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Objective:To correlate neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and D-dimer (DD) with the severity of acute cholangitis.Methods:The clinical data of 96 patients with acute cholangitis who received treatment in Panjin Central Hospital from September 2019 to March 2021 were retrospectively analyzed. These patients were divided into three groups according to the severity of acute cholangitis: 36 patients with mild acute cholangitis (group A), 35 patients with moderate acute cholangitis (group B), and 25 patients with severe acute cholangitis (group C). The correlation between age, sex, NLR, PLR, DD, and the severity of acute cholangitis was compared among the three groups.Results:In groups A and B, the area under the receiver operating characteristic curve (AUC) showing the performance of DD, NLR, and PLR levels in predicting acute cholangitis was 0.800, 0.838, and 0.721, respectively, with the optimal cut-off value of 1.985 mg/L, 9.589, and 154.410, respectively. Among them, NLR had the largest AUC, and the highest sensitivity (82.9%), and had a high diagnostic value. In groups B and C, the AUC for DD, NLR, and PLR was 0.967, 0.915, and 0.543, respectively, with the optimal cut-off value of 6.000 mg/L, 22.390, and 264.220, respectively. DD and NLR had a diagnostic significance (both P < 0.05), but PLR had no diagnostic significance ( P > 0.05). The AUC for DD was the largest, and therefore DD had a great diagnostic significance. When NLR, PLR, and DD were jointly detected, the AUC was the highest and the diagnostic value was the highest. The AUC in groups A and B was 0.866, and that in groups B and C was 0.977. Conclusion:The levels of DD, NLR, and PLR increase in patients with acute cholangitis, which are related to the severity of the disease. DD, NLR, and PRL can be used as indicators to evaluate mild and moderate acute cholangitis, and NLR has the highest diagnostic value. DD and NLR can be used as indicators to evaluate moderate to severe acute cholangitis, and the effect of DD is superior to that of NLR. The combined detection of the three indicators can increase the value to evaluate the severity of acute cholangitis, and its effect is superior to that of a single detection. The combined detection of NLR, PLR, and DD is helpful for the clinical diagnosis and treatment of acute cholangitis.
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Objective:To investigate the effect of peripheral blood neutrophil-to-lymphocyte ratio (NLR) before radical radiotherapy on overall survival (OS) of patients with esophageal squamous cell carcinoma.Methods:The clinical data of 359 patients with esophageal squamous cell carcinoma from March 2011 to January 2017 in Shanxi Provincial Cancer Hospital were retrospectively analyzed. The gender, age, smoking index, Karnofsky score, lesion site, lesion length, tumor length, TNM stage, concurrent chemoradiotherapy, NLR, etc., were observed. Receiver operating characteristic (ROC) curve was drawn according to patients' NLR to find the optimal cut-off value, the patients were divided into the low NLR group and the high NLR group, and the OS of the two groups was analyzed. Univariate log-rank test and multivariate Cox analysis were used to determine the factors affecting the OS of patients.Results:The area under the curve (AUC) of NLR for predicting OS was 0.576, the best cut-off value for OS prediction was 2.103 6, and the sensitivity and specificity were 60.8% and 55.2%, respectively. According to the best cut-off value of peripheral blood NLR 2.103 6, the 359 patients were divided into the low NLR group (NLR < 2.103 6, 156 cases, 43.5%) and high NLR group (NLR ≥ 2.103 6, 203 cases, 56.5%). There were statistical differences in gender ( χ2 = 8.960, P = 0.003) and lesion length ( χ2 = 12.948, P = 0.002) between low NLR group and high NLR group. Univariate analysis showed that the lesion length, NLR, N stage, M stage and total TNM clinical stage were influencing factors affecting OS of patients (all P < 0.05). Multivariate Cox regression analysis showed that the lesion length ( HR = 1.456, 95% CI 1.215-1.745, P < 0.01), NLR ( HR = 1.313, 95% CI 1.020-1.690, P = 0.035) and N stage ( HR = 1.768, 95% CI 1.391-2.248, P < 0.01) were independent influencing factors affecting OS of patients with esophageal squamous cell carcinoma before radical radiotherapy. Conclusions:Peripheral blood NLR is an independent influencing factor affecting OS of esophageal squamous cell carcinoma patients before radical radiotherapy. NLR has important reference value for predicting the OS of patients with esophageal squamous cell carcinoma after radical radiotherapy.
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ObjectiveCardiovascular disease (CVD) is the main cause of morbidity and mortality in patients with hemodialysis (HD) end-stage renal disease (ESRD). This paper analyzes and discusses the relationship between neutrophils-to-lymphocytes ratio (NLR) and heart valve calcification (CVC) in maintenance hemodialysis (MHD) patients to provide theoretical basis for the prevention and treatment of CVC.MethodsThe demographic data, relevant clinical indicators and laboratory examination results of 135 patients with MHD in the Second Hospital of Anhui Medical University were retrospectively analyzed to calculate the NLR value. Echocardiography was used to detect the incidence of CVC in the patients, and they were divided into calcification group and non-calcification group. The correlation between NLR value and CVC in MHD patients was analyzed, and the independent risk factors of CVC were discussed by using Logistic regression.ResultsAmong the 135 MHD patients, CVC was found in 59 cases (43.7%). Compared with the non-calcification group, patients in the calcification group showed significant increases in age, dialysis age, high-sensitivity c-reactive protein (HsCRP), ALP and NLR, with statistically significant differences (P5.02 (OR=17.709, P=0.046) were independent risk factors for heart valve calcification in MHD patients.ConclusionThe incidence of heart valve calcification is high in MHD patients, and NLR is an independent risk factor for it.
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Objective To investigate the prognostic value of Ki67 and derived neutrophil to lymphocyte ratio (dNLR) in clinical outcomes of patients with nasopharyngeal carcinoma.Methods A total of 180 patients with undifferentiated nasopharyngeal carcinoma confirmed by pathology from January 2011 to June 2015 in our hospital were enrolled.The neutrophil count and white blood cell count before radiotherapy and chemotherapy were collected,and dNLR was calculated.The positive rate of Ki67 in tumor tissues was detected by immunohistochemistry.The predictive values of Ki67 positive rate and dNLR on the overall survival (OS) rate and progression free survival (PFS) rate were evaluated.Results The 3-year OS rate prediction thresholds for patients with nasopharyngeal carcinoma by Ki67 and dNLR were 73.5％ and 2.21,respectively,which assessed by receiver operating characteristic (ROC) curve.The proportion of TNM Ⅲ-Ⅳ stage in patients with Ki67 ≥73.5％ was higher than that in Ki67 ＜ 73.5％ (100％ vs.89.7％,x2 =5.529,P =0.019);the proportion of T3-4 stage in dNLR ≥2.21 was higher than that in dNLR ＜ 2.21 (91.1％ vs.75.0％,x2 =6.228,P=0.013),and the proportion of TNM Ⅲ-Ⅳ stage in the dNLR≥2.21 group was higher than that in the dNLR ＜ 2.21 group (100％ vs.90.3％,x2 =4.355,P =0.037).Multivariate Cox regression analysis indicated that Ki67≥73.5％ (HR=3.011,95％CI:1.874-4.982,P＜0.001) and dNLR≥2.21 (HR =2.234,95％CI:1.274-3.382,P =0.001) were independent risk factors for OS in patients with nasopharyngeal carcinoma,while Ki67 ≥ 73.5％ (HR =2.842,95 ％ CI:2.055-4.337,P ＜ 0.001) and dNLR ≥ 2.21 (HR =2.086,95％ CI:1.452-2.983,P ＜0.001) were also independent risk factors for PFS in patients with nasopharyngeal carcinoma.Patients were divided into high-risk group,medium-risk group and low-risk group combined with Ki67 and dNLR,the 3-year OS rates were 20.0％,85.7％ and 95.3％ respectively,and the 3-year PFS rates were 12.0％,78.6％ and 89.4％ respectively,with statistical differences (x2 =15.521,P ＜ 0.001;x2 =15.849,P ＜ 0.001).Conclusion Ki67 and dNLR can effectively predict OS and PFS in patients with nasopharyngeal carcinoma,combined with Ki67 and dNLR can prognose stratification of patients with nasopharyngeal carcinoma.
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@#Objective To investigate the association between neutrophil to lymphocyte ratio (NLR) and the severity of coronary artery disease in patients with acute coronary syndrome (ACS), and analyze the value of NLR in the diagnosis of acute myocardial infarction. Methods The clinical data of 259 ACS patients with coronary angiography at our hospital from November 2016 to March 2017 were retrospectively analyzed. Among them, there were 148 cases of unstable angina (UA group), 46 cases of acute non-ST elevation myocardial infarction (NSTEMI group), and 65 cases of acute ST-elevation myocardial infarction (STEMI group). The differences of white blood cell count (WBC), neutrophil counts (N), lymphocyte count (L), NLR, hypersensitive c-reactive protein (hs-CRP), myocardial enzyme spectrum, blood lipids, blood glucose, and liver function were compared between the three groups. According to the results of coronary angiography, patients were divided into single-vessel disease group (n=70), double-vessel disease group (n=70) and three-vessel disease group (n=119) in the basis of the number of coronary lesions, and the differences in inflammatory cells were compared between the different-number vessel lesion groups. At the same time, the receiver operating characteristic (ROC) curves of NLR were drawn to evaluate the predictive values of NLR for acute myocardial infarction. Results The levels of WBC, N, NLR, hs- CRP, cTnT, CK and CK-MB were significantly higher in turn in UA group, NSTEMI group and STEMI group (P＜0.05). NLR increased gradually with the increased numbers of stenosed coronary artery. The ROC curve showed that the area under the curve of NLR was 0.865 (95%CI: 0.814-0.916)． In addition, the optimal cutoff value of NLR in predicting acute myocardial infarction was 4.22 with sensitivity of 72.1% and specificity of 95.3%. Conclusion NLR levels are positively correlated with the severity of ACS, and which have high value for the diagnosis of acute myocardial infarction, and can be used as a predictor of the condition of ACS patients.
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Objective To analyze the related influencing factors of progressive ischemic stroke, and to investigate the value of serum markers for prediction of progressive ischemic stroke. Methods Three hundred and six patients with acute cerebral infarction were divided into progressive ischemic stroke (PIS) group (n=91) and non-progressive ischemic stroke (NPIS) group (n=215). Data of gender, age, past medical history, personal history and serum markers were collected and compared in two groups. Binary Logistic regression was used to analyze the influencing factors of PIS. The receiver operating characteristic (ROC) curves of neutrophils to lymphocytes ratio (NLR), fibrinogen and fasting blood glucose were analyzed in two groups. Results Positive rates of hypertension history, diabetes history, hypercholesterolemia history, incidence of large artery atherosclerotic (LAA) stroke were significantly higher in PIS group than those in NPIS group ( P<0.05). The levels of neutrophils, NLR, fibrinogen and fasting blood glucose were significantly higher, but the level of lymphocytes was significantly lower in patients with PIS than those in patients with NPIS (P<0.05). Logistic regression analysis confirmed that diabetes, LAA stroke, NLR, fibrinogen and fasting blood glucose were independent risk factors for the PIS ( P<0.05). The areas under ROC curve by NLR, fibrinogen and fasting blood glucose were 0.777, 0.560 and 0.574, respectively. The sensitivities of NLR, fibrinogen and fasting blood glucose were 72.5%, 59.8%and 47.3%, respectively;and the specificities were 76.7%, 51.2% and 69.8%, respectively. Conclusion The occurrence of PIS is related with blood pressure, blood lipids, inflammatory cells in peripheral bolld, fibrinogen and fasting blood glucose. The level of NLR in peripheral blood can predict the occurrence of PIS, which can be used as an important reference index for early diagnosis of PIS.
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OBJECTIVE: To predict the American Joint Cancer Committee tumor-node-metastasis stage in patients with papillary thyroid carcinoma by evaluating the relationship between the preoperative neutrophil-to-lymphocyte ratio and the tumor-node-metastasis stage. METHODS: We retrospectively examined 161 patients with a diagnosis of papillary thyroid carcinoma. The Neutrophil-to-Lymphocyte Ratio was calculated according to the absolute neutrophil counts and absolute lymphocyte counts on routine blood tests obtained prior to surgery and patients with a Neutrophil-to-Lymphocyte Ratio of 2.0 or more were classified as the high NLR group, while those with a Neutrophil-to-Lymphocyte Ratio less than 2.0 were classified as the low Neutrophil-to-Lymphocyte Ratio group. Clinicopathological variables, which were stratified by the Neutrophil-to-Lymphocyte Ratio, were analyzed. A multivariate analysis was performed to determine factors that affect the Neutrophil-to-Lymphocyte Ratio. The association between the Neutrophil-to-Lymphocyte Ratio and the TNM stage in patients ≥45 years of age was analyzed using the Spearman rank correlation. RESULTS: Various blood indices, including hemoglobin, platelet and thyroid-stimulating hormone levels in the two groups showed no significant differences. Lymph node metastasis, multifocality and tumor size exhibited significant differences in the two groups (p=0.000, p=0.000 and p=0.035, respectively). Correlation analysis indicated that a higher preoperative Neutrophil-to-Lymphocyte Ratio was observed in patients with lymph node metastasis, larger tumor size and multifocality (r=0.341, p=0.000; r=0.271, p=0.000; and r=0.182, p=0.010, respectively). For patients ≥45 years of age, the number of patients with an advanced TNM stage in the high NLR group was higher than that in the low Neutrophil-to-Lymphocyte Ratio group (p=0.013). A linear regression analysis showed that the preoperative Neutrophil-to-Lymphocyte Ratio was positively correlated with the American Joint Cancer Committee tumor-node-metastasis stage (rho=0.403, p=0.000). CONCLUSION: The preoperative Neutrophil-to-Lymphocyte Ratio was closely related to the stage of papillary thyroid carcinoma. The increase in the preoperative Neutrophil-to-Lymphocyte Ratio contributed to the advanced tumor-node-metastasis stage of papillary thyroid carcinoma patients ≥45 years of age.