Systemic immune-inflammation index,neutrophilto-lymphocyte ratio,and platelet-to-lymphocyte ratio in patients with type 2 diabetes at different stages of diabetic retinopathy

AIM:To investigate systemic immune-inflammation index(SII),neutrophil-to-lymphocyte ratio(NLR),and plateletto-lymphocyte ratio(PLR)levels in patients with type 2 diabetes at different stages of diabetic retinopathy(DR).METHODS:This retrospective study included 141 patients with type 2 diabetes mellitus(DM):45 without diabetic retinopathy(NDR),47 with non-proliferative diabetic retinopathy(NPDR),and 49 with proliferative diabetic retinopathy(PDR).Complete blood counts were obtained,and NLR,PLR,and SII were calculated.The study analysed the ability of inflammatory markers to predict DR using receiver operating characteristic(ROC)curves.The relationships between DR stages and SII,PLR,and NLP were assessed using multivariate logistic regression.RESULTS:The average NLR,PLR,and SII were higher in the PDR group than in the NPDR group(P=0.011,0.043,0.009,respectively);higher in the NPDR group than in the NDR group(P<0.001 for all);and higher in the PDR group than in the NDR group(P<0.001 for all).In the ROC curve analysis,the NLR,PLR,and SII were significant predictors of DR(P<0.001 for all).The highest area under the curve(AUC)was for the PLR(0.929 for PLR,0.925 for SII,and 0.821 for NLR).Multivariate regression analysis indicated that NLR,PLR,and SII were statistically significantly positive and independent predictors for the DR stages in patients with DM[odds ratio(OR)=1.122,95%confidence interval(CI):0.200–2.043,P<0.05;OR=0.038,95%CI:0.018–0.058,P<0.05;OR=0.007,95%CI:0.001–0.01,P<0.05,respectively).CONCLUSION:The NLR,PLR,and SII may be used as predictors of DR.

Neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio:Markers predicting immune-checkpoint inhibitor efficacy and immune-related adverse events

We conducted a comprehensive review of existing prediction models pertaining to the efficacy of immune-checkpoint inhibitor(ICI)and the occurrence of immune-related adverse events(irAEs).The predictive potential of neutrophil-to-lymphocyte ratio(NLR)and platelet-to-lymphocyte ratio(PLR)in determining ICI effectiveness has been extensively investigated,while limited research has been conducted on predicting irAEs.Furthermore,the combined model incor-porating NLR and PLR,either with each other or in conjunction with additional markers such as carcinoembryonic antigen,exhibits superior predictive capabilities compared to individual markers alone.NLR and PLR are promising markers for clinical applications.Forthcoming models ought to incorporate established efficacious models and newly identified ones,thereby constituting a multifactor composite model.Furthermore,efforts should be made to explore effective clinical application approaches that enhance the predictive accuracy and efficiency.

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.

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.

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.

Diagnostic implications of neutrophil-to-lymphocyte ratio,platelet-tolymphocyte ratio,and systemic immune-inflammatory index for gastric carcinoma

BACKGROUND The diagnosis of gastric carcinoma(GC)is essential for improving clinical outcomes.However,the biomarkers currently used for GC screening are not ideal.AIM To explore the diagnostic implications of the neutrophil-to-lymphocyte ratio(NLR),platelet-to-lymphocyte ratio(PLR),and systemic immune-inflammatory index(SII)for GC.METHODS The baseline data of 133 patients with GC and 134 patients with precancerous gastric conditions admitted between January 2022 and December 2023 were retrospectively analyzed.The information on peripheral blood platelet,neutrophil,and lymphocyte counts in each patient was collected,and the NLR,PLR,and SII levels of both groups were calculated.Additionally,multivariate logistic regression analysis was conducted,and the diagnostic implications of NLR,PLR,and SII in differentiating patients with precancerous gastric conditions,compared with those with GC,were analyzed through receiver operating characteristic(ROC)curves.RESULTS The data indicated that NLR,PLR,and SII had abnormally increased levels in the patients with GC.Gender and body mass index were risk factors for the occurrence of GC.ROC data revealed that the areas under the curve of three patients with precancerous gastric conditions,who were differentiated from those with GC,were 0.824,0.787,and 0.842,respectively.CONCLUSION NLR,PLR,and SII are all abnormally expressed in GC and have diagnostic implications,especially when used as joint indicators,in distinguishing patients with precancerous gastric conditions from those with GC.

Clinical study of neutrophil-to-lymphocyte ratio and platelet-tolymphocyte ratio in hypertriglyceridemia-induced acute pancreatitis and acute biliary pancreatitis with persistent organ failure

BACKGROUND The neutrophil-to-lymphocyte ratio(NLR)and platelet-to-lymphocyte ratio(PLR)are novel inflammatory indicators that can be used to predict the severity and prognosis of various diseases.We categorize acute pancreatitis by etiology into acute biliary pancreatitis(ABP)and hypertriglyceridemia-induced acute pancreatitis(HTGP).AIM To investigate the clinical significance of NLR and PLR in assessing persistent organ failure(POF)in HTGP and ABP.METHODS A total of 1450 patients diagnosed with acute pancreatitis(AP)for the first time at Shanxi Bethune Hospital between January 2012 and January 2023 were enrolled.The patients were categorized into two groups according to the etiology of AP:ABP in 530 patients and HTGP in 241 patients.We collected and compared the clinical data of the patients,including NLR,PLR,and AP prognostic scoring systems,within 48 h of hospital admission.RESULTS The NLR(9.1 vs 6.9,P<0.001)and PLR(203.1 vs 160.5,P<0.001)were significantly higher in the ABP group than in the HTGP group.In the HTGP group,both NLR and PLR were significantly increased in patients with severe AP and those with a SOFA score≥3.Likewise,in the ABP group,NLR and PLR were significantly elevated in patients with severe AP,modified computed tomography severity index score≥4,Japanese Severity Score≥3,and modified Marshall score≥2.Moreover,NLR and PLR showed predictive value for the development of POF in both the ABP and HTGP groups.CONCLUSION NLR and PLR vary between ABP and HTGP,are strongly associated with AP prognostic scoring systems,and have predictive potential for the occurrence of POF in both ABP and HTGP.

外周血NLR与PLR对原发性胃癌患者生存状况的评估价值

目的探讨原发性胃癌患者入院时中性粒细胞与淋巴细胞比值(neutrophil-to-lymphocyte ratio,NLR)和血小板与淋巴细胞比值(platelet-to-lymphocyte ratio,PLR)对胃癌患者生存预后的预测价值。方法分析132例原发性胃癌患者及30例健康对照的临床资料,采用Kaplan-Meier、Log-rank检验、多元COX回归分析胃癌患者的生存状况。结果病例组NLR、PLR水平均明显高于健康对照组(t=6.67,P=0.000;t=13.23,P=0.000);年龄越高、肿瘤直径越大、临床分期越高、分化程度越差、出现淋巴结转移及未进行手术治疗NLR、PLR有升高的趋势(P<0.05);NLR与PLR呈明显的正相关关系(r=0.3164,P=0.0002);低NLR组生存时间为(57.59±2.23)月(中位生存时间为55个月),高NLR组生存时间为(35.22±3.09)月(中位生存时间为37个月),2者差异有统计学意义(χ2=6.298,P=0.0361);低PLR组生存时间为(54.09±2.66)月(中位生存时间为54个月),高PLR组生存时间为(35.22±2.75)月(中位生存时间为37个月),2者差异有统计学意义(χ2=5.879,P=0.0377)。胃癌患者总体生存期的独立影响因素有年龄、临床分期、有无淋巴结转移及NLR、PLR水平(P<0.05)。结论胃癌患者NLR、PLR显著升高,与患者的年龄、肿瘤大小、转移程度、临床分期等密切相关,并且对于患者的生存预后变差具有一定的预测价值。

NLR和PLR与糖尿病肾脏病

目的:研究中性粒细胞与淋巴细胞比值(NLR)和血小板与淋巴细胞比值(PLR)与DKD患者主要实验室指标间的关系。方法:收集100例正常人和120例DKD患者的临床资料,将DKD患者根据e GFR分为早、中、晚期,NLR和PLR由全血细胞分析结果计算,进行统计分析。结果:(1)与健康人相比,NLR在DKD患者中明显升高(P=0.000),且随着疾病的进展而逐渐升高(P=0.000);(2)NLR与DKD患者的年龄、收缩压、平均动脉压、血肌酐、尿素氮、24-UTP、ESR和IL-6呈正相关(P<0.01),与血红蛋白、白蛋白和e GFR呈负相关(P<0.01);PLR与DKD患者的年龄呈正相关(P<0.05),与血红蛋白和白蛋白呈负相关(PHGB<0.05,PALB<0.01);(3)逐步回归结果显示,NLR与24-UTP间的关系为y=0.874+0.237x(y为24-UTP,x为NLR,P<0.01),NLR与e GFR间关系为y=89.912-7.622x(y为e GFR,x为NLR,P<0.01)。结论:NLR作为一个廉价、易测的指标可以很好地评估DKD患者的尿蛋白和肾功能水平。

治疗前PLR和NLR对鼻咽癌患者预后的影响

目的探讨鼻咽癌患者治疗前外周血中血小板与淋巴细胞比(platelet-lymphocyte ratio,PLR)、中性粒细胞与淋巴细胞比(neutrophil-lymphocyte ratio,NLR)与总生存期(overall survival,OS)、无进展生存期(progression-free survival,PFS)的相关性。方法回顾性分析西安交通大学第一附属医院和陕西省人民医院2009年1月至2013年9月期间初治的91例鼻咽癌患者临床资料,根据ROC曲线选取PLR和NLR的截断值,将患者根据截断值分组,采用Kaplan-Meier法和Log rank检验比较不同组患者的总生存率和无进展生存率,应用Cox比例风险模型进行单因素和多因素分析。结果当PLR=143.3、NLR=2.6时,对患者的预后预测价值最高。Cox多因素分析发现PLR≥143.3(RR=2.491,95%CI=1.139~5.451,P=0.022)、NLR≥2.6(RR=2.186,95%CI=1.021~4.682,P=0.044)时,患者的OS较短,而PLR≥143.3(RR=2.461,95%CI=1.242~4.874,P=0.01)时,患者的PFS较差。结论治疗前PLR和NLR可能是影响鼻咽癌患者预后的独立危险因素。

术前NLR和PLR对上皮性卵巢癌患者预后的评估价值

目的:探讨术前中性粒细胞与淋巴细胞比值(NLR)和血小板与淋巴细胞比值(PLR)对上皮性卵巢癌患者预后的评估价值。方法:收集2005年11月至2012年12月在天津市中心妇产科医院初治且经手术治疗的153例卵巢良性肿瘤和206例上皮性卵巢癌患者的临床病理资料,比较术前NLR和PLR在卵巢良恶性肿瘤的区别,根据统计学方法选取NLR和PLR临界值,分析NLR和PLR与上皮性卵巢癌临床病理因素的关系。通过单因素及多因素分析评估术前NLR和PLR对患者术后生存的影响。结果:术前NLR和PLR水平在上皮性卵巢癌中明显高于卵巢良性肿瘤。选取NLR=2.62和PLR=173分别作为临界值。单因素分析结果显示,FIGO分期晚、中-低分化、腹水、脉管癌栓、CA125≥35、NLR≥2.62、PLR≥173是影响患者术后无病生存期(DFS)的危险因素(P<0.05);FIGO分期晚、腹水、脉管癌栓、CA125≥35、PLR≥173是影响患者术后总生存期(OS)的危险因素(P<0.05)。多因素分析显示,FIGO分期晚、NLR≥2.62、脉管癌栓是上皮性卵巢癌患者DFS的独立危险因素(P<0.05)。结论:NLR和PLR方便测得且价格便宜,对卵巢癌的预后有一定的评估价值。

外周血NLR联合PLR对主动脉夹层的诊断意义

目的探讨外周血中性粒细胞与淋巴细胞比值(NLR)和血小板与淋巴细胞比值(PLR)对主动脉夹层(AD)患者的诊断意义。方法明确诊断的AD患者病例34例(AD组)、急性ST段抬高型心肌梗死病例48例(STEMI组)和低危胸痛病例50例(低危胸痛组),收集3组患者基础疾病等资料、记录入院时首次血常规检测的中性粒细胞计数(NEUT)、淋巴细胞计数(LYM)、血小板计数(PLT)等数据,计算NLR及PLR,应用受试者工作(ROC)曲线评估NLR和PLR对AD的诊断作用。结果AD组和STEMI组NEUT和NLR明显高于低危胸痛组(P<0.001),AD组PLT和PLR明显低于STEMI组(P分别为<0.001、0.006);AD组PLT明显低于低危胸痛组(P<0.001),且PLR亦有下降趋势(P=0.07);STEMI组与低危胸痛组PLT和PLR比较,差异无统计学意义(P分别为0.402、0.233);PLR诊断AD的能力曲线下面积(AUC)为0.655(P=0.008),NLR筛查STEMI和AD等高危胸痛的能力AUC为0.778(P<0.001),PLR对NLR筛选出的高危胸痛病例中AD的诊断能力AUC为0.683(P=0.006),应用NLR联合PLR的方法较单用PLR诊断AD的特异性有明显提高(χ^(2)=12.027,P=0.001)。结论NLR联合PLR的方法可用于AD的诊断,并有较高的特异性。

早期NLR、PLR、N/LP及其联合其他因素在预测重度创伤性颅脑损伤早期预后的研究

目的探讨人外周血早期中性粒细胞-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)和中性粒细胞-淋巴细胞和血小板比值(neutrophils to lymphocytes and platelets ratio,N/LP)在重度创伤性颅脑损伤(severe traumatic brain injury,sTBI)患者早期结果中的预测价值。方法回顾性分析2014年6月-2016年12月中国医科大学第七临床学院神经外科收治的95例sTBI患者的临床资料。比较预后良好组(n=36)和预后不良组(n=59)患者的早期NLR、PLR和N/LP差异,分析影响预后相关危险因素并绘制森林图,采用多因素logsitic回归确定独立危险因素并构建临床预测模型;绘制出受试者工作特征曲线(receiver operating characteristic curve,ROC),分析并比较NLR、PLR和N/LP单独或联合其他指标构建出的不同临床预测模型的差异。结果sTBI预后良好组和预后不良组早期NLR、PLR和N/LP比较,差异均有统计学意义(P<0.05);多因素logsitic回归分析提示,年龄、入院格拉斯哥昏迷评分(Glasgow coma scale,GCS)、NLR、PLR和N/LP是影响sTBI患者早期结果的独立危险因素,差异有统计学意义(P<0.05)。根据多因素logstic回归分析构建出19个临床预后预测模型,其中NLR+PLR+N/LP及其联合指标(年龄和GCS)模型曲线下面积(area under curve,AUC)均高于同组其他模型,分别为0.912、0.935、0.933和0.954;Age+GCS+NLR+PLR+N/LP预测模型在所有组别中AUC最大,表明该模型预测患者预后的价值最高。结论NLR、PLR和N/LP的升高与sTBI不良预后相关;早期NLR、PLR及N/LP联合年龄和GCS评分在sTBI早期结果预测中具有重要价值。

治疗前NLR和PLR对宫颈鳞癌患者预后的影响

目的探讨经手术治疗的宫颈鳞癌患者治疗前中性粒细胞与淋巴细胞比(neutrophil-tolymphocyte ratio,NLR)及血小板与淋巴细胞比(platelet-to-lymphocyteratio,PLR)与总生存期(overall survival,OS)、无病生存期(disease-free survival,DFS)和各临床病理因素的相关性。方法回顾性分析中山大学附属第一医院于2005年1月1日至2009年12月31日期间初治的并且经过手术治疗的143例宫颈鳞癌患者的临床病理资料,根据统计学方法选取NLR和PLR截断值,将患者根据截断值分组,分析NLR和PLR与患者生存、复发情况的相关性以及与临床病理因素的相关性。结果选取NLR=2.8和PLR=125分别作为截断值,高NLR组5年生存率为30.3%,低NLR组5年生存率为80%,差异有统计学意义(P=0.000)。高NLR组复发率为69.7%,低NLR组复发率为24.5%,差异有统计学意义(P=0.000)。高PLR组5年生存率为53.7%,低PLR组5年生存率为81.6%,差异有统计学意义(P=0.000)。高PLR组复发率为50%,低PLR组复发率为22.4%,差异有统计学意义(P=0.000)。经过单因素和多因素分析,国际妇产科联盟(International Federation of Gynecology and Obstetrics,FIGO)分期、术前化疗、病灶大小、外周血血小板计数(platelet,PLT),NLR值和PLR值是影响宫颈鳞癌患者总生存率和无病生存率的独立危险因素。结论治疗前NLR及PLR均是影响宫颈鳞癌患者总生存时间和无病生存时间的独立危险因素。

Unmasking gastric carcinoma: Unveiling diagnostic biomarkers and the role of critical care

We discuss the findings of Wu et al on the utility of neutrophil-to-lymphocyte ratio,platelet-to-lymphocyte ratio,and systemic immune-inflammatory index as diagnostic markers for gastric carcinoma(GC).We commend the study's contributions to the field and suggest a prospective study to validate these markers'sensitivity and specificity for early GC detection.We also propose developing surveillance protocols that incorporate these markers with other diagnostic methods to enhance clinical decision-making.Furthermore,we highlight the need for a more diverse patient cohort to assess the generalizability of these markers across different ethnic groups and demographic factors.Our suggestions aim to refine the application of these markers in clinical practice and to understand their potential in diverse clinical scenarios.

术前外周血中NLR、PLR、LMR与早期宫颈癌患者预后的相关性研究

目的探讨接受早期宫颈癌根治术患者术前外周血中中性粒/淋巴细胞(neutrophil to lymphocyte ratio,NLR)、血小板/淋巴细胞(platelet to lymphocyte ratio,PLR)及单核/淋巴细胞(Lymphocyte to monocyte ratio,LMR)与预后的关系。方法分析2012-2018年新疆医科大学第一附属医院妇科确诊为宫颈癌(I-IIa期)并接受早期根治术的116例患者的相关资料并计算NLR、PLR、LMR,讨论高、低比值组与临床资料的相关性及其对预后的影响。结果高、低NLR组在年龄、肿块大小方面的差异有统计学意义(P<0.05);高低PLR组在年龄、淋巴结转移、肿块大小、脉管浸润方面的差异有统计学意义(P<0.05);高、低LMR组在年龄、脉管浸润方面的差异有统计学意义(P<0.05)。高NLR组患者5年生存率(34.4%)低于低NLR组(63.3%),高PLR组患者5年生存率(45.6%)低于低PLR组(55.8%),高LMR组患者5年生存率(57.6%)高于低LMR组(37.6%),差异均有统计学意义(P<0.05)。单因素分析显示,浸润深度≥1/2、NLR≥2.77、PLR≥133.57、LMR<4.04、临床分期为II期、有淋巴结转移是影响患者生存情况的危险因素。多因素分析显示,NLR≥2.77、浸润深度≥1/2、临床分期为II期是影响患者生存率的独立危险因素。结论宫颈癌患者术前高NLR、高PLR及低LMR是提示预后不良的指标,NLR较其他2个比值对预后的预测更具意义。

外周血NLR联合PLR对动脉粥样硬化性脑梗死诊断及预测斑块稳定性的价值研究

目的探究外周血中性粒细胞与淋巴细胞比值(NLR)联合血小板与淋巴细胞比值(PLR)在诊断动脉粥样硬化性脑梗死(ACI)与预测斑块稳定性的价值。方法选取陕西省人民医院神经内二科2020年1月~2021年1月住院治疗的ACI患者54例作为脑梗死组,另选取同期健康体检者65例作为对照组。均进行颈动脉超声检查、外周血NLR,PLR检测,比较两组外周血NLR和PLR水平。采用受试者工作(ROC)曲线探究NLR和PLR诊断ACI的价值,对比不同稳定性斑块患者外周血NLR和PLR水平,探究二者之间关系及与斑块稳定性的相关性。结果脑梗死组外周血NLR(3.16±0.17 vs 2.23±0.12)和PLR(133.45±5.02 vs 111.04±7.56)水平高于对照组,差异均有统计学意义(t=4.723,2.150,均P<0.05);外周血NLR,PLR联合诊断ACI优于二者单独诊断(AUC 0.779,95%CI:0.677~0.881);易损斑块患者外周血NLR和PLR水平>稳定斑块患者>无斑块患者(NLR 3.21±11.05 vs 1.88±0.61,1.27±0.23,PLR 131.98±45.91 vs 99.85±34.22,73.07±18.55),差异有统计学意义(F=33.38,12.30,均P<0.05);多元logistic回归分析提示NLR是易损斑块的独立危险因素(P<0.01),但PLR不是易损斑块的独立危险因素(P=0.491)。结论外周血NLR和PLR水平有助于ACI的诊断,且NLR是颈动脉易损斑块发生的独立危险因素。

弥漫性大B细胞淋巴瘤患者外周血NLR、PLR以及LDH的水平及其临床意义

目的:研究弥漫性大B细胞淋巴瘤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)及乳酸脱氢酶(LDH)与健康人的差异、不同分期之间的差异,以及三者联合检测的诊断价值。方法:收集我院血液科2018年10月至2020年10月收治的81例DLBCL患者作为实验组,同期85例健康体检者作为对照组,根据Ann Arbor分期标准将淋巴瘤组患者分为Ⅰ-Ⅱ期(n=27)、Ⅲ-Ⅳ期(n=54),测定外周血NLR、PLR及LDH水平,对比两组及不同分期之间是否存在差异;建立受试者工作特征(ROC)曲线,通过分析曲线下面积(AUC),对比NLR、PLR、LDH以及三者联合对DLBCL的诊断价值。结果:淋巴瘤组81例,NLR、PLR、LDH分别为(3.65±2.55)、(207.73±11.01)、(371.79±63.56)ng/mL,均显著高于对照组(1.96±0.62,P<0.05)、(127.88±41.05,P<0.05)、(151.99±43.72,P<0.05)ng/mL,两组之间差异有统计学意义。与Ⅰ-Ⅱ期患者的NLR(3.00±1.63)、PLR(172.99±61.87)、LDH(279.15±19.12)ng/mL水平对比,Ⅲ-Ⅳ期患者NLR(3.98±2.86)、PLR(225.10±25.71)、LDH(418.11±23.83)ng/mL的水平均显著升高,差异有统计学意义(P=0.045,P=0.014,P=0.011)。ROC曲线:NLR以2.44为临界值时对DLBCL的诊断灵敏度、特异性、准确度分别为69.1%、78.8%、74.1%,PLR以168.64为临界值时对DLBCL的诊断灵敏度、特异性、准确度分别为61.7%、87.1%、74.7%,LDH以186.50 ng/mL为临界值时对DLBCL的诊断灵敏度、特异性、准确度分别为75.3%、94.1%、84.9%,三者联合时分别为80.2%、91.8%、85.5%。四种方法特异度的差异有统计学意义(P=0.022),灵敏度、准确度的差异无统计学意义(P=0.054,P=0.133)。两两比较发现,三者联合的灵敏度高于PLR单独检测(P=0.009),特异性高于NLR单独检测(P=0.027)。NLR、PLR、LDH的曲线下面积分别为0.78、0.788、0.866,三者联合为0.916,显著高于三者单独检测(P<0.05)。结论:与健康人对比,NLR、PLR及LDH在弥漫性大B细胞淋巴瘤患者中显著升高,且与分期有关,三者联合检测可以显著提高对DLBCL的诊断价值。

术前外周血SII、NLR、PLR对宫颈癌淋巴结转移的评估价值

目的探讨术前外周血系统免疫炎症指数(SII)、中性粒细胞与淋巴细胞比(NLR)、血小板与淋巴细胞比(PLR)与宫颈癌淋巴结转移的相关性,分析其预测价值。方法回顾性分析我院2016年1月至2020年1月收治的191例宫颈癌患者的临床资料,根据组织病理学淋巴结是否转移将其分为转移组(n=31)和未转移组(n=160)。采用单因素和多因素Logistic回归分析淋巴结转移的影响因素;通过受试者工作特征(ROC)曲线分析SII、NLR和PLR预测淋巴结转移的最佳界值和效能;分析SII、NLR和PLR与临床病理特征的关系。结果单因素分析显示,肿瘤≥4cm、脉管浸润、高SII、高NLR、高PLR的患者中淋巴结转移发生率较高(χ^(2)/Z值分别为4.532、8.342、14.363、4.837、11.478,P<0.05);多因素分析显示,肿瘤≥4cm(OR=2.347,95%CI:1.645~4.272)、脉管浸润(OR=1.924,95%CI:1.724~2.236)、高SII(OR=2.458,95%CI:1.557~1.968)、高PLR(OR=1.884,95%CI:1.418~8.654)是宫颈癌患者淋巴结转移的危险因素。ROC分析显示,SII、NLR和PLR预测宫颈癌淋巴结转移的界值分别为424.57、2.45和142.51,曲线下面积(AUC)分别为0.765、0.691、0.715,且三者联合的预测价值更高(AUC=0.836)。高SII组中高龄(≥50岁)、淋巴结转移、肿瘤≥4cm、ⅡA期、脉管浸润比例较高(P<0.05);高NLR和高PLR组中淋巴结转移、肿瘤≥4cm、脉管浸润比例较高(P<0.05)。结论SII、NLR和PLR是宫颈癌淋巴结转移的预测指标,三者联合的预测价值更高;高SII和高PLR是宫颈癌淋巴结转移的危险因素,具有一定的临床指导意义。

Does the preoperative platelet-tolymphocyte ratio and neutrophil-tolymphocyte ratio predict morbidity after gastrectomy for gastric cancer?

Background:Gastric cancer is the 2 nd most common cause of cancer-related deaths,and the morbidity rate after surgery is reported to be as high as 46%.The estimation of possible complications,morbidity,and mortality and the ability to specify patients at high risk have become substantial for an intimate follow-up and for proper management in the intensive care unit.This study aimed to determine the prognostic value of the preoperative platelet-tolymphocyte ratio(PLR)and neutrophil-to-lymphocyte ratio(NLR)and their relations with clinical outcomes and complications after gastrectomy for gastric cancer.Methods:This single-center,retrospective cohort study evaluated the data of 292 patients who underwent gastrectomy with curative intent between January 2015 and June 2018 in a tertiary state hospital in Ankara,Turkey.A receiver operating characteristic curve was generated to evaluate the ability of laboratory values to predict clinically relevant postoperative complications.The area under the curve was computed to compare the predictive power of the NLR and PLR.Then,the cutoff points were selected as the stratifying values for the PLR and NLR.Results:The area under the curve values of the PLR(0.60,95%CI 0.542–0.657)and NLR(0.556,95%CI 0.497–0.614)were larger than those of the other preoperative laboratory values.For the PLR,the diagnostic sensitivity and specificity were 50.00%and 72.22%,respectively,whereas for the NLR,the diagnostic sensitivity and specificity were 37.50%and 80.16%,respectively.The PLR was related to morbidity,whereas the relation of the NLR with mortality was more prominent.This study demonstrated that the PLR and NLR may predict mortality and morbidity via the ClavienDindo classification in gastric cancer patients.The variable was grade≥3 in the Clavien-Dindo classification,including complications requiring surgical or endoscopic interventions,life-threatening complications,and death.Both the PLR and NLR differed significantly according to Clavien-Dindo grade≥3.In this analysis,the PLR was related to morbidity,while the NLR relation with mortality was more intense.Conclusion:Based on the results of the study,the PLR and NLR could be used as independent predictive factors for mortality and morbidity in patients with gastric cancer.