I was an independent protective factor against non-MAP (OR=0.138, 95% CI: 0.070-0.264, P＜0.001); NLR was an independent risk factor for SAP (OR=1.163, 95% CI: 1.107-1.222, P＜0.001), while ApoA-I was an independent protective factor against SAP (OR=0013, 95% CI: 0.003-0.056, P＜0.001). NLR had an area under the ROC curve (AUC) of 0.700 (95% CI: 0.656-0.742, P＜0.001) in predicting non-MAP; ApoA-I had an AUC of 0.684 (95% CI: 0.640-0.726, P＜0.001) in predicting non-MAP; NLR combined with ApoA-I had an AUC of 0.748 (95%CI: 0.706-0.787, P＜0.001) in predicting non-MAP. NLR combined with ApoA-I had a better value than NLR or ApoA-I alone in predicting non-MAP (Z=3.439 and 2.462, both P＜0.05). NLR had an AUC of 0.752 (95% CI: 0.710-0.791, P＜0.001) in predicting SAP; ApoA-I had an AUC of 0.797 (95% CI: 0.757-0.833, P＜0.001) in predicting SAP; NLR combined with ApoA-I had an AUC of 0.857 (95% CI: 0.822-0.888, P＜0.001) in predicting SAP. NLR combined with ApoA-I had a better value than NLR or ApoA-I alone in predicting SAP (Z=3.171 and 2.630, both P＜0.05). ConclusionNLR combined with ApoA-I can be used as a good indicator for predicting the severity of AP in the early stage after admission.
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Objective To investigate the predictive effect of hypersensitive C-reactive protein(Hs-CRP)and neutrophil and lymphocyte ratio(NLR)on the prognosis in young patients with ischemic stroke. Methods From October 2016 to October 2017,110 consecutive young patients(18-45 years old)with ischemic stroke admitted to the Department of Neurology,Xuanwu Hospital,Capital Medical University were enrolled retrospectively. According to the modified Rankin scale(mRS)scores,they were divided into either a good prognosis group(mRS≤2;n=90)or a poor prognosis group(mRS>2;n=20).The patients completed the related examinations within 24 h after admission,including blood routine and Hs-CRP.The NLR value was calculated according to the count of neutrophils and lymphocyte in blood routine.The age,gender,underlying diseases(hypertension,diabetes,hyperlipidemia,hyperhomocysteinemia),histories of smoking and drinking,National Institutes of Health stroke scale(NIHSS)scores of both groups of patients were documented.The poor prognosis after discharge at 90 d was used as the dependent variable,the independent variables of P<0.05 in univariate analysis were further performed with multivariate logistic regression analysis.The receiver operating characteristic(ROC)curve was used to evaluate the sensitivity and specificity of the independent risk factors. The Youden index was calculated and the optimal cut-off value was determined. Results (1)Compared with the good prognosis group,the poor prognosis group had higher NIHSS score,NLR and Hs-CRP at admission.The differences between the 2 groups were statistically significant(9.0[4.5,13.0]vs.2.5[2.0,4.0],2.97[2.31,4.20]vs.2.13[1.76,2.70],4.65 [2.70,9.52]mg/L vs.2.06[0.87,4.54]mg/L;all P<0.05).There were no significant differences in other baseline data and clinical characteristics between the two groups(all P>0.05).(2)The results of the multivariate logistic regression analysis indicated that the high level of Hs-CRP(OR,1.086,95%CI 1.009-1.169)and higher NIHSS score(OR,1.487,95%CI 1.229-1.797)at admission were the independent risk factors for poor prognosis(all P < 0. 05),and there was no significant relation between NLR and prognosis(P>0.05).(3)The area under the ROC curve of the Hs-CRP levels at admission was 0.722(95%CI 0.591-0.853,P=0.002).When the predictive value of Hs-CRP level at admission was 3.365 mg/L,the maximum Youden index was 0.367,its corresponding sensitivity was 70.0%and specificity was 66.7%. Conclusions The higher Hs-CRP level and NIHSS score at admission may independently predict the poor prognosis of young patients with ischemic stroke at 90 d after discharge to a certain extent.It is not appropriate to use Hs-CRP≥3.365 mg/L alone for poor prognosis screening,but NLR may not be associated with the prognosis at admission.
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Objective To investigate value of peripheral NLR and PLR for the survival of patients with primary gastric cancer.Methods The clinical data of 132 primary gastric cancer patients and 30 healthy controls were analyzed by the Kaplan-Meier, Log-rank test and multivariate COX regression.Results NLR, PLR levels of the case group were significantly higher than that in the healthy control group (t=6.67, P=0.000;t=13.23, P=0.000); the higher the age, the greater tumor diameter, the higher the degree of differentiation, lymph node metastasis, and not be treated with surgery, NLR and PLR could increase (P<0.05);NLR and PLR showed a significant positive correlation (r=0.3164, P=0.0002);survival time of low NLR group was (57.59 ±2.23) months and high NLR group was (35.22 ±3.09) months(P<0.05);survival time of low PLR group was (54.09 ±2.66) months and high PLR group was (35.22 ±2.75 ) months(P<0.05);age, clinical stage, lymph node metastasis and NLR, PLR levels were independent factors for the overall survival in patients with gastric cancer ( P<0.05 ) .Conclusion NLR and PLR of gastric cancer patients increase significantly and are closely related to tumor size, metastasis, clinical stage, and the deterioration, which showes some predictive value for the survival prognosis of the patients.