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.

Preoperative neutrophil-to-lymphocyte ratio plus platelet-to-lymphocyte ratioin predicting survival for patients with stage Ⅰ-Ⅱgastric cancer

Background:The preoperative neutrophil-to-lymphocyte ratio(NLR) and the platelet-to-lymphocyte ratio(PLR) are associated with poor prognosis of gastric cancer.We aimed to determine whether the combination of NLR and PLR(NLR-PLR) could better predict survival of patients after curative resection for stage Ⅰ-Ⅱ gastric cancer.Methods:We collected data from the medical records of patients with stage Ⅰ-Ⅱ gastric cancer undergoing curative resection between December 2000 and November 2012 at the Sun Yat-sen Cancer Center.The preoperative NLRPLR was calculated as follows:patients with both elevated NLR(≥2.1) and PLR(≥ 120) were given a score of 2,and patients with only one or neither were given a score of 1 or 0,respectively.Results:Kaplan-Meier analysis and log-rank tests revealed significant differences in overall survival(OS) among patients with NLR-PLR scores of 0,1 and 2(P < 0.001).Multivariate analysis showed that OS was independently associated with the NLR-PLR score[hazard ratio(HR) = 1.51,95%confidence interval(CI) 1.02-2.24,P = 0.039]and TNM stage(HR = 1.36,95%CI 1.01-1.83,P= 0.041).However,other systemic inflammation-based prognostic scores,including the modified Glasgow prognostic score,the prognostic nutritional index,and the combination of platelet count and NLR,were not.In TNM stage-stratified analysis,the prognostic significance of NLR-PLR was maintained in patients with stage Ⅰ(P < 0.001) and stage Ⅱ cancers(P= 0.022).In addition,the area under the receiver operating characteristic curve for the NLR-PLR score was higher than those of other systemic inflammation-based prognostic scores(P = 0.001).Conclusion:The preoperative NLR-PLR score is a useful predictor of postoperative survival in the patients with stage l-ll gastric cancer and may help identify high-risk patients for rational therapy and timely follow-up.

Platelet-to-lymphocyte ratio in the setting of liver transplantation for hepatocellular cancer: A systematic review and meta-analysis

AIM To perform a systematic review and meta-analysis on platelet-to-lymphocyte ratio(PLR) as a risk factor for post-transplant hepatocellular cancer(HCC) recurrence. METHODS A systematic literature search was performed using PubM ed. Participants of any age and sex, who underwent liver transplantation for HCC were considered following these criteria:(1) studies comparing pre-transplant low vs high PLR values;(2) studies reporting post-transplant recurrence rates; and(3) if more than one study was reported by the same institute, only the most recent was included. The primary outcome measure was set for HCC recurrence after transplantation. RESULTS A total of 5 articles, published between 2014 and 2017, fulfilled the selection criteria. As for the quality of the reported studies, all the investigated articles presented an overall high quality. A total of 899 cases were investigated: 718 cases(80.0%) were males. Three studies coming from European countries and one from Japan presented HCV as the main cause of cirrhosis. On the opposite, one Chinese study presented a greater incidence of HBV-related cirrhotic cases. In all the studies apart one, the PLR cut-off value of 150 was reported. At meta-analysis, high PLR value was associated with a significant increase in recurrence after transplantation(OR = 3.33; 95%CI: 1.78-6.25; P < 0.001). A moderate heterogeneity was observed among the identified studies according to the Higgins I^2 statistic value.CONCLUSION Pre-transplant high PLR values are connected with an increased risk of post-operative recurrence of hepatocellular cancer. More studies are needed for better clarify the biological mechanisms of this results.

Clinical utility of the platelet-lymphocyte ratio as a predictor of postoperative complications after radical gastrectomy for clinical T2-4 gastric cancer

AIM To identify simple and sensitive markers for postoperative complications after gastrectomy, the predictive values were compared among candidate preoperative factors. METHODS Three-hundred and twelve patients with previously untreated clinical T2-4 gastric cancer who underwent a D2 standard gastrectomy(distal gastrectomy or total gastrectomy) were included in the analysis.Correlations between 21 parameters that can be determined by preoperative routine blood tests and clinically relevant postoperative complications(grade Ⅱ or higher according to the Clavien-Dindo classification) were evaluated. The optimal cutoff values and clinical significance of the selected markers were further evaluated by subgroup analyses according to age, body mass index, operative procedure and clinical disease stage.RESULTS Sixty-six patients(21.1%) experienced grade Ⅱ or higher postoperative complications. The plateletlymphocyte ratio(PLR, total lymphocyte count/platelet count × 100) exhibited the highest area under the curve value(0.639) for predicting postoperative complications among the 21 parameters, and the optimal cutoff value was determined to be 0.71(sensitivity = 70%, specificity = 56%). In the univariate analysis, the odds ratio of a low PLR for the occurrence of postoperative complications was 2.94(95%CI: 1.66-5.35, P < 0.001), and a multivariate binomial logistic analysis involving other potential risk factors identified a low PLR as an independent risk factor for postoperative complications(OR = 3.32, 95%CI: 1.82-6.25, P < 0.001). In subgroups classified according to age, body mass index, operative procedure and clinical disease stage, the low PLR group exhibited an increased incidence of postoperative complications. CONCLUSION The preoperative PLR is a simple and useful predictor of complications after curative gastrectomy in patients with clinical T2-4 gastric 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.

Correlation of neutrophil/lymphocyte and platelet/lymphocyte ratio with visual acuity and macular thickness in age-related macular degeneration

AIM：To investigate the place of neutrophil-to-lymphocyte ratio（NLR） and platelet-to-lymphocyte ratio（PLR） in the diagnosis of and prognosis for neovascular age-related macular degeneration（AMD）. METHODS：One hundred AMD patients and 100 healthy controls were included in the study. Blood samples were obtained from the venous blood, which is used for routine analysis, and these samples were subjected to complete blood count. NLR was defined as the neutrophil count divided by the number of lymphocytes, and PLR was defined as the platelet count divided by the number of lymphocytes. RESULTS：No statistically significant difference was observed between the two groups under consideration in terms of demographic features（P〉0.05）. The average NLR in the patient group was found to be significantly higher than that in the healthy control group（P〈0.05）. The average PLR was significantly higher in the patient group as compared to the control group（P〈0.05）. As best corrected visual acuity（BCVA） increased, both NLR and PLR decreased（significant negative correlations at 49.8% and 63.0%, respectively）, whereas as central macular thickness（CMT） increased, both NLR and PLR increased（significant positive correlations at 59.3% and 70.0%, respectively）.CONCLUSION：NLR and PLR levels are higher among neovascular AMD patients as compared to healthy control group. NLR and PLR levels were found to be inversely proportional to BCVA and directly proportional to CMT.

Combined preoperative platelet-to-lymphocyte ratio and serum carbohydrate antigen 19–9 level as a prognostic factor in patients with resected pancreatic cancer

Background: Carbohydrate antigen 19–9(CA19-9) is the most frequently used tumor marker and serves as a prognostic indicator in patients with pancreatic cancer(PC). The platelet-to-lymphocyte ratio(PLR) is thought to be an inflammation-related serum marker. An elevated PLR represents increased inflammatory status and is associated with poor prognosis in patients with various cancers including PC. Methods: This study involved 103 patients with a histopathological diagnosis of pancreatic ductal adenocarcinoma who underwent pancreatectomy. The patients were assessed to determine the prognostic significance of the combination of the PLR and CA19-9 level. Results: Based on the receiver operating characteristic analysis results, the patients were divided into PLR H igh(PLR ≥ 129.1) andPLRLow(PLR < 129.1) groups and into CA19-9High(CA19-9 ≥ 74.0 U/mL) and CA19-9Low(CA19-9 < 74.0 U/mL) groups. The cumulative 5-year overall survival(OS) and disease-specific survival(DSS) rates significantly differed by both the PLR(PLR H igh group: 19.5% and 22.9%;PLRLow group: 39.1% and 45.9%) and CA19-9(CA19-9 H igh group: 19.1% and 25.6%;CA19-9Low group: 41.0% and 41.0%). We then divided the patients into Groups A(PLR L ow/CA19-9Low), B(PLR Low/CA19-9High or PLRHigh/CA19-9Low), and C(PLR H igh/CA19-9High). The cumulative 5-year OS rates in Groups A, B, and C were 44.0%, 31.9%, and 11.9%, respectively( P = 0.002). The cumulative 5-year DSS rates in Groups A, B, and C were 47.7%, 36.4%, and 16.8%, respectively( P = 0.002). Multivariate analysis revealed that the combination of the PLR and CA19-9 was an independent prognostic factor in patients with resected PC. Conclusions: The combination of the PLR and CA19-9 is useful for predicting the prognosis of patients with resected PC.

Value of Platelet to Lymphocytes Ratio in Predicting Angiographic Reflow after Primary Percutaneous Coronary Intervention in STEMI Patient

Background: Acute myocardial infarction is a leading cause of death worldwide nowadays and treatment of choice is primary percutaneous coronary intervention (PCI). No reflow is a complication that increases mortality and morbidity post intervention and one of its predictors is platelet lymphocyte ratio. Aim of Study: To assess relation between admission platelet to lymphocyte ratio (PLR) and angiographic reflow after primary PCI in acute ST elevation myocardial infarction (STEMI). Patients and Methods: This is a prospective study that was conducted from May 2017 to May 2018 at Cardiology Department, Menoufia University Hospital. Sixty patients presented with ST-elevation myocardial infarction who were eligible for primary PCI were enrolled in the study. According to TIMI flow post intervention, patients were arranged into 2 groups: Group 1 (Normal Reflow) included thirty patients with post intervention TIMI flow III and Group 2 (NO Reflow) included thirty patients with post intervention TIMI flow (0, I, II). Comparison between both groups was done regarding platelet lymphocyte ratio (PLR). Result: PLR was significantly higher in patients with coronary no reflow than in patients with normal reflow with a P-value of , timing interval between onset of chest pain to time of intervention and thrombus grading was significantly higher in patients with no reflow than in patients with normal reflow. Conclusion: Pre-intervention PLR is an independent predictor of slow flow/no reflow following PPCI in patient with acute STEMI.

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 Significance of the Preoperative Platelet-Lymphocyte Ratio in Japanese Patients with Localized Breast Cancer

Inflammation has been shown to be a factor in tumorigenesis. The circulating platelet to lymphocyte ratio (PLR) is a representative index of systemic inflammation. In this study, we analyzed the association between preoperative PLR levels and clinicopathological variables in two hundred sixty-four Japanese patients with localized breast carcinoma. We also evaluated the prognostic significance of preoperative PLR levels using the Cox proportional hazard model. Seventy-five patients (28.4%) had elevated PLR values, whereas 189 (71.6%) had depressed PLR values. The PLR correlated significantly with venous invasion (P < 0.05). Disease-free survival rates were significantly worse among patients with elevated PLR values than among those with lower PLR value (5-year survival, 81.6% vs. 90.7%, respectively;P < 0.05). In multivariate analysis, elevated PLR, nuclear grade, and lymph node involvement were significant prognostic factors for disease-free survival in patients with breast carcinoma (P < 0.05). Preoperative PLR levels may be an independent prognostic factor in patients with breast carcinoma.

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.

Significances of Peripheral Inflammatory Cells and Neutrophil/Platelet-Lymphocyte Ratio in Breast Cancer after Resection

Introduction: Breast cancer had become top leading cause of death in Taiwan and endangered women’s health worldwide. Therefore, we try to invest the peripheral inflammatory cell counts and neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) from our routine practice for the predictor of prognosis of breast cancer after resection. Patients and Methods: There were 574 breast cancer patients accepted surgical resection and registered in Cancer Registry Center of our hospital. Patient’s basic profiles, peripheral neutophil, lymphocyte and platelet count were measured for study. The scales of NLR and PLR were derived from the lower and higher normal range in cell count from neutrophil, lymphocyte and platelet respectively. Therefore, the scales for NLR and PLR were ≤1.62, 1.63 - 2.57, ≥2.58 and ≤224, 225 - 253, ≥254 respectively for analysis. Results: Poor 5-yr survival rate was found if higher cell counts of neutrophil and platelet (p ≤ 0.05). Three scales of NLR were ≤1.62, 1.63 - 2.57, ≥2.58, and their 5-year survival rates were 94%, 91% and 84% respectively (p = 0.019). In the subgroup of HER-2 (negative), and 3-Negative breast patients had a higher NLR of poor prognosis. But higher PLR was found less in 3-Negative and non in 3-Positive patients (p = 0.039). The PLR was ≤224, 225 - 253, ≥254 and their 5-year survival rates were 92%, 87%, and 64% respectively (p = 0.001);Multivariate Cox regression model for predictor of breast cancer patients who have 3.39 (PLR ≥ 254) and 2.45 (NLR ≥ 2.58 ) times risk (p = 0.02 and p = 0.002) of poor prognosis respectively. Conclusion: Peripheral inflammatory cell counts are easily to take in our clinical practice and have a potential role as predictors of prognosis. We have to pay attention to the trends of peripheral inflammatory cell count and their ratio in our clinical practice where possible.

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。

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。

超声血流参数联合NLR、CA125、PLR对子宫内膜癌鉴别诊断价值

目的:探讨超声联合中性粒细胞/淋巴细胞比值(NLR)、血小板/淋巴细胞比值(PLR)NLR、糖类抗原125(CA125)对子宫内膜癌鉴别诊断价值。方法:收集2020年1月-2022年10月本院收治的子宫内膜癌患者92例为内膜癌组,子宫内膜良性病变患者82例为良性病变组,超声检测两组患者血流搏动指数(PI)、阻力指数(RI)、收缩期峰值流速(PSV),检测患者血清NLR、PLR、CA125水平,采用受试者工作特征(AUC)曲线分析各指标对子宫内膜癌鉴别诊断价值。结果:内膜癌组超声血流参数PSV高于对照组,PI、RI低于良性病变组,且内膜癌组Ⅲ-Ⅳ期患者PSV高于Ⅰ-Ⅱ期患者,PI、RI低于Ⅰ-Ⅱ期患者;血清CA125、NLR、PLR水平,内膜癌组均高于良性病变组,且内膜癌组Ⅲ-Ⅳ期患者高于Ⅰ-Ⅱ期患者(均P<0.05);ROC曲线分析显示,超声血流参数、CA125、NLR、PLR及联合应用鉴别诊断子宫内膜癌的曲线下面积分别为0.813、0.892,0.717、0.632、0.952,联合诊断效能最佳,敏感度98.2%。结论:超声血流参数,血清CA125、NLR、PLR在子宫内膜癌患者中发生异常,各指标联合应用对子宫内膜癌的鉴别诊断效力较高,有较好的临床指导价值。

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.

NLR、PLR、SII在乙肝相关性肝癌中的表达水平及影响乙肝相关性肝癌预后的因素分析

目的分析术前中性粒细胞/淋巴细胞比值(NLR)、血小板/淋巴细胞比值(PLR)、系统免疫炎症指数(SII)在乙肝相关性肝癌患者血液中的表达水平,探究影响乙肝相关性肝癌预后的因素。方法将2018年7月—2019年9月我院收治的乙肝相关性肝癌患者110例纳入研究组,所有患者均接受根治性手术治疗,根据术后3年内是否出现复发、转移及死亡情况,将患者分为预后不良组(42例)和预后良好组(68例)。另择同期我院收治的肝脏良性疾病手术患者128例作为对照组,回顾性收集患者临床资料。比较研究组、对照组患者术前NLR、PLR、SII表达水平;分析乙肝相关性肝癌患者预后的影响因素;绘制受试者工作特征曲线(ROC曲线)分析NLR、PLR、SII单独及三者联合检测对乙肝相关性肝癌预后不良的预测价值。结果研究组患者术前NLR、PLR、SII水平为6.92±2.16、167.90±33.21、432.52±56.22,高于对照组的3.13±0.84、110.11±24.26、326.40±20.35(t=18.310、15.465、19.898,均P<0.001)。多因素Logistic回归分析结果显示,NLR(OR=1.822,95%CI:1.295~2.563)、PLR(OR=1.037,95%CI:1.015~1.060)、SII(OR=1.007,95%CI:1.002~1.012)水平升高为乙肝相关性肝癌预后不良的危险因素(<0.05)。绘制ROC曲线结果显示,NLR、PLR、SII单独及三者联合检测预测乙肝相关性肝癌预后不良的曲线下面积(AUC)分别为0.852、0.862、0.813、0.904(均P<0.001),灵敏度分别为80.95%、85.71%、74.16%、82.10%,特异度分别为77.94%、77.94%、77.94%、95.59%。结论NLR、PLR、SII升高为乙肝相关性肝癌预后不良的危险因素;乙肝相关性肝癌患者NLR、PLR、SII单独以及三者联合检测有助于预测乙肝相关性肝癌预后。

Neutrophil-lymphocyte ratio is useful for the prognosis of patients with hepatocellular carcinoma

There is increasing evidence that neutrophil-lymphocyte ratio(NLR)may play a role in predicting recurrence in patients with hepatitis B virus-related hepatocellular carcinoma(HCC)after liver transplantation.In the original study by Yan et al,it was aimed to determine whether an elevated NLR is associated with tumor recurrence.Total tumor size(>9 cm)and macro-vascular invasion were found to be more significant than NLR according to the multivariate logistic regression analysis.Therefore,substantive significance should be emphasized rather than NLR because total tumor size and macro-vascular invasion are easier and more expressive than NLR in assessing HCC recurrence.NLR and platelet-lymphocyte ratio(PLR)are markers which are easy to obtain and can be used as inflammation indicators.Moreover,assessment of both NLR and PLR may add some value as a good predictor of risk for post-liver transplantation HCC recurrence.However,while the study was constructed on whole blood analysis,further details about the features and performance characteristics of the whole-blood analyzer,and preanalytical/analytical variables should also be mentioned.

血清NLR、PLR水平与子痫前期患者早期肾损伤的关系

目的 探讨中性粒细胞/淋巴细胞比值(neutrophil to lymphocyte ratio, NLR)、血小板/淋巴细胞比值(platelet to lymphocyte ratio, PLR)与子痫前期(pre-eclampsia, PE)患者早期肾损伤的关系。方法 选取2020年1月至2022年2月本院产科收治的98例PE患者(PE组)与113例妊娠期高血压(gestational hypertension, GH)患者(GH组),另将68例在我院定期做孕检的健康孕妇作为对照组。记录3组孕妇血清NLR、PLR、肾功能指标[尿素氮(urea nitrogen, BUN)、血肌酐(serum creatinine, Scr)、胱抑素C(cystatin C,Cys-C)以及肾小球滤过率(estimate glomerular filtration rate, eGFR)]。根据是否发生肾损伤分为未发生肾损伤组(56例)与已发生肾损伤组(42例)。分析NLR、PLR与肾功能指标的关系,并进行危险因素分析以及分析NLR、PLR对PE患者发生早期肾损伤的预测价值。结果 GH组与PE组的NLR、BUN、Scr、Cys-C、24 h尿蛋白水平显著高于对照组,且PE组明显高于GH组(P<0.05);PLR、eGFR水平显著低于对照组,且PE组明显低于GH组(P<0.05)。Pearson相关性分析结果显示,NLR与BUN、Scr、Cys-C、24 h尿蛋白呈正相关,与eGFR呈负相关;PLR与BUN、Scr、Cys-C、24 h尿蛋白呈负相关,与eGFR呈正相关。多因素分析结果显示,重度PE、NLR、PLR、24 h尿蛋白、eGFR是影响PE患者发生早期肾损伤的主要危险因素(P<0.05)。受试者工作特征曲线分析发现,NLR、PLR预测PE患者发生早期肾损伤的截断值分别为2.71、103.26,曲线下面积分别为0.896、0.809,敏感度分别为93.28%、90.81%,特异度分别为80.17%、80.01%。结论 NLR、PLR水平升高与PE患者早期肾损伤有关,是PE患者发生早期肾损伤的危险因素,且对PE患者的早期肾损伤具有较高的预测价值。

维持性腹膜透析患者外周血NLR PLR HGB水平变化及其与钙磷代谢异常和全因病死率的关系

目的:探究维持性腹膜透析患者外周血中性粒细胞与淋巴细胞比值(NLR)、血小板与淋巴细胞比值(PLR)、血红蛋白(HGB)水平变化及其与钙磷代谢异常和全因病死率的关系。方法:选取2019年3月至2022年6月收治的维持性腹膜透析患者206例,评估患者是否存在钙磷代谢异常,分为异常组和正常组,比较两组外周血NLR、PLR、HGB水平,分析NLR、PLR、HGB与血钙、血磷水平相关性;随访至2022年12月,以全因病死为终点事件,分为病死组和存活组,比较两组外周血NLR、PLR、HGB水平,并用受试者工作特征(ROC)曲线评价NLR、PLR、HGB对患者全因病死的预测价值。结果:异常组外周血NLR、PLR及血磷水平高于正常组,血钙水平低于正常组(P<0.05);但两组年龄、性别、文化程度、原发疾病、透析时间及外周血HGB水平的比较,差异无统计学意义(P>0.05)。维持性血液透析老年患者外周血NLR、PLR与血钙水平呈负相关,与血磷水平呈正相关(P<0.05);而HGB与血钙、血磷水平无明显相关性(P>0.05)。病死组透析时间长于存活组,外周血NLR、PLR及血磷水平高于存活组,血钙水平低于存活组(P<0.05);但两组年龄、性别、文化程度、原发疾病及外周血HGB水平的比较,差异无统计学意义(P>0.05)。ROC曲线分析结果显示,外周血NLR、PLR预测患者全因病死的曲线下面积(AUC)分别为0.777(95%CI:0.688~0.866)、0.781(95%CI:0.668~0.895)。结论:维持性腹膜透析患者钙磷代谢异常与外周血NLR、PLR水平相关,且上述指标对患者全因病死具有一定的预测价值。