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In the non-specific immune system of human, neutrophils, lymphocytes, monocytes and platelets are important components that play a role in regulating and inducing tissue damage and can reflect the body′s level of immunity.These peripheral blood cells are functionally and quantitatively abnormal in the presence of serious infections or immune deficiencies, but these parameters are usually interpreted in isolation.Recent studies have found that comprehensive indicators derived from peripheral blood parameters, such as neutrophil to lymphocyte ratio, platelet to lymphocyte ratio, monocyte to lymphocyte ratio or lymphocyte to monocyte ratio have predictive value for the occurrence and prognosis of diseases.This article reviews the role of these indicators in common childhood diseases and provides a reference for the diagnosis and treatment of some diseases.
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The study aimed to evaluate the predictive value of the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) for 28-day mortality in patients treated with extracorporeal membrane oxygenation (ECMO). Patients receiving ECMO treatment were selected from the Department of Intensive Care Medicine of Zhejiang Hospital from January 2019 to February 2022. The moment when patients started receiving ECMO treatment was set as the starting point, and death at 28 days was set as the endpoint. The patients were divided into survivors and deaths. Laboratory tests, such as neutrophil, lymphocyte, and platelet counts, using the peripheral blood of all patients were collected within 24 h after ECMO treatment. NLR and PLR were calculated. The risk factors influencing prognosis were analyzed by logistic regression. The correlation between NLR, PLR, acute physiology, and chronic health score Ⅱ (APACHE Ⅱ) was investigated. Receiver operating characteristic (ROC) curve analysis was used to analyze the value of NLR and PLR in predicting the 28-day mortality of patients treated with ECMO. Kaplan-Meier method was used to analyze the cumulative survival of patients at 28 days. The results showed that of 53 patients, 20 survived, and 33 died. The NLR and PLR of the deceased were higher than those of the survivors (NLR: 30.67±14.48 vs. 17.41±7.06;PLR: 303.34±159.23 vs. 191.54±106.03; P<0.001). NLR and PLR were positively correlated with APACHE Ⅱ ( r=0.296, r=0.284, P<0.05). ROC curve analysis showed that the area under the curve (AUC) of NLR and PLR to predict the 28 d death of ECMO-treated patients was 0.805 and 0.714, respectively, and the optimal cutoff values of NLR and PLR were 18.93 and 253.0, respectively. The 28-day fatality rate in patients with NLR≥18.93 was higher than that in patients with NLR<18.93 [86.20%(25/29) vs. 33.33%(8/24), χ2=15.625, P<0.01],that in patients with a PLR≥253.0 was higher than that in patients with PLR<253.0 [82.61%(19/23) vs. 46.67%(14/30), χ2=7.158, P<0.01]. Kaplan-Meier survival curve showed that the 28-day cumulative survival rate of NLR≥18.93 was lower than that of NLR<18.93 [9.00 (2.00, 19.50) d vs. 28.00 (10.75, 28.00) d, Z=-3.124, P<0.01], and that of PLR≥253.0 was lower than that of PLR<253.0 [6.00 (2.00, 19.00) d vs. 28.00 (6.25, 28.00) d, Z=-2.673, P<0.01]. Thus, NLR and PLR have good predictive value for 28-day mortality in patients treated with ECMO.
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Objective:To evaluate the prognostic value of combined detection of platelet-to-lymphocyte ratio (PLR), neutrophil-to-lymphocyte ratio (NLR) and squamous cell carcinoma antigen (SCC) for patients with advanced cervical squamous cell carcinoma undergoing radical radiotherapy.Methods:Clinical data of 127 patients with advanced cervical squamous cell carcinoma who received radical radiotherapy in the Affiliated Tumor Hospital of Nantong University from January 2016 to February 2019 were analyzed retrospectively. The enrolled cases were divided into the survival group and death group according to the survival at the end of 3 years after treatment. The laboratory indexes of peripheral blood were collected before treatment, PLR and NLR were calculated, and the differences of clinical parameters were compared between two groups. The prediction model was established, and the prediction efficiency of PLR, NLR and SCC alone and combined prediction models for 3-year overall survival (OS) in patients with advanced cervical squamous cell carcinoma was compared through the ROC curve. Univariate and multivariate analyses of prognosis were carried out by binary logistic regression model.Results:A total of 127 patients with advanced cervical squamous cell carcinoma were included in the study. There were 96 cases in the survival group and 31 cases in the death group. There were significant differences between two groups in FIGO stage, longest diameter of tumor, lymph node metastasis, PLR, NLR and SCC (all P<0.05). The area under ROC curve (AUC) of PLR, NLR and SCC was 0.660, 0.712 and 0.700, respectively. The AUC of PLR+NLR+SCC combined prediction model was increased to 0.784. Logistic multivariate analysis showed that FIGO Ⅲ, FIGO Ⅳ, lymph node metastasis, PLR≥205.555, NLR≥3.060 and SCC≥6.950 ng/ml were the independent risk factors for 3-year OS in patients with advanced cervical squamous cell carcinoma (all P<0.05). Conclusions:PLR, NLR and SCC have good value in predicting the 3-year OS of patients with advanced cervical squamous cell carcinoma, and the combined prediction model of PLR+NLR+SCC has higher prediction value.
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Objective:To investigate the clinical significance of the acute physiology and chronic health evaluationⅡ (APACHEⅡ) combined with different systematic inflammation markers (SIMs) including neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and lymphocyte-to-monocyte ratio (LMR)-in adult patients with venous-arterial extracorporeal membrane oxygenation (VA-ECMO).Methods:A total of 89 adult patients with VA-ECMO ( ≥ 3 d) in the Emergency Department of Jiangsu Provincial People's Hospital from January 2017 to June 2020 were retrospectively analyzed. Patients were divided into two groups: survivors ( n=39) and non-survivors ( n=50). The baseline APACHE Ⅱscore and PLR, NLR, LMR before ECMO implantation and at 1, 2, 3 day after ECMO were recorded. Binary logistic regression was used to analyze the risk factors of 28-day mortality in patients with VA-ECMO. The utility of APACHEⅡ score and SIMs alone or combination for predicting clinical prognosis was evaluated using receiver operating characteristic (ROC) curve analysis. The patients were divided into the high risk group and the low risk group according to the best cut-off value, and the difference of ECMO-related complications between the two groups was compared. Results:When combined APACHEⅡ score with SIMs, APACHEⅡ + PLR 48 h + LMR 24 h + LMR 72 h demonstrated the greatest predictive ability with an AUC of 0.833. Compared with the high-risk group, the low-risk group has a lower incidence of acute renal injury, infection, bleeding complications, the use of continuous renal replacement therapy, mechanical ventilation, and a higher hospital survival rate.Conclusions:The combination of APACHEⅡ score and SIMs-PLR, LMR- is better than a single one for death prediction, and it is expected to be a new predictive model for early identification of the risk of death or poor prognosis in patients with VA-ECMO.
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Objective:To explore the value of neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) combined with bedside index for severity in acute pancreatitis (BISAP) score in predicting severe acute pancreatitis (SAP) in patients with hypertriglyceridemia pancreatitis (HTGP).Methods:Patients who met the diagnostic criteria of HTGP were retrospectively collected in the Emergency Department of Peking University People's Hospital from January to December in 2019. Patients were assigned to two groups according to the severity of acute pancreatitis: the mild acute pancreatitis group and severe acute pancreatitis (SAP) group. Blood samples were taken within 24 h after the onset of HTGP for analysis. White blood cell count, neutrophil count, lymphocyte count, and other laboratory indicators were detected. BISAP score was performed, and NLR and PLR were calculated in all patients within 24 h of the onset of HTGP. Comparison of various indicators was performed in the two groups. The risk factors of SAP patients with HTGP were analyzed by Logistic regression. The correlation of risk factors was analyzed by correlation. The receiver operating characteristic (ROC) curve was drawn, and the optimal thresholds of NLR and PLR were calculated respectively. The BISAP score, NLR combined with BISAP score (BN score), PLR combined with BISAP score (BP score), and NLR, PLR combined with BISAP score (BNP score) were compared respectively to predict SAP in patients with HTGP.Results:A total of 82 patients were collected. There were significant differences in the proportion of patients with fever, NLR, PLR, lactate dehydrogenase, urea nitrogen, Ranson score, acute physiology and chronic health evaluationⅡ(APACHEⅡ) score and BISAP score between the two groups (all P<0.05). Logistic regression analysis showed that NLR ( OR=1.859, 95% CI: 1.385-2.497, P<0.001), PLR ( OR=1.074, 95% CI: 1.036-1.112, P<0.001) and BISAP score ( OR=2.880, 95% CI: 1.578-5.258, P=0.001) were risk factors for severe HTGP. Correlation analysis confirmed that NLR and PLR were positively correlated with BISAP, APACHE Ⅱand Ranson score. The AUC of BISAP score, BN score, BP score and BNP score for predicting SAP in HTGP were 0.865 (95% CI: 0.787-0.943), 0.925 (95% CI: 0.869-0.981),0.930 (95% CI: 0.885-0.987), and 0.936 (95% CI: 0.874-0.986). Conclusions:NLR and PLR combined with BISAP score has a higher sensitivity to predict the severity of HTGP, which can predict severe pancreatitis within 24 h of the onset of HTGP, so that providing better guidance for treatment.
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Tumor recurrence is the main issue that affects the long-term survival of recipients after liver transplantation for hepatocellular carcinoma. Accurate preoperative evaluation and proper selection of transplant recipients are the key factors affecting the long-term prognosis of recipients undergoing liver transplantation for hepatocellular carcinoma. Neutrophil, lymphocyte, C-reactive protein, platelet and fibrinogen (FIB) are major biomarkers that indicate inflammatory response of the host. Multiple studies have found that these biomarkers may not only represent the inflammatory response, but also could be integrated to predict tumor recurrence and long-term survival rate of the recipients following liver transplantation for hepatocellular carcinoma. These biomarkers mainly consist of neutrophil-to-lymphocyte ratio (NLR), Glasgow prognostic score (GPS), FIB, platelet-to-lymphocyte ratio (PLR) and prognostic nutritional index (PNI), etc. In this article, research progresses on predictive effect of inflammatory biomarkers on prognosis of liver transplantation for hepatocellular carcinoma were reviewed.
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Objective:To explore the association of platelet to lymphocyte ratio (PLR) and neutrophil to lymphocyte ratio (NLR) with early gastric cancer (EGC), and to assess the predictive value of PLR and NLR in EGC diagnosis.Methods:From January 1, 2017 to December 31, 2020, 178 patients with EGC, 129 patients with chronic gastritis (CG), 122 patients with gastric intraepithelial neoplasia (GIN) admitted and treated at Taizhou Hospital of Zhejiang Province were enrolled. According to Rand random function and with the ratio of 7 to 3, the patients were divided into training group ( n=301, 125 cases of EGC, 90 cases of CG, 86 cases of GIN) and validation group ( n=128, 53 cases of EGC, 39 cases of CG, 36 cases of GIN). The age, gender, routine blood test, carcinoembryonic antigen (CEA) level, Helicobacter pylori ( H. pylori) infection status and other data of the patients were collected. The routine blood test and clinical characteristics of EGC, CG and GIN patients of the training group, and the routine blood test of EGC patients and CG+ GIN patients (hereinafter referred to as non-EGC group) of training group were compared to analyzed the independent risk factors of EGC. Receiver operator characteristic curve (ROC) was drawn. The optimal cut-off value, area under the curve (AUC), OR, 95% confidence interval (95% CI) of independent risk factors were analyzed for EGC diagnosis and prediction. A diagnostic prediction model was established, and the model was apply to the validation group for validation. Hosmer-Lemeshow test was used to test the fitting degree of the model. Compared the AUC of the model applied to training group with validation group to evaluate the discrimination of model. Kruskal-Wallis H test, Mann-Whitney U test or Wilcoxon rank sum test, chi square test, and univariate and multivariate logistic regression analysis were used for statistical analysis. Results:In the training group, the proportions of males and females in CG, GIN and EGC patients were 50.0% (45/90) and 50.0% (45/90), 61.6% (53/86) and 38.4% (33/86), 69.6% (87/125) and 30.4% (38/125), respectively, and the difference was statistically significant ( χ2=8.49, P=0.014). The proportion of males in EGC patients was higher than that in CG patients, and the difference was statistically significant ( χ2 =8.48, P=0.004). The H. pylori infection rate, age, PLR, NLR, lymphocyte count, neutrophil count, and CEA level of CG, GIN and EGC patients in the training group were 18.9% (17/90), 18.6% (16/86) and 43.2% (54/125); 54.0 years old (45.5 years old, 64.0 years old), 63.0 years old (58.0 years old, 66.3 years old) and 66.0 years old (58.5 years old, 71.0 years old); 113.70 (84.48, 136.09), 120.00 (97.94, 138.37) and 124.29 (101.97, 173.57), 1.55 (1.17, 2.23), 1.71 (1.44, 2.02) and 2.04 (1.57, 2.62), 2.00×10 9/L (1.50×10 9/L, 2.40×10 9/L), 1.75×10 9/L (1.50×10 9/L, 2.40×10 9/L) and 1.60×10 9/L (1.30×10 9/L, 2.05×10 9/L), 3.00×10 9/L (2.38×10 9/L, 3.90×10 9/L), 3.00×10 9/L (2.48×10 9/L, 3.40×10 9/L) and 3.30×10 9/L (2.60×10 9/L, 4.30×10 9/L), 1.70 g/L (1.10 g/L, 2.50 g/L), 2.05 g/L (1.48 g/L, 2.90 g/L) and 2.50 g/L (1.55 g/L, 3.40 g/L), respectively, and the differences were statistically significant ( χ2=21.26, H=41.00, 11.79, 21.13, 10.82, 8.54 and 14.42; all P<0.05). The H. pylori infection rate of EGC patients was higher than that of CG and GIN patients, the ages of EGC and GIN patients were older than that of CG patients, the NLR and PLR levels of EGC patients were higher than those of CG patients, the NLR level of EGC patients was higher than that of GIN patients, the level of lymphocyte count of EGC patients was lower than that of CG patients, and the levels of neutrophil count and CEA were higher than those of CG patients, and the differences were statistically significant( χ2=13.98 and 13.90, Z=-6.13, -4.15, -4.07, -3.25, -3.40, -3.18, -2.62 and -3.74; all P<0.017). The levels of PLR, NLR, neutrophil count and CEA of EGC patients were all higher than those of non-EGC patients(124.29 (101.97, 173.57) vs. 117.97 (101.57, 137.32); 2.04(1.57, 2.62) vs.1.66(1.25, 2.17); 3.30×10 9/L (2.60×10 9/L, 4.30×10 9/L) vs.3.00×10 9/L(2.40×10 9/L, 3.60×10 9/L); 2.50 g/L (1.55 g/L, 3.40 g/L) vs. 1.90 g/L(1.23 g/L, 2.70 g/L)), and the lymphocyte count level was lower than that of non-EGC patients (1.60×10 9/L(1.30×10 9/L, 2.05×10 9/L) vs. 1.80×10 9/L(1.50×10 9/L, 2.20×10 9/L)), and the differences were statistically significant ( Z=-3.23, -4.45, -2.91, -3.30 and -2.35; all P<0.05). The results of ROC analysis showed that the optimal cut-off value of PLR, NLR, CEA, neutrophil count and lymphocyte count was 138.18, 1.76, 2.70 g/L, 3.40×10 9/L, 1.80×10 9/L, respectively. The results of univariate analysis indicated that the gender, age, H. pylori infection, neutrophil count, PLR, NLR, lymphocyte count and CEA were all related to EGC ( χ2=5.98, 27.73, 21.26, 8.26, 10.26, 22.80, 4.81 and 25.91; all P<0.05). The results of multivariate analysis demonstrated that age≥70 years old( OR=9.267, 95% CI 3.239 to 26.514), H. pylori infection ( OR=3.353, 95% CI 1.862 to 6.037), NLR >1.76 ( OR=2.084, 95% CI 1.190 to 3.648), PLR>138.18 ( OR=2.452, 95% CI 1.325 to 4.539), CEA >2.70 g/L ( OR=2.637, 95% CI 1.490 to 4.667) were independent risk factors for EGC (all P<0.05). The Hosmer-Lemeshow test showed that there was no statistically significant difference between the predicted value of the model and the actual observed value ( P>0.05), which indicated that the fitting degree of the model was good. In the training group, the AUC of the diagnostic prediction model was 0.787 (95% CI 0.737 to 0.832, P<0.001). The model was applied to the validation group for validation, and the result showed that the AUC of the model was 0.664 (95% CI 0.576 to 0.745, P<0.001), which indicated that the discrimination of the model was good. Conclusions:PLR and NLR are independent risk factors of EGC, and may help to identify EGC. In this study the established diagnostic model has good discrimination and fitting degree, which can provide important reference information for early clinical diagnosis of EGC, which may facilitate early treatment and improve prognosis of patients.
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Objective:To study the value of neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) in diagnosing severe Mycoplasma pneumoniae pneumonia (MPP).Methods:A total of 616 cases of MPP patients in the Children′s Hospital of Soochow University from January 2015 to December 2017 were retrospectively analyzed.During the same period, 100 healthy children were selected as the healthy control group.NLR and PLR between MPP group and healthy control group, and those between severe MPP group and ordinary MPP group were compared by t test or rank sum test.Risk factors for severe MPP were identified.Receiver operating characteristic(ROC) curves were plotted to identify the cut-off point of NLR and PLR in distinguishing MPP from healthy subjects. Results:(1)The median of white blood cell count (WBC), neutrophil count (N), platelet count (PLT), NLR, PLR, immunoglobulin M (IgM) and the median percentage of CD3 -CD 19+ , CD 19+ CD 23+ in MPP group were significantly higher than those in healthy control group(8.36×10 9/L vs.7.49×10 9/L, 4.41×10 9/L vs.3.11×10 9/L, 340.92×10 9/L vs.234.00×10 9/L, 1.70 vs.0.91, 112.99 vs.70.34, 1.33 g/L vs.1.29 g/L, 20.95% vs.17.10%, 11.25% vs.9.70%), whereas the median of lymphocyte count (L), IgA and the median percentage of CD3 + , CD3 + CD8 + , and CD3 -CD +(16+ 56) were significantly lower(2.64×10 9/L vs.3.37×10 9/L, 0.86 g/L vs.1.30 g/L, 64.55% vs.68.00%, 23.65% vs.24.90%, 10.50% vs.12.20%)( Z=-3.074, -2.413, -2.972, -1.357, -1.863, -2.251, -4.282, -3.420, -2.221, -4.181, -2.784, -2.024, -2.791, all P<0.05). (2)The median of N, NLR, PLR, IgA, IgG, IgM and the average of percentage of CD3 + , CD3 + CD8 + in severe MPP group were significantly higher than those in ordinary MPP group[5.18×10 9/L vs.3.52×10 9/L, 2.39 vs.1.03, 149.32 vs.94.23, 1.29 g/L vs.0.71 g/L, 9.63 g/L vs.8.19 g/L, 1.40 g/L vs.1.29 g/L, (65.53±9.75)% vs.(62.81±9.89)%, (25.35±6.65)% vs.(23.38±6.91)%], whereas the median of L, the median percentage of CD3 -CD 19+ , and CD 19+ CD 23+ were significantly lower than those of ordinary MPP group(2.02×10 9/L vs.3.25×10 9/L, 17.40% vs.21.50%, 9.00% vs.11.70%)( Z/ t=-7.807, -11.313, -10.452, -8.819, -6.162, -3.047, -3.128, -3.270, -9.402, -5.191, -5.214, all P<0.05). (3)Univariate and multivariate Logistic regression analysis showed that CD3 -CD 19+ was the protective factor for severe MPP, while N, NLR and PLR were the risk factors for severe MPP (all P<0.05), with the risk sequence of NLR>PLR>N.(4)Area under ROC curve analysis of NLR and PLR in the diagnosis of severe MPP: NLR: AUC=0.789, 95% CI: 0.754~0.823, P<0.001; PLR: AUC=0.767, 95% CI: 0.730~0.804, P<0.001; when the critical value of NLR was 1.09, the sensitivity was 98.9%, and the specificity was 70.6%.When the critical value of PLR was 97.47, the sensitivity and specificity were 88.5% and 69.4%. Conclusions:NLR and PLR can be served as independent influencing factors for severe MPP, showing the diagnostic potential in severe MPP.
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Objective: Platelet-to-lymphocyte ratio (PLR) has recently been investigated as a new inflammatory marker in many inflammatory diseases, including systemic lupus erythematosus and immunoglobulin A vasculitis. However, there were very few reports regarding the clinical role of PLR in patients with anti-neutrophil cytoplasmic antibody (ANCA) associated vasculitis. This study was thus undertaken to investigate the relationship between inflammatory response and disease activity in Chinese patients with myeloperoxidase-anti-neutrophil cytoplasmic antibody (MPO-ANCA) associated vasculitis. Furthermore, we evaluated whether PLR predicts the progression of end stage of renal disease (ESRD) and all-cause mortality.Methods:The clinical, laboratory and pathological data, and the outcomes of MPO-ANCA associated vasculitis patients were collected. The Spearman correlation coefficient was computed to examine the association between 2 continuous variables. Cox regression analysis was used to estimate the association between PLR and ESRD or all-cause mortality. Results:A total of 190 consecutive patients with MPO-ANCA associated vasculitis were included in this study. Baseline PLR was positively correlated with CRP (r=0.333, P<0.001) and ESR (r=0.218, P=0.003). PLR had no obvious correlation with Birmingham Vasculitis Activity Score (BVAS). Patients having PLR≥330 exhibited better cumulative renal survival rates than those having PLR<330 (P=0.017). However, there was no significant difference in the cumulative patient survival rates between patients with PLR≥330 and those with PLR<330 at diagnosis (P>0.05). In multivariate analysis, PLR is associated with the decreased risk of ESRD (P=0.038, HR=0.518, 95％CI 0.278 to 0.963). We did not find an association between PLR with all-cause mortality using multivariate analysis (HR=1.081, 95％CI 0.591 to 1.976, P=0.801).Conclusion: PLR is positively correlated with CRP and ESR. Furthermore, PLR may independently predict the risk of ESRD.
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OBJECTIVES@#Platelet-to-lymphocyte ratio (PLR) has recently been investigated as a new inflammatory marker in many inflammatory diseases, including systemic lupus erythematosus and immunoglobulin A vasculitis. However, there were very few reports regarding the clinical role of PLR in patients with anti-neutrophil cytoplasmic antibody (ANCA) associated vasculitis. This study was thus undertaken to investigate the relationship between inflammatory response and disease activity in Chinese patients with myeloperoxidase-anti-neutrophil cytoplasmic antibody (MPO-ANCA) associated vasculitis. Furthermore, we evaluated whether PLR predicts the progression of end stage of renal disease (ESRD) and all-cause mortality.@*METHODS@#The clinical, laboratory and pathological data, and the outcomes of MPO-ANCA associated vasculitis patients were collected. The Spearman correlation coefficient was computed to examine the association between 2 continuous variables. Cox regression analysis was used to estimate the association between PLR and ESRD or all-cause mortality.@*RESULTS@#A total of 190 consecutive patients with MPO-ANCA associated vasculitis were included in this study. Baseline PLR was positively correlated with CRP (r=0.333, P<0.001) and ESR (r=0.218, P=0.003). PLR had no obvious correlation with Birmingham Vasculitis Activity Score (BVAS). Patients having PLR≥330 exhibited better cumulative renal survival rates than those having PLR<330 (P=0.017). However, there was no significant difference in the cumulative patient survival rates between patients with PLR≥330 and those with PLR<330 at diagnosis (P>0.05). In multivariate analysis, PLR is associated with the decreased risk of ESRD (P=0.038, HR=0.518, 95% CI 0.278 to 0.963). We did not find an association between PLR with all-cause mortality using multivariate analysis (HR=1.081, 95% CI 0.591 to 1.976, P=0.801).@*CONCLUSIONS@#PLR is positively correlated with CRP and ESR. Furthermore, PLR may independently predict the risk of ESRD.
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Humans , Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis/diagnosis , Antibodies, Antineutrophil Cytoplasmic/analysis , China/epidemiology , Kidney Failure, Chronic/complications , Lymphocytes , Peroxidase , Retrospective StudiesABSTRACT
OBJECTIVES: This study aimed to prospectively observe the changes in the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) before and after percutaneous coronary intervention (PCI) and their impact on the prognosis of patients with acute coronary syndrome (ACS). METHODS: Blood samples from 205 patients with ACS were collected at admission and at 24h and 30 days post-PCI to observe changes in the complete blood count. The Cox multivariate regression model was used to analyze the factors influencing major adverse cardiac events (MACE) after PCI in patients with ACS. A receiver operating characteristic (ROC) curve was used to evaluate the predictive value of inflammation indicators for MACE after PCI. RESULTS: Following PCI, NLR and PLR first increased postoperatively and then decreased within 30 days after PCI. Cox multivariate regression analysis showed that NLR and PLR at 24h post-PCI and acute ST-segment elevation myocardial infarction were independent influencing factors for the incidence of MACE after PCI. The ROC curve analysis showed that the NLR at 24h post-PCI was a better predictor of the incidence of MACE. The NLR at 24h post-PCI was significantly correlated with the number and length of implanted stents and operation duration. CONCLUSIONS: After PCI, patients with ACS had an increased neutrophil proportion and NLR. The NLR at 24h post-PCI was a better predictor of the incidence of postoperative MACE.
Subject(s)
Humans , Acute Coronary Syndrome/surgery , Percutaneous Coronary Intervention , Prognosis , Lymphocytes , Retrospective Studies , Lymphocyte Count , NeutrophilsABSTRACT
Objective:To explore the early prediction value of neutrophil to lymphocyte ratio (NLR) combined with platelet to lymphocyte ratio (PLR) for severe acute pancreatitis (SAP).Methods:A total of 216 patients were collected in the Emergency Department of Peking University People's Hospital who met the diagnostic criteria of acute pancreatitis (AP) from January to December in 2019. Patients were assigned to 3 groups according to the severity of AP: the mild acute pancreatitis group (MAP, n=86), moderately severe acute pancreatitis group (MSAP, n=40), and severe acute pancreatitis group (SAP, n=90). The peripheral blood was taken immediately. White blood cell count (WBC), neutrophil count (NEUT), lymphocyte count (LYM), hemoglobin (HGB), platelet count (PLT), total cholesterol (TC), triglyceride (TG), high-density lipoprotein (HDL), low density lipoprotein (LDL), serum creatinine (CR), and glucose (GLU) were detected. At the same time, CT imaging and other examinations were completed. NLR and PLR were calculated and compared among the three groups. The correlation between NLR, PLR, APACHE II score and Ranson score were compared. The receiver operating characteristic (ROC) curve was drawn to calculate the optimal thresholds of NLR and PLR. NLR-PLR was calculated according to the optimal thresholds of NLR and PLR, and the ROC curve was drawn to study the predictive value of NLR-PLR for SAP. Results:NLR [ OR=1.071, 95% CI (1.025, 1.120), P=0.002] and PLR [ OR=1.003, 95% CI (1.000, 1.244), P=0.044] were risk factors for SAP. NLR was positively correlated with Ranson score ( r=0.0342). NLR was positively correlated with APACHE II score ( r=0.0210). PLR was positively correlated with Ranson score ( r=0.0218, P=0.002). There was no correlation between PLR and APACHE II score ( P=0.157). The areas under the ROC curve (AUC) of NLR and PLR were 0.894 and 0.728. The optimal threshold, sensitivity and specificity of NLR were 6.105, 92.9% and 76.1%, and the optimal threshold, sensitivity and specificity of PLR were 154.358, 78.2% and 73.2%. The AUC of NLR-PLR (0.864) was the largest. Conclusions:NLR and PLR have predictive value for SAP patients within 48 h of the onset of AP. NLR-PLR combined detection have early predictive value for SAP within 48 h of onset.
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Objective:To analyze the potential role and prognostic value of platelet-to-lymphocyte ratio (PLR) at an early stage in arterial-venous extracorporeal membrane oxygenation (VA -ECMO).Methods:Totally 83 adult patients with VA-ECMO from June 2018 to June 2020 treated at Emergency Department of Jiangsu Provincial Hospital were retrospectively analyzed. Baseline characteristics between survivors ( n=46) and non-survivors ( n=37) were compared. Logistic regression analysis was used to predict the risk factors associated with 28-day mortality in VA-ECMO patients. The cut-off value was calculated by the receiver operating characteristic (ROC) curve. Results:PLR48-h ( OR=1.018,95% CI: 1.001-1.036, P=0.039) and continuous renal replacement therapy (CRRT) ( OR=7.095,95% CI: 1.099-45.799, P=0.039) were relevant risk factors of 28-day mortality in VA-ECMO patients. The cut-off value of PLR48-h was 156.3 [sensitivity: 57.8%, specificity: 86.1%, and area under the curve (AUC): 0.756]. Compared with the high PLR group (>156.3), the incidences of acute kidney injury (AKI) ( P<0.001) and bleeding events ( P=0.013) were significantly higher in the low PLR group (<156.3). Conclusions:The early PLR reduction and CRRT application during VA-ECMO support are related to poor prognosis.
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@#AIM:To explore the serum retinol binding protein 4(RBP4), inflammatory index neutrophil to lymphocyte ratio(NLR), platelet to lymphocyte ratio(PLR)in patients with type 2 diabetes mellitus(T2DM)after diabetic retinopathy(DR)levels and factors affecting the occurrence of DR in patients. <p>METHODS: The clinical data of 142 patients with T2DM who reached the standard of blood glucose control in our hospital from February 2017 to February 2020 were analyzed retrospectively. According to the results of fundus angiography, the patients were divided into Normal group(<i>n</i>=74), NPDR group(<i>n</i>=36)and PDR group(<i>n</i>=32). Compared the general data and blood test indexes of the three groups, and analyzed the factors affecting the occurrence of DR by multivariate Logistic regression analysis. Constructed a line chart prediction model to predict the occurrence of DR and evaluated its predictive efficiency. <p>RESULTS: The course of DM, serum GH, IGF-I, LDL-C, UA, RBP4, NLR and PLR in PDR group were significantly higher than those in Normal group and NPDR group, while C-P and 2h C-P were significantly lower than those in Normal group and NPDR group. The course of disease >12a, IGF-I >145μg/L, C-P <0.75ng/mL, UA >245ng/mL, RBP4 >54mg/L, NLR >1.8 and PLR >110 were independent risk factors for DR. The line chart model has high degree of differentiation and calibration, and has good prediction efficiency. <p>CONCLUSION: In addition to the common risk factors such as the course of DM, IGF-I, C-P and UA, the increase of RBP4, NLR and PLR is also related to DR, which may be involved in the occurrence and development of DR.
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Neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) have been associated with multiple entities and several types of cancers. They can be assumed as markers of inflammatory imbalance. The objective of this study is to evaluate the NLR and PLR in Peyronie's disease (PD) and to establish a comparison of its values in the acute and chronic stages. We recruited patients with PD from March 2018 to March 2019. The patients enrolled underwent medical and sexual history as well as a physical examination. The values of blood count of each patient were collected both in the acute and chronic stages. Wilcoxon test was used to compare the acute and chronic stage ratios. Kruskal-Wallis test was carried out to evaluate the impact of treatments on the ratios. To identify cutoff values, we used sensibility and specificity tables and receiver operating characteristic (ROC) curves. A total of 120 patients were enrolled. Their mean age was 55.85 (range: 18-77) years and the mean penile curvature was 48.43° (range: 10°-100°). In the acute stage, the mean NLR was 2.35 and the mean PLR was 111.22. These ratios, in the chronic stage, were 1.57 and 100.00, respectively. Statistically significant differences between acute and stable stages for both indices were found (NLR: P< 0.0001; PLR: P= 0.0202). The optimal cutoff for classification in acute or stable stage was 2 for NLR and 102 for PLR. According to our results, with an ordinary blood count, we could have important indications regarding the disease stage of the patient, and consequently on the most appropriate type of therapy to choose.
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Resumen Introducción: La relación entre 25-OH-vitamina D y el sistema inmune en pacientes con enfermedad renal crónica es objeto de atención. Objetivos: Evaluar la prevalencia de la deficiencia de vitamina D en pacientes en hemodiálisis e investigar la asociación entre la vitamina D y proteína C reactiva ultrasensible (PCRus), índice neutrófilo/linfocito (INL) e índice plaqueta/linfocito (IPL). Método: Estudio transversal de 80 pacientes en hemodiálisis, divididos en dos grupos: un nivel sérico de 25-OH-vitamina D < 20 ng/mL se consideró como deficiencia de vitamina D y ≥ 20 ng/mL, como normal. Con el análisis de correlación de Spearman se definió la relación entre los parámetros. Resultados: 40 % de los pacientes presentó deficiencia de vitamina D. Hubo diferencias significativas entre los grupos en PCRus (p = 0.047), INL (p = 0.039), IPL (p = 0.042) y tratamiento con análogos de vitamina D (p = 0.022). La vitamina D tuvo una correlación negativa significativa con PCRus (p = 0.026), INL (p = 0.013) e IPL (p = 0.022). Conclusiones: La deficiencia de vitamina D fue de 40 %. Los niveles de PCRus, INL e IPL fueron significativamente más altos ante deficiencia de vitamina D. Se encontró correlación inversa significativa entre vitamina D y PCRus, INL e IPL.
Abstract Introduction: The relationship between 25-OH-vitamin D and the immune system in patients with chronic kidney disease is a subject of attention. Objectives: To assess the prevalence of vitamin D deficiency in patients on hemodialysis and to investigate the association between vitamin D, ultra-sensitive C-reactive protein (US-CRP), neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR). Method: Cross-sectional study of 80 patients on hemodialysis, divided into two groups: a serum 25-OH-vitamin D level < 20 ng/mL was considered to be vitamin D deficiency and a serum level ≥ 20 ng/mL was regarded as normal. The relationship between the parameters was defined with Spearmans correlation analysis. Results: 40 % of the patients had vitamin D deficiency. There were significant differences between groups in US-CRP (p = 0.047), NLR (p = 0.039), PLR (p = 0.042) and treatment with vitamin D analogues (p = 0.022). Vitamin D had a significant negative correlation with US-CRP (p = 0.026), NLR (p = 0.013) and PLR (p = 0.022). Conclusions: The prevalence of vitamin D deficiency was 40 %. The values of US-CRP, NLR and PLR were significantly higher in the presence of vitamin D deficiency. A significant inverse correlation was found between vitamin D levels and US-CRP, NLR and PLR.
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Humans , Male , Female , Aged , Vitamin D/blood , Vitamin D Deficiency/blood , Vitamin D Deficiency/epidemiology , Renal Dialysis , Inflammation Mediators/blood , Renal Insufficiency, Chronic/blood , Blood Platelets/cytology , C-Reactive Protein/analysis , Lymphocytes/cytology , Biomarkers/blood , Prevalence , Cross-Sectional Studies , Renal Insufficiency, Chronic/therapy , Neutrophils/cytologyABSTRACT
Resumen Introducción: Existen índices hematológicos que correlacionan la severidad y predicen la mortalidad, principalmente en estados sépticos y de inflamación. Objetivo: Correlacionar los índices neutrófilo/linfocito (INL), plaqueta/linfocito (IPL) e inmunidad/inflamación sistémica (IIIS) con la severidad de COVID-19. Método: Estudio descriptivo, analítico y retrospectivo de pacientes con neumonía por COVID-19, en quienes se analizaron INL, IPL e IIIS. Resultados: Se incluyeron 100 pacientes, 54 hombres y 46 mujeres, con una media de 49.4 ± 19.3 años. Las medias de INL, IPL e IIIS fueron 10.7 ± 10.9, 290.1 ± 229.2 y 2.6 ± 3.4 × 109, respectivamente. En 54 %, la neumonía fue leve y en 46 %, grave. En cuanto a los desenlaces hospitalarios, 75 % egresó por mejoría y 25 % falleció. Las medias de INL, IPL e IIIS de los pacientes que fallecieron versus las de los pacientes que mejoraron fueron 20.4 ± 16.9 versus 7.5 ± 4.9 (p = 0.001), 417.1 ± 379.7 versus 247.7 ± 127.4 (p = 0.038) y 4.8 ± 6.1 versus 1.9 ± 1.2 × 109 (p = 0.030), respectivamente. Conclusión: Los índices hematológicos en pacientes con neumonía por COVID-19 pueden ser empleados como predictores de severidad y pronóstico.
Abstract Introduction: There are hematological parameters that correlate severity and predict mortality mainly in septic and inflammatory states. Objective: To correlate the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and systemic immune-inflammation index (SII) with COVID-19 severity. Method: Descriptive, analytical, retrospective study of patients with COVID-19 pneumonia, in which NLR, PLR and SII were analyzed. Results: One-hundred patients were included, 54 men and 46 women, with a mean age of 49.4 ± 19.3 years. NLR, PLR and SII means were 10.7 ± 10.9, 290.1 ± 229.2, and 2.6 ± 3.4 × 109, respectively. In 54 %, pneumonia was mild, and in 46 %, severe. Regarding hospital outcomes, 75 % were discharged due to improvement and 25 % died. NLR, PLR and SII means of the patients who died versus the patients who improved were 20.4 ± 16.9 versus 7.5 ± 4.9 (p = 0.001), 417.1 ± 379.7 versus 247.7 ± 127.4 (p = 0.038) and 4.8 ± 6.1 versus 1.9 ± 1.2 × 109 (p = 0.030), respectively. Conclusion: Hematological parameters can be used in patients with COVID-19-associated pneumonia as predictors of severity and prognosis.
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Humans , Male , Female , Adult , Middle Aged , Aged , Pneumonia, Viral/virology , Lymphocytes/metabolism , COVID-19/complications , Inflammation/virology , Pneumonia, Viral/physiopathology , Prognosis , Severity of Illness Index , Blood Platelets/metabolism , Retrospective Studies , Lymphocyte Count , COVID-19/physiopathology , Inflammation/pathology , Neutrophils/metabolismABSTRACT
Objective: The hemoglobin, albumin, lymphocyte, and platelet (HALP) score, neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) are the important prognostic markers in some tumor types. This study aimed to evaluate the prognostic impact of pretreatment using HALP, NLR, and PLR for patients with small-cell lung cancer (SCLC), who were undergoing chemotherapy. Materials and Methods: In this retrospective study, 335 patients with SCLC were included between 2016 and 2018. The cutoff values for HALP, NLR, and PLR were defined using X-tile software. Survival was analyzed by the Kaplan–Meier method, with differences analyzed through the log-rank test. The multivariate Cox proportional hazard model was used to evaluate the prognostic significance of HALP, NLR, and PLR for SCLC. Results: The median follow-up period was 27.1 months (range: 0.5–46.2 months). Based on the Kaplan–Meier curve analysis, it was noticed that the low pretreatment HALP (≤18.6), high pretreatment NLR (>2.4), and high PLR (>191.6) were significantly associated with worse overall survival (OS) (P = 0.009, 0.001, and 0.033, respectively). Cox multivariate analysis demonstrated that low pretreatment HALP and high pretreatment NLR were the independent prognostic factors for worse OS (hazard ratio [HR] = 1.468, 95% confidence interval [CI]: 1.004–2.146, P = 0.047; HR = 0.722, 95% CI: 0.542–0.960, P = 0.025, respectively). Conclusion: HALP and NLR were the independent prognostic factors of OS for SCLC patients undergoing chemotherapy
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Abstract Objective Missed abortion occurs in ~ 15% of all clinical pregnancies. The pathogenesis is not clearly known. However, defective placentation resulting in maternal systemic inflammatory response is considered responsible for missed abortion. Platelet lymphocyte ratio (PLR) and neutrophil lymphocyte ratio (NLR) are increasingly cited parameters of inflammation in the literature. However, no study evaluated the PLR and NLR rates in missed abortions so far. The aim of the present study is to investigate whether complete blood count (CBC) inflammatory parameters such as NLR and PLR are increased in patients with missed abortion. Methods Medical records of 40 pregnant women whose gestation ended in missed abortion at between 6 and14 weeks of gestation and of 40 healthy pregnant women were collected and compared retrospectively. The groups were compared regarding hemoglobin, hematocrit, platelet count (PLT), mean platelet volume (MPV), platelet distribution width (PDW), PLR and NLR. Results Platelet distribution width, NLR and PLR values were higher in the missed abortion group compared with the healthy pregnant women group (rates are p = 0.043; p = 0.038; and p = 0.010, respectively). Hematocrit, MPV, and lymphocyte values were found to be lower in the missed abortion group compared with the healthy pregnant women group (p = 0.027, p = 0.044 and p = 0.025, respectively). Conclusion The PDW, NLR and PLR values of the missed abortion group were reported high; and MPV values were reported low in the present study. These findings may help to speculate a defective placentation in the pathogenesis of missed abortion.
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Platelet Count , Lymphocytes , Abortion, Missed/diagnosis , Neutrophils , Pregnancy Trimester, First , Biomarkers/blood , Medical Records , Retrospective Studies , ROC Curve , Sensitivity and Specificity , Abortion, Missed/bloodABSTRACT
Background: Although clear cell renal cell carcinoma (ccRCC) is the most common histological variety of malignant renal tumor, histological variants are often encountered in clinical practice which behaves differently. Paucity of such tumors makes them a subject of interest worldwide. As per European Association of Urology, since ccRCC is a non-designation, they included all non-clear cell RCC under one nomenclature as rare kidney cancer (RKC). The objective of our study is to determine influence of inflammatory markers on the prognosis of RKC.Methods: Data from cancer registry was retrieved and all rare kidney cancer patient’s data were analysed particularly the markers of inflammation like neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), systemic inflammatory immune index (SIII) and C reactive protein (CRP) to albumin ratio and their probable influence on cancer free survival (CFS), progression free survival (PFS) and overall survival (OS).Results: Data of 33 cases of rare kidney cancers were included in this study. The follow up duration ranges from 6.8 months to 38.6 months. In the univariate analysis, NLR had a significant influence on CFS, PFS and OS (cutoff value-3.2, 95% confidence interval [CI], CFS: p<0.05; PFS: p=0.05; OS: p<0.05), PLR in respect to CFS (cutoff value-67.5, 95% CI, p<0.05) and SIII had a significant impact on CFS and OS (cutoff value-8.67, 95% CI, 11.10-19.57, CFS: p<0.05; OS: p<0.05).Conclusions: Inflammation markers such as NLR, PLR, SII Index and CRP or albumin ratio could be independent predictors of clinical outcome and prognostics factors in rare kidney cancers. However, this needs to be validated by multicentre randomised studies.