Serum cystatin C,monocyte/high-density lipoprotein-C ratio,and uric acid for the diagnosis of coronary heart disease and heart failure

BACKGROUND Coronary heart disease(CHD)and heart failure(HF)are the major causes of morbidity and mortality worldwide.Early and accurate diagnoses of CHD and HF are essential for optimal management and prognosis.However,conventional diagnostic methods such as electrocardiography,echocardiography,and cardiac biomarkers have certain limitations,such as low sensitivity,specificity,availability,and cost-effectiveness.Therefore,there is a need for simple,noninvasive,and reliable biomarkers to diagnose CHD and HF.AIM To investigate serum cystatin C(Cys-C),monocyte/high-density lipoprotein cholesterol ratio(MHR),and uric acid(UA)diagnostic values for CHD and HF.METHODS We enrolled 80 patients with suspected CHD or HF who were admitted to our hospital between July 2022 and July 2023.The patients were divided into CHD(n=20),HF(n=20),CHD+HF(n=20),and control groups(n=20).The serum levels of Cys-C,MHR,and UA were measured using immunonephelometry and an enzymatic method,respectively,and the diagnostic values for CHD and HF were evaluated using receiver operating characteristic(ROC)curve analysis.RESULTS Serum levels of Cys-C,MHR,and UA were significantly higher in the CHD,HF,and CHD+HF groups than those in the control group.The serum levels of Cys-C,MHR,and UA were significantly higher in the CHD+HF group than those in the CHD or HF group.The ROC curve analysis showed that serum Cys-C,MHR,and UA had good diagnostic performance for CHD and HF,with areas under the curve ranging from 0.78 to 0.93.The optimal cutoff values of serum Cys-C,MHR,and UA for diagnosing CHD,HF,and CHD+HF were 1.2 mg/L,0.9×10^(9),and 389μmol/L;1.4 mg/L,1.0×10^(9),and 449μmol/L;and 1.6 mg/L,1.1×10^(9),and 508μmol/L,respectively.CONCLUSION Serum Cys-C,MHR,and UA are useful biomarkers for diagnosing CHD and HF,and CHD+HF.These can provide information for decision-making and risk stratification in patients with CHD and HF.

Analysis of the Peripheral Blood Helper T-Cell 17- Cell Level and Monocyte/Lymphocyte Ratio for Colorectal Cancer Prognosis Prediction

Objective: To investigate the value of peripheral blood helper T cell 17 cell level and monocyte/lymphocyte ratio to predict the prognosis of colorectal cancer patients. Methods: 74 colorectal cancer patients who attended Hospital 960 from January 2021 to January 2022 were retrospectively analyzed. Clinical data of the patients were collected, including gender, age, and histologic type. Immunohistochemical indexes such as Th17 cell level and monocyte/ lymphocyte ratio in the peripheral blood of patients were also collected. The prognosis of patients after treatment, as well as peripheral blood Th17 and MLR levels, were observed and analyzed. Results: After follow-up after treatment, in the final 74 patients, the prognosis was good in 32 patients, accounting for 43.24%, and the prognosis was bad in 42 patients, accounting for 56.76%. There were no significant differences between the average age and tumor diameters of the good prognosis and poor prognosis groups (P > 0.05). However, the TNM staging, intervention taken, differentiation degree, presence of distant metastasis, presence of lymph node metastasis, Th17 level, and MLR level are significantly different between the two groups (P < 0.05). Conclusion: Peripheral blood Th17 and MLR have predictive value for the prognosis of colorectal cancer patients, and high levels of peripheral blood Th17 and MLR imply poor prognosis. The detection of peripheral blood Th17 and MLR levels is simple and convenient and can be used as indicators to provide a reference for the prognostic assessment of colorectal cancer patients.

Systemic immune inflammation index, ratio of lymphocytes to monocytes, lactate dehydrogenase and prognosis of diffuse large Bcell lymphoma patients

BACKGROUND In malignant tumors,inflammation plays a vital role in the development,invasion,and metastasis of cancer cells.Diffuse large B-cell lymphoma(DLBCL),the most common malignant proliferative disease of the lymphatic system,is commonly associated with inflammation.The international prognostic index(IPI),which includes age,lactate dehydrogenase(LDH),number of extranodal lesions,Ann Arbor score,and Eastern Cooperative Oncology Group(ECOG)score,can evaluate the prognosis of DLBCL.However,its use in accurately identifying highrisk patients and guiding treatment is poor.Therefore,it is important to find novel immune markers in predicting the prognosis of DLBCL patients.AIM To determine the association between the systemic immune inflammation index(SII),ratio of lymphocytes to monocytes(LMR),ratio of LMR to LDH(LMR/LDH),and prognosis of patients with DLBCL.METHODS A total of 68 patients diagnosed with DLBCL,treated in our hospital between January 2016 and January 2020,were included.χ2 test,Pearson’s R correlation,Kaplan Meier curves,and Cox proportional risk regression analysis were used.The differences in the SII,LMR,and LMR/LDH among patients with different clinicopathological features were analyzed.The differences in progression-free survival time among patients with different SII,LMR,and LMR/LDH expressions and influencing factors affecting the prognosis of DLBCL patients,were also analyzed.RESULTS The LMR and LMR/LDH in patients with Ann Arbor stage III–IV,ECOG score≥2,and SII,IPI score 2–5 were significantly higher than those of patients with Ann Arbor stage I-II and ECOG score<2(P<0.05).Patients with high SII,LMR,and LMR/LDH had progression-free survival times of 34 mo(95%CI:32.52–38.50),35 mo(95%CI:33.42–36.58)and 35 mo(95%CI:33.49–36.51),respectively,which were significantly lower than those with low SII,LMR,and LMR/LDH(P<0.05);the SII,LMR,and LMR/LDH were positively correlated(P<0.05).Cox proportional risk regression analysis showed that the SII,LMR,and LMR/LDH were influencing factors for the prognosis of DLBCL patients(hazard ratio=1.143,1.665,and 1.704,respectively;P<0.05).CONCLUSION The SII,LMR,and LMR/LDH are related to the clinicopathological features of DLCBL,and they also influence the prognosis of patients with the disease.

Monocyte-to-lymphocyte ratio as a prognostic factor in peripheral whole blood samples of colorectal cancer patients

BACKGROUND Colorectal cancer is the third most common malignancy worldwide.Therefore,it is critically important to identify new useful markers that can be easily obtained in routine practice.Inflammation is a crucial issue in the pathogenesis and development of cancer.AIM To evaluate the prognostic value of absolute monocyte count,monocyte to lymphocyte ratio(MLR),the combination of neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio(NLR-PLR),and combined platelet and neutrophilto-lymphocyte ratio(PLT-NLR)in peripheral blood samples of patients with colorectal cancer undergoing surgery.METHODS We conducted a retrospective study of 160 patients with colorectal cancer who underwent surgery,and 42 healthy controls.The status of absolute monocyte count,MLR,NLR-PLR and PLT-NLR was calculated on the basis of blood samples obtained before and after surgery.Haematologic factors were examined in correlation with the type of tumour growth,tumour size,histological type,percentage of mucinous component,grade of malignancy,Tumour-Node-Metastasis stage,venous,lymphatic and perineural invasion of cancer cells,status of lymph node invasion and the presence of cancer cell deposits.The Kaplan-Meier method and the long-rank test were used to compare survival curves.To determine independent prognostic factors,univariate and multivariate Cox proportional hazards regression models were applied.RESULTS The PLT-NLR status was correlated with tumour size and the presence of perineural invasion(P=0.015;P=-0.174,P=0.037).Moreover,high NLR-PLR and PLR-NLR ratios in the blood samples obtained after surgery were positively associated with histological type of cancer and percentage of the mucinous component(NLR-PLR:P=0.002;P=0.009;PLR-NLR status:P=0.002;P=0.007).The analysis of 5-year disease-free survival showed that the MLR of whole blood obtained after surgery[HR=2.903,95%CI:(1.368-6.158),P=0.005]and the status of lymph node metastasis[HR=0.813,95%CI:(0.653-1.013),P=0.050]were independent prognostic factors in colorectal cancer patients.CONCLUSION The postoperative MLR in whole blood samples can be used as an independent prognostic factor in patients diagnosed with colorectal cancer.

Prognostic value of neutrophil/lymphocyte,platelet/lymphocyte,lymphocyte/monocyte ratios and Glasgow prognostic score in osteosarcoma:A meta-analysis

BACKGROUND Some studies investigated the prognostic role of several blood biomarkers,including the neutrophil/lymphocyte ratio(NLR),platelet/lymphocyte ratio(PLR),lymphocyte/monocyte ratio(LMR)and Glasgow prognostic score(GPS),in osteosarcoma,but their results were inconsistent with each other.AIM To identify the prognostic value of NLR,PLR,LMR and GPS in osteosarcoma patients through reviewing relevant studies.METHODS The PubMed,EMBASE,Web of Science and CNKI databases were searched up to October 2,2021.The primary and second outcomes were overall survival(OS)and disease-free survival(DFS),respectively.The hazard ratios(HRs)with 95%confidence intervals(CIs)were combined to assess the association between these indicators and prognosis of osteosarcoma patients.RESULTS A total of 13 studies involving 2087 patients were eventually included.The pooled results demonstrated that higher NLR and GPS were significantly associated with poorer OS(HR=1.88,95%CI:1.38-2.55,P<0.001;HR=2.19,95%CI:1.64-2.94,P<0.001)and DFS(HR=1.67,95%CI:1.37-2.04,P<0.001;HR=2.50,95%CI:1.39-4.48,P<0.001).However,no significant relationship of PLR and LMR and OS(P=0.085;P=0.338)and DFS(P=0.396;P=0.124)was observed.CONCLUSION Higher NLR and GPS were related with worse prognosis and might serve as novel prognostic indicators for osteosarcoma patients.

Lymphocyte-to-monocyte ratio can predict mortality in pancreatic adenocarcinoma

AIM To determine if the lymphocyte-to-monocyte ratio(LMR) could be helpful in predicting survival in patients with pancreatic adenocarcinoma.METHODS We retrospectively reviewed the medical records of all patients diagnosed with pancreatic adenocarcinoma in the VA North Texas Healthcare System from January 2005 to December 2010. The LMR was calculated from peripheral blood cell counts obtained at the time of diagnosis of pancreatic cancer by dividing the absolute lymphocyte count by the absolute monocyte count. A Univariable Cox regression analysis was performed using these data, and hazard ratios(HR) and 95%CI were calculated. The median LMR(2.05) was used to dichotomize patients into high-LMR and low-LMR groups and the log rank test was used to compare survivalbetween the two groups.RESULTS We identified 97 patients with pancreatic adenocarcinoma(all men, 66% white, 30% African-American). The mean age and weight at diagnosis were 66.0 ± 0.9(SEM) years and 80.4 ± 1.7 kg respectively. Mean absolute lymphocyte and monocyte values were 1.50 ± 0.07 K/mL and 0.74 ± 0.03 K/mL respectively. Mean, median and range of LMR was 2.36, 2.05 and 0.4-12 respectively. In the univariable Cox regression analysis, we found that an increased LMR was a significant indicator of improved overall survival in patients with pancreatic adenocarcinoma(HR = 0.83; 95%CI: 0.70-0.98; P = 0.027). Kaplan-Meier analysis revealed an overall median survival of 128 d(95%CI: 80-162 d). The median survival of patients in the high-LMR(> 2.05) group was significantly greater than the low-LMR group(≤ 2.05)(194 d vs 93 d; P = 0.03), validating a significant survival advantage in patients with a high LMR.CONCLUSION The LMR at diagnosis is a significant predictor for survival and can provide useful prognostic information in the management of patients with pancreatic adenocarcinoma.

The combined prognostic value of pretreatment neutrophil-to-lymphocyte ratio, lymphocyte-to-monocyte ratio, and platelet-to-lymphocyte ratio in stage IE/IIE extranodal natural killer/T-cell lymphoma

Objective This study aimed to explore the combined prognostic value of pretreatment neutrophil-tolymphocyte ratio(NLR), lymphocyte-to-monocyte ratio(LMR), and platelet-to-lymphocyte ratio(PLR) in newly diagnosed IE/IIE extranodal natural killer/T-cell lymphoma(ENKTL) treated with a P-Gemox regimen combined with radiotherapy or radiotherapy alone.Methods A total of 132 patients from 2009 to 2017 at the Sichuan Cancer Hospital were enrolled in the study. The cutoff values of NLR, LMR, and PLR using overall survival(OS) rate as an endpoint were obtained by the receiver operating curve. Results The cutoff value of NLR was 3.5. Patients with high NLR had significantly shorter progressionfree survival(PFS)(P < 0.001) and OS(P < 0.001) than those with low NLR. Similarly, the cutoff value of LMR was 3.0. The high LMR group had significantly longer PFS(P=0.001) and OS(P < 0.001) than the low LMR group. Similarly, the cutoff value of PLR was 191.7. The high PLR group was significantly associated with poor PFS(P < 0.001) and OS(P < 0.001) than the low PLR group. Furthermore, combining NLR, LMR, and PLR to build a new model to stratify patients into low-, intermediate-, intermediate-high-, and high-risk groups, there were also significant differences in PFS(P < 0.001) and OS(P < 0.001). The univariate analysis showed that presenting B symptoms, stage IIE, local tumor invasion, Eastern Cooperative Oncology Group score ≥ 2, elevated lactate dehydrogenase level, elevated NLR, decreased LMR, and elevated PLR were significantly associated with poor survival. The multivariate analysis demonstrated that PLR was an independent prognostic factor for both PFS(hazard ratio [HR]= 2.073, 95% confidence interval [CI]= 1.080–3.981, P = 0.028) and OS(HR = 2.127, 95% CI = 1.102–4.107, P = 0.025).Conclusion Elevated pretreatment PLR was a novel simple predictor of poor survival in patients with stage IE/IIE ENKTL. Combining NLR, LMR, and PLR could provide additional stratification.

The prognostic value of lymphocyte-to-monocyte ratio in retinopathy of prematurity

AIM： To evaluate the associations between development of retinopathy of prematurity（ROP） and serum lymphocyteto-monocyte ratio（LMR）, neutrophil-to-lymphocyte ratio（NLR）, and platelet-to-lymphocyte ratio（PLR）. METHODS： A retrospective cohort study was performed, involving infants who were screened for ROP from January 2015 to December 2015. Preterm newborns of ≤32 gestational weeks with ROP were enrolled as the observation group, and non-ROP infants were enrolled as the control group, whose complete blood cell were measured within the first 24 h of life. The levels of NLR, LMR and PLR were determined in all groups. The data obtained were analyzed using univariate and multivariate logistic regression analysis.RESULTS： In this study, 40 cases of ROP were enrolled and 40 cases of non-ROP as controls. The LMR levels were significantly higher（P〈0.001） in ROP group（3.96±1.16） compared to non-ROP group（2.85±0.79）. The NLR levels were significantly lower（P=0.035） in ROP group {median [interquartile range（IQR）], 0.88（0.67-1.46）} compared to non-ROP group [median（IQR）, 1.20（0.85-1.89）]. The median PLR values were 61.99（IQR, 50.23-75.98） in ROP group and 69.24（IQR, 55.52-88.12） in non-ROP group（P=0.104）. Logistic regression analysis suggested that LMR was an independent risk factor for ROP（OR： 0.275; 95% CI： 0.134-0.564; P=0.001）. CONCLUSION： The findings demonstrate that higher LMR is independently and significantly associated with the development of ROP, and the LMR may be invoked as a predictive tool for identifying risk for ROP.

Association of the Monocyte to HDL Cholesterol Ratio with Thrombus Burden in Patients with Acute Coronary Syndrome

Background: Intracoronary thrombus burden is associated with some adverse events and poor prognosis in patients with Acute Coronary Syndrome. Identifying predictors of the intracoronary thrombus burden may contribute to the management of Acute Coronary Syndrome. Objective: To assess the correlation between the Monocyte to HDL Cholesterol ratio with thrombus burden in patients with Acute Coronary Syndrome. Patients and Methods: 138 patients with ACS who were admitted to CCU department in National Heart Institute Cairoand Menoufia University Hospitals, Menoufia, underwent primary percutaneous coronary intervention (PCI).Angiographic thrombus burden was classified based on thrombolysis in myocardial infarction (TIMI) thrombus grades. The patients were grouped into 2 categories of low thrombus burden (grades 0 - 3) (49.7%) and high thrombus burden (grades 4 and 5) (50.3%). Results: On analysis we found that the MHR was significantly higher in the high thrombus burden group compared with the low thrombus (0.052 ± 0.019 vs 0.014 ± 0.008);P 0.001. Conclusion: Among Acute Coronary Syndrome patients underwent Primary PCI, MHR was independent predictor of high thrombus burden in patients with Acute Coronary Syndrome.

Evaluation of the neutrophil-lymphocyte ratio, platelet-lymphocyte ratio and monocyte lymphocyte ratio for diagnosis of testicular torsion

Objective:To explore the value of complete blood count(CBC),including neutrophil-lymphocyte ratio(NLR),platelet-lymphocyte ratio(PLR),and monocyte lymphocyte ratio(MLR)in diagnosis of testicular torsion(TT)and differential diagnosis from epididymo-orchitis.Methods:The study was conducted at the Antalya Training and Research Hospital Emergency Department in Turkey with acute scrotal pain patients from January 1st,2016 to January 1st,2018.The patients were categorized into 3 groups:the TT group who underwent an operation for TT(n=70),the epididymo-orchitis group who received epididymo-orchitis treatment(n=120),and the healthy control group(n=100).NLR,PLR,and MLR of the three groups were analysed and compared.The optimum cut-off values of NLR,MLR,and PLR were analyzed.Results:Mean NLR and MLR values were significantly higher in the epididymo-orchitis group and the TT group compared to the control group(P<0.001).Receiver operating characteristic analysis revealed a sensitivity of 77.1%and a specificity of 80%for NLR(77.1)and a sensitivity of 68.2%and a specificity of 78%for PLR(124.80).Moreover,when MLR was used to differentiate the two treatment groups,the optimal cut-off value had a sensitivity of 67.1%and a specificity of 75%(AUC:0.677-0.826,P<0.001).Conclusions:NLR,PLR,and MLR might be associated with the diagnosis of TT.These parameters provide a useful and economical method to help diagnose TT in the emergency department.

The Lower Peripheral Blood Lymphocyte to Monocyte Ratio Following Completion of First Line Chemotherapy Is a Risk Factor for Predicting Relapse in Patients with Diffuse Large B-Cell Lymphoma

Background and objective: During routine follow up, there is no specific predictor to ascertain relapse after standard first line chemotherapy in diffuse large cell lymphoma. Therefore, this study was designed to assess the prognostic significance of the ratio between absolute lymphocyte and monocyte counts (LMR) in the peripheral blood to verify relapse in diffuse large B cell lymphoma. Patients and methods: A total of 139 patients with newly diagnosed diffuse large B cell lymphoma (DLBCL) were evaluated and treated with CHOP or R-CHOP between the years 2009 and 2016. Three months following completion of first line therapy, Lymphocyte/monocyte ratio (LMR) was calculated from the routine automated complete blood cell count (CBC) attained a plateau after the bone marrow recovery after first line chemotherapy. The absolute lymphocyte count/absolute monocyte count ratio (LMR) was calculated by dividing the ALC by the AMC. Results: ROC curve analysis of 139 patients established 2.8 as cutoff point of LMR for relapse with AUC of 0.97 (95% CI 0.93 - 0.99, P ≤ 0.001). Cox regression analysis was performed to identify factors predicting relapse. In univariate regression analysis, ALC (95% CI 0.003 - 0.03, p ≤ 0.001), AMC (95% CI 15.4 - 128.8, p ≤ 0.001), LMR (95% CI 0.001 - 0.01, p ≤ 0.001), and LDH (95% CI 0.1 - 0.5, p ≤ 0.001) following completion of therapy are significant factors for relapse. Other significant factors for relapse are Ann Arbor stage (95% CI 1.1 - 6.9, P = 0.03), extranodal sites (95% CI 1.2 - 6.1, P = 0.01), age (95% CI 1.3 - 6.5, P = 0.01) and treatment of CHOP protocol (95% CI 0.05 - 0.6, P = 0.007). In a multivariate analysis LMR following completion of therapy was predictive for relapse (95% CI 0.001 - 0.2, P = 0.005). ALC was also significant in multivariate analysis (95% CI 0.01 - 0.8, P = 0.03). LDH following completion of therapy (95% CI 0.2 - 14.9, P = 0.5), AMC following completion of therapy (95% CI 0.3 - 43.1, P = 0.3), age (95% CI 0.9 - 205.4, P = 0.06), extra-nodal sites (95% CI 0.04 - 9.8, P = 0.8), Ann Arbor stage (95% CI 0.3 - 28.7, P = 0.3), and Treatment of CHOP protocol (95% CI 0.01 - 2.4, P = 0.2) were not statistically significant. Conclusion: This study observed that LMR assessed after first line chemotherapy during routine follow up is an independent predictor of relapse and clinical outcome in DLBCL patients. LMR at follow up can be used a simple inexpensive biomarker to alert clinicians for relapse during follow up after standard first line chemotherapy in DLBCL patients.

Absolute Lymphocyte/Monocyte Ratio at Diagnosis and Interim Positron-Emission Tomography Predict Survival in Classical Hodgkin Lymphoma

Interim Positron-Emission Tomography (int-PET) and the peripheral blood absolute lymphocyte/monocyte ratio at di- agnosis (ALC/AMC-DX) have been shown to be predictors for progression-free survival (PFS) and time to progression (TTP) in classical Hodgkin lymphoma (cHL). Therefore, we studied if the combination of ALC/AMC-DX and the (int-PET) can further stratified PFS and TTP in cHL patients. Patients were required to be diagnosed, treated, and followed with int-PET at Mayo Clinic, Rochester, Minnesota. From 2000 until 2008, 111 cHL patients qualified for the study. The median follow-up was 2.8 years (range: 0.3 - 10.4 years). Patients with a negative int-PET (N = 98) pre- sented with a higher ALC/AMC-DX (median of 2.32, range: 0.26 - 37.5) compared with patients with a positive int-PET (N = 13) (median of 0.9, range: 0.29 - 3.10), p 1.1. Group 1 experienced superior PFS and TTP in comparison with the other groups. In conclusion, the combination of ALC/AMC-DX and the int-PET provides a simple model to assess clinical outcomes in cHL.

Research progress of monocyte/high density lipoprotein ratio in cardiovascular diseases

In recent years,monocyte to high density lipoprotein cholesterol ratio(MHR)has attracted wide attention as a new marker of inflammatory response.This indicator includes two aspects:inflammatory response and lipid accumulation,which are the two most basic characteristics of Atherosclerosis(AS).AS is closely related to the occurrence of Cardiovascular diseases(CVD).A large number of existing studies have confirmed that MHR is an inflammatory marker that can dynamically reflect the trend of inflammation,can reflect the chronic inflammatory response in blood vessels,and can evaluate the occurrence,development and prognosis of cardiovascular disease in a non-invasive manner.This article reviews recent studies on the role of monocytes and high-density lipoproteins in chronic inflammation of blood vessels,as well as the current status of research on MHR and cardiovascular disease in the light of recent literature.

外周血NLR、NMR、LMR表达与帕金森病的相关性研究

目的探讨外周血中性粒细胞与淋巴细胞之比(NLR)、中性粒细胞与单核细胞之比(NMR)、淋巴细胞与单核细胞之比(LMR)表达水平与帕金森病(PD)的相关性。方法选取224例原发性PD患者为病历组,230例健康人为对照组,检测其外周血中NLR、NMR、LMR水平。①比较PD组和对照组间的NLR、NMR、LMR水平是否存在差异;②比较PD组按照不同因素分层后NLR、NMR、LMR水平是否存在差异;③分析PD组NLR、NMR、LMR的水平是否与临床特征之间存在相关性。结果①在总体样本中,PD组和对照组间NLR、NMR、LMR水平的比较差异均无统计学意义(均P>0.05)。按照性别、年龄分层,各亚组PD患者与其相对应正常对照组间NLR、NMR、LMR水平差异均无统计学意义(均P>0.05);②PD组按不同因素分层后:A.发病年龄>65岁PD组NLR水平(2.84±1.22)高于发病年龄≤65岁PD组(2.46±1.16),差异有统计学意义(P=0.018);B.女性PD组NMR水平(12.08±3.71)高于男性PD组(10.91±3.27),差异有统计学意义(P=0.013)女性PD组LMR水平(5.12±1.72)高于男性PD组(4.43±1.62),差异有统计学意义(P=0.002);C.病程>4年PD组和病程≤4年PD组间、早中晚三期PD组间、三种运动亚型(震颤为主型、姿势不稳/步态障碍型、混合型)PD组间、合并痴呆PD组和未合并痴呆PD组间的NLR、NMR、LMR水平比较差异均无统计学意义(均P>0.05);(3)PD组NLR水平与发病年龄存在正相关(r=0.223,P=0.001),LMR水平与发病年龄存在负相关(r=-0.202,P=0.002);PD组NLR、NMR、LMR水平与病程、H-Y分级、UPDRS-Ⅲ评分、NPI评分不存在相关性(均P>0.05)。结论外周血NLR、NMR、LMR水平在PD患者和正常健康人群间无差异,此三项指标均非导致PD患病的危险因素。NLR在发病年龄>65岁PD患者中的表达水平较发病年龄≤65岁PD患者高;NMR、LMR在女性PD患者中的表达水平较男性PD患者高。PD患者NLR表达水平与发病年龄呈正相关,而LMR表达水平与发病年龄呈负相关。

NLR、LMR、PLR在自身免疫性肝炎患者中的表达及意义

目的探讨自身免疫性肝炎(AIH)患者中炎性指标表达及意义。方法选取2019年1月—2022年1月龙岩市第二医院收治的91例AIH患者作为本次研究对象,作为AIH组,另外选取同期健康体检患者90例为对照组,比较两组患者肝脏生化和免疫指标及中性粒细胞-淋巴细胞比值(NLR)、血小板-淋巴细胞比值(PLR)、淋巴细胞-单核细胞比值(LMR)三项血细胞指标。结果AIH组患者的谷丙转氨酶(ALT)、谷草转氨酶(AST)、总胆红素(TBIL)、免疫球蛋白G(IgG)等肝脏生化指标均高于对照组(均P<0.05);AIH组NLR、PLR指标水平均高于对照组,LMR水平低于对照组(均P<0.05);经过二元logistic回归分析,NLR、PLR、LMR均是AIH的独立危险因素(均P<0.05)。根据绘制ROC曲线显示,NLR、PLR、LMR的AUC值分别为0.941、0.996、0.863,PLR诊断的价值高于NLR和LMR(P<0.05)。结论肝脏生化和免疫指标与AIH发生有影响,NLR、LMR、PLR是AIH的独立危险因素,在诊断AIH具有应用价值。

蛛网膜下腔出血患者外周血NLR、LMR、PLR和SII值变化的临床意义

目的 分析动脉瘤性蛛网膜下腔出血(aSAH)对血液学参数的影响及其与患者临床状态和短期预后的关系。方法 分析2019年3月至2022年5月于四川省科学城医院神经外科治疗的62例颅内动脉瘤(IA)破裂急性期患者和55例正常对照组。采用流式细胞术分析两组患者外周血中白细胞(WBC)与淋巴细胞(LC)计数的变化,计算中性粒细胞/淋巴细胞比(NLR)、淋巴细胞/单核细胞比(LMR)、血小板/淋巴细胞比(PLR)和全身免疫-炎症指数(SII),并分析血液学参数与患者临床状况和短期预后的关系。结果 与正常对照组相比,IA破裂组WBC、中性粒细胞(Ns)计数、NLR以及SII均明显升高,而LC计数和LMR降低。此外相比于临床状态恢复良好的患者,临床状态较差的患者LC计数明显降低,而NLR、PLR和SII值明显升高。格拉斯哥昏迷评分法(GCS)评分较低的患者CD3+、CD4-、CD8-细胞比例减少。此外,LC计数降低和PLR升高与较差的短期预后相关。结论 IA破裂后会导致全身免疫和炎症反应,LC计数、NLR、PLR和SII值可以作为临床状态及预后的标志物。

MLR与冠心病和冠状动脉病变程度相关性分析

目的探讨单核细胞/淋巴细胞比值(MLR)与冠心病(CHD)和冠状动脉病变程度的相关性。方法选取2022年6—12月上海交通大学医学院附属瑞金医院北部院区200例冠状动脉造影阳性(主要血管直径≥50%)的CHD患者(CHD组),以同期131例造影结果为阴性的患者为对照组。比较CHD组和对照组MLR、中性粒细胞/淋巴细胞比值(NLR)、血小板/淋巴细胞比值(PLR)的差异。采用Pearson或Spearman相关分析评估CHD患者MLR与肌酸激酶(CK)、乳酸脱氢酶(LDH)和Gensini积分的相关性。采用Logistic回归分析评估CHD的影响因素。采用受试者工作特征(ROC)曲线评估MLR诊断CHD的效能。结果CHD组MLR、NLR、PLR均高于对照组(P<0.001);CHD患者治疗后MLR水平与对照组差异无统计学意义(P>0.05)。MLR与CHD患者CK、LDH、Gensini积分均呈正相关(r值分别为0.1500、0.2900、0.5451,P<0.05)。Logistic回归分析结果显示,CK、MLR、NLR、PLR均是CHD的影响因素;调整混杂因素后,多因素Logistic回归分析结果显示,MLR>0.25时,发生CHD的风险是MLR≤0.17时的1.6倍[比值比(OR)值为1.609,95%可信区间(CI)为1.213~2.133]。ROC曲线分析结果显示,MLR诊断CHD的曲线下面积为0.6743,敏感性为62.00%,特异性为62.60%。结论MLR与CHD和冠状动脉病变程度有关,可能是CHD患者冠状动脉病变严重程度的独立预测因子,可帮助临床判断是否需要进行进一步的侵入性诊疗。

淋巴细胞与单核细胞比值、C反应蛋白与前白蛋白比值检测对甲型流感病毒重症感染婴幼儿的临床价值

目的 探讨淋巴细胞与单核细胞比值(LMR)、C反应蛋白与前白蛋白比值(CRP/PA)预测甲型流感病毒重症感染婴幼儿的临床价值。方法 选取2019年1月至2022年12月泰安市妇幼保健院儿内科住院的婴幼儿甲型流感病毒感染重症组(192例)、轻症组(187例)及健康对照者(393例),检测其血常规、CRP及PA水平,计算中性粒细胞/淋巴细胞比值(NLR)、LMR、血小板/淋巴细胞比值(PLR)、系统免疫炎症指数(SII)、CRP/PA。采用受试者工作特征(ROC)曲线和Logistic回归分析LMR、CRP/PA对甲型流感病毒重症感染的诊断及预测价值。结果 与对照组和轻症组比较,重症组NLM、PLR、SII、CRP/PA均显著升高,LMR显著降低(分别为1.09、88.07、310.75、0.05和3.90,P<0.05)。与对照组相比,轻症组CRP/PA显著升高,LMR显著降低(分别为0.04和6.31,P<0.05)。ROC曲线显示,诊断重症感染时,CRP/PA的特异度最高,为96.1%,LMR、CRP/PA联合检测的灵敏度、ROC曲线下面积(AUC)均优于单项检测(分别为88.5%、0.941)。LMR、CRP/PA联合检测对轻症与重症感染鉴别诊断的灵敏度、特异度和AUC均优于单项检测(分别为76.4%、60.2%、0.707)。校正年龄、性别及NLM、PLR、SII后,CRP/PA的升高与LMR的降低与甲型流感病毒感染独立相关,并区分轻症和重症。结论 甲型流感病毒感染患儿CRP/PA升高与LMR降低,还有助于区分轻症和重症,可为预测感染严重程度的指标,LMR、CRP/PA联合分析对轻重症感染的鉴别诊断具有重要价值。

术前淋巴细胞与单核细胞比值在乳腺癌预后评估的探讨

目的探究外周血中淋巴细胞/单核细胞比值对乳腺癌患者中预后评估作用。方法收集2013年-2018年军区总医院接受手术切除的乳腺癌患者82例,分析淋巴细胞单核细胞比值与患者临床资料、预后评估的价值。结果(1)根据无疾病生存期,建立ROC曲线,根据约登指数取最佳敏感度及特异度,得出淋巴细胞单核细胞比值临界值为5.78。(2)按照LMR5.78分组,通过单因素方差分析得出术前高值LMR组与低值LMR组的临床资料中,年龄、绝经状态、TNM分期、雌激素受体、孕激素受体等均与LMR分组无统计学意义,DFS与LMR分组有统计学意义(P<0.05)。(3)生存函数分析,高LMR组乳腺癌患者的DFS明显延长,差异有统计学意义(P<0.05)。结论术前LMR≥5.78是乳腺癌预后有力的因素,术前LMR检测方便、低廉、结果稳定可作为乳腺癌患者预后的生物学标志物之一。

MHR和SII早期联合检测对急性一氧化碳中毒患者病情及预后的评估

目的分析单核细胞与高密度脂蛋白胆固醇比值(MHR)、系统性免疫炎症指数(SII)在急性一氧化碳中毒(ACOP)患者中变化,探讨其早期联合检测对ACOP患者的病情及预后的评估。方法选取2019年1月—2023年1月在河北医科大学哈励逊国际和平医院急救医学部收治的ACOP患者120例,根据患者病情严重程度将其分为轻度中毒组30例、中度中毒组35例和重度中毒组55例;根据患者是否发生急性一氧化碳中毒迟发性脑病(DEACMP)情况分为DEACMP组17例和预后良好组103例;同期健康体检者30例作为对照组。所有患者均在入院时,对照组于体检时,检测MHR、SII、白细胞介素-18(IL-18)和C反应蛋白(CRP)的变化,记录患者60 d内DEACMP发生情况。通过Logistic回归分析ACOP发生DEACMP的独立危险因素。绘制受试者工作特征(ROC)曲线,计算曲线下面积(AUC),评估MHR和SII对ACOP患者发生DEACMP的预测价值。结果入院时,不同中毒程度患者MHR、SII、IL-18和CRP水平均高于对照组,中度高于轻度,重度高于中度、轻度,均有统计学差异(P<0.05)。3组患者DEACMP发生率分别为0,5.71%和27.27%,有统计学差异(χ^(2)=14.777,P=0.001)。相关分析结果显示,ACOP患者中毒程度与DEACMP发生率呈正相关(r=0.648,P=0.000)。Logistic回归分析结果显示,MHR、SII水平升高均是ACOP患者发生DEACMP的危险因素(OR=7.757、5.169,均P<0.01)。入院时MHR、SII、IL-18、CRP及MHR+SII预测发生DEACMP的AUC分别为0.840、0.862、0.771、0.706和0.899,MHR和SII联合应用预测能力优于MHR、SII、IL-18和CRP(P<0.05)。结论MHR和SII是ACOP患者发生DEACMP的独立危险因素,MHR和SII早期联合检测有助于ACOP患者病情和预后的评估。