Preoperative Neutrophil Lymphocyte Ratio and Platelet Lymphocyte Ratio Cannot Predict Lymph Node Metastasis and Prognosis in Patients with Early Gastric Cancer:a Single Institution Investigation in China

In the present study,we aimed at exploring the applied value of preoperative neutrophil lymphocyte ratio(NLR)and platelet lymphocyte ratio(PLR)in the prediction of lymph node metastasis(LNM)and prognosis in patients with early gastric cancer(EGC).We retrospectively analyzed a total of 248 consecutive patients who underwent curative gastrectomy to be identified T1 stage gastric adenocarcinoma between January 1,2010 and May 1,2016 in a single institution.According to median preoperative NLR and PLR value,we divided the patients into four groups:high NLR≥1.73 and low NLR〈1.73,high PLR≥117.78 and low PLR〈117.78.Furthermore,to evaluate the relationship between preoperative NLR and PLR values,we categorized patients according to cutoff preoperative NLR-PLR score of 2[high NLR(≥1.73)and high PLR(≥117.78)],1[either high NLR or high PLR],and 0[neither high NLR nor high PLR].Statistical analyses were conducted using SPSS 20.0 software.The results showed that the preoperative NLR or PLR values,lower or higher,could not predict the LNM in patients with EGC(both P=0.5440.05).The invasive depth of tumor was significantly correlated with LNM of EGC(P〈0.001).Kaplan-Meier plots illustrated that preoperative NLR and PLR values were not associated with overall survival(OS)in patients with EGC.It was concluded that the preoperative NLR and PLR may be the predictors for LNM and prognosis in patients with advanced gastric cancer;nevertheless,they cannot predict LNM and prognosis in patients with EGC.

Can the neutrophil-lymphocyte ratio, platelet-lymphocyte ratio and lymphocyte-monocyte ratio predict active bleeding in patients with upper gastrointestinal bleeding?

Objective:To investigate the relationship between upper gastrointestinal bleeding and neutrophil-lymphocyte ratio(NLR),platelet-lymphocyte ratio(PLR),and lymphocyte-monocyte ratio(LMR),and examine whether they can be used as markers of inflammation.Methods:The retrospective single-center study included a total of 189 patients with upper gastrointestinal bleeding admitted to the tertiary emergency department between January 2018 and January 2019.Besides,59 patients with similar demographic characteristics were selected as the control group.Besides,42 patients with active bleeding and 147 patients without active bleeding were categorized into two groups according to their endoscopy reports.The NLR,PLR,LMR values,potential risk factors,and demographic characteristics were analyzed.Results:The mean NLR levels were found significantly higher in the patient group compared to the control group(P<0.001),whereas the mean LMR levels were significantly lower in the patient group(P<0.001).The mean NLR and PLR levels were significantly higher in patients with active bleeding compared to those without active bleeding(P<0.001),whereas the mean LMR levels were significantly lower(P<0.001)for patients with active bleeding.The optimal cut-off value of NLR was found 2.1 for predicting uppergastrointestinal bleeding,with a sensitivity of 80.2%and specificity of 78.9%(AUC:0.840;P<0.001).Conclusions:NLR was determined to be a parameter that can be used as an indicator of active bleeding in patients with upper gastrointestinal bleeding.

Neutrophil Lymphocyte Ratio as an Inflammatory Marker in Chronic Kidney Disease: Determinants and Correlates

Introduction: Inflammation has been implicated as a major reason for the higher morbidity and mortality in chronic kidney disease (CKD) compared to the diseases that commonly precedes it. The neutrophil lymphocyte ratio (NLR) has increasingly been reported to be a marker of systemic inflammation. We studied the neutrophil lymphocyte ratio and its relationship with kidney function and other markers of inflammation in health and in CKD. Methods: Two hundred and forty four participants in three cohorts: healthy, CKD stage 1 - 2 and, stage 3 - 4, were studied. Data of clinical, NLR, uric acid, urine albumin creatinine ratio (UACR), electrolytes were documented and independent associates of NLR were determined. Results: The NLR was higher in the CKD cohorts, P Conclusion: The NLR as an inflammatory marker is elevated in chronic kidney disease, and increases with disease severity hence it can be a useful tool in determining the presence and severity of inflammation in CKD.

Inflammatory response related scoring systems in assessing the prognosis of patients with pancreatic ductal adenocarcinoma:a systematic review

BACKGROUND： Various scoring systems based on assessment of the systemic inflammatory response help assessing the prognosis of patients with pancreatic ductal adenocarcinoma.In the present systematic review we evaluated the validity of four pre-intervention scoring systems： Glasgow prognostic score（GPS） and its modified version（mGPS）, platelet lymphocyte ratio（PLR）, neutrophil lymphocyte ratio（NLR）, and prognostic nutrition index（PNI）.DATA SOURCES： MOOSE guidelines were followed and EMBASE and MEDLINE databases were searched for all published studies until September 2013 using comprehensive text word and MeSH terms. All identified studies were analyzed, and relevant studies were included in the systematic review.RESULTS： Six studies were identified for GPS/mGPS with3 reporting statistical significance for GPS/mGPS on both univariate analysis（UVA） and multivariate analysis（MVA）.Two studies suggested prognostic significance on UVA but not MVA, and in the final study UVA failed to show significance.Eleven studies evaluated the prognostic value of NLR. Six of them reported prognostic significance for NLR on UVA that persisted at MVA in 4 studies, and in the remaining 2 studies NLR was the only significant factor on UVA. In the remaining5 studies, all in patients undergoing resection, there was no significance on UVA. Seven studies evaluated PLR, with only one study demonstrated its prognostic significance on both UVAand MVA, the rest did not show the significance on UVA. Of the two studies identified for PNI, one demonstrated a statistically significant difference in survival on both UVA and MVA, and the other reported no significance for PNI on UVA.CONCLUSIONS： Both GPS/mGPS and NLR may be useful but further better-designed studies are required to confirm their value. PLR might be little useful, and there are at present inadequate data to assess the prognostic value of PNI. At present, no scoring system is reliable enough to be accepted into routine use for the prognosis of patients with pancreatic ductal adenocarcinoma.

Association between routine hematological parameters and sudden sensorineural hearing loss:A meta-analysis

Objective:Recent studies have shown that chronic inflammation contributes to the development of sudden sensorineural hearing loss(SSNHL).Some hematologic parameters have also been linked to the prognosis of SSNHL.However,the prognostic value of such hematological factors is not conclusive.This study explored the association of routine hematological parameters with SSNHL.Methods:A systematic literature search was conducted in PubMed,Cochrane Library,Web of Science and Embase to identify eligible studies.Standardized mean deviation(SMD)and the 95%confidence interval(CI)were retried from relevant studies for analysis.Heterogeneity,subgroup,and publication bias analyses were performed.Results:A total of 18 studies involving 1505 SSNHL patients and 1466 healthy persons were enrolled in the final analysis.The study population included 699 responders and 458 non-responders to treatment.Pooled results revealed that the neutrophil/lymphocyte ratio(NLR)and platelet/lymphocyte ratio(PLR)value in the SSNHL patient group were higher than in the healthy group(SMD=1.05,95%CI:0.86,1.24,p<0.001,SMD=0.52,95%CI:0.26,0.78,p<0.001,respectively).However,there was no significant difference in the mean platelet volumes(MPV)between the groups(SMD=0.03,95%CI:0.44,0.49,p=0.91).Notably,NLR and PLR values were evidently higher in the unrecovered group than in the recovered group(SMD=0.63,95%CI:1.02,0.23,p=0.002,SMD=0.4,95%CI:0.76,0.03,p=0.03,respectively).However,the MPV value was similar in both groups(SMD=0.35,95%CI:1.14,0.44,p=0.38).Conclusions:Our results show that NLR and PLR values can predict the onset and prognosis of SSNHL.

Value of Preoperative Hematological Parameters in the Prognosis of Gastric Cancer Patients Undergoing a Total Gastrectomy

Objective This study aimed to evaluate the relationships between the albumin/globulin ratio(AGR),neutrophil/lymphocyte ratio(NLR),and platelet/lymphocyte ratio(PLR)and clinicopathological information for gastric cancer patients.In addition,the prognostic values of these hematological parameters for resectable gastric cancer patients undergoing a total gastrectomy were determined.Methods A total of 245 patients with gastric cancer who underwent a total gastrectomy at our hospital between January 1,2005,and December 30,2015,were enrolled into this study.The preoperative AGR,NLR,and PLR in the serum samples of the patients were measured.The relationships between the hematological parameters and the disease-free survival(DFS)as well as overall survival(OS)were analyzed by statistical analysis.Results The cutoff values of AGR,NLR,and PLR were 1.57,3.5,and 193,respectively.Univariate analyses demonstrated that a low AGR,a high NLR,and a high PLR were significant risk factors for a poor prognosis.According to multivariate analysis,a high PLR was found to be independently associated with a poor survival.Additionally,when age was considered as a stratified factor,univariate analyses demonstrated that a low AGR had the tendency to be correlated with a shorter DFS in nonelderly patients(<65 years old).A low AGR was significantly correlated with a shorter DFS and OS in elderly patients(≥65 years old).Conclusion AGR,NLR,and PLR are independent risk factors associated with a poor gastric cancer survival by univariate analysis,and AGR is an independent risk factor for predicting DFS and OS in elderly patients(≥65 years old)with gastric cancer after total gastrectomy.