Correlation of the Neutrophil Lymphocyte Ratio with Malignancy Status in Thyroid Nodule

Background: Thyroid nodules are very common, found in more than 50% of patients when using ultrasonography. While the prevalence of thyroid nodules in the population is increasing, only 5% to 10% harbor malignant disease. Still, there is a pressing need to correctly identify the nature of thyroid nodules, because thyroid cancer is the most common endocrine malignancy and often presents in thyroid nodules. Inflammation plays a critical role in many aspects of cancer, including tumor development, progression, clinical presentations, and prognosis. The neutrophil/ lymphocyte ratio (NLR) is a simple index of systemic inflammatory response1,2. The aim of this study is to determine whether there is a relationship between the neutrophil/lymphocyte ratio with malignancy status of thyroid nodules. Methods: One hundred two cases of benign and malignant thyroid nodule were analyzed retrospectively. We evaluated neutrophil lymphocyte ratio with result post-operative pathological anatomy. Complete blood counts with differential counts were taken before operation. NLR was calculated by dividing preoperative neutrophil count with lymphocyte count. Sample were categorized into low grade (NLR < 1,91) and high grade (NLR ≥ 1,92). Results: There was statistically significant difference of neutrophil-lymphocyte ratio between benign thyroid nodule and malignant thyroid nodule (p=0,001). Conclusion: NLR is easily accessible tests that can be automatically calculated from complete blood count without additional cost in differentiation of malignant thyroid nodule from benign nodule in the preoperative period. Keywords: Thyroid nodule; neutrophil lymphocyte ratio; malignancy.

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Comparison of hematological parameters and perinatal outcomes between COVID-19 pregnancies and healthy pregnancy cohort

Journal of Perinatal Medicine ◽

10.1515/jpm-2020-0403 ◽

2020 ◽

Vol 0 (0) ◽

Author(s):

Esin Merve Erol Koç ◽

Rahime Bedir Fındık ◽

Hatice Akkaya ◽

Işılay Karadağ ◽

Eda Özden Tokalıoğlu ◽

...

Keyword(s):

Complete Blood Count ◽

Perinatal Outcomes ◽

Control Group ◽

Strong Positive Correlation ◽

Monocyte Count ◽

Distribution Width ◽

Neutrophil Lymphocyte Ratio ◽

Lymphocyte Ratio ◽

Significant Difference ◽

Adverse Perinatal Outcomes

AbstractObjectivesTo evaluate the relationship between Coronavirus Disease 2019 (COVID-19) in pregnancy and adverse perinatal outcomes. The secondary aim is to analyze the diagnostic value of hematologic parameters in COVID-19 complicated pregnancies.MethodsThe current study is conducted in a high volume tertiary obstetrics center burdened by COVID-19 pandemics, in Turkey. In this cohort study, perinatal outcomes and complete blood count indices performed at the time of admission of 39 pregnancies (Study group) complicated by COVID-19 were compared with 69 uncomplicated pregnancies (Control group).ResultsThere was no significant difference between the obstetric and neonatal outcomes of pregnancies with COVID-19 compared to data of healthy pregnancies, except the increased C-section rate (p=0.026). Monocyte count, red cell distribution width (RDW), neutrophil/lymphocyte ratio (NLR), and monocyte/lymphocyte ratio (MLR) were significantly increased (p<0.0001, p=0.009, p=0.043, p<0.0001, respectively) whereas the MPV and plateletcrit were significantly decreased (p=0.001, p=0.008) in pregnants with COVID-19. ROC analysis revealed that the optimal cut-off value for MLR was 0.354 which indicated 96.7% specificity and 59.5% sensitivity in diagnosis of pregnant women with COVID-19. A strong positive correlation was found between the MLR and the presence of cough symptom (r=41.4, p=<0.0001).ConclusionsThe study revealed that, pregnancies complicated by COVID-19 is not related with adverse perinatal outcomes. MLR may serve as a supportive diagnostic parameter together with the Reverse Transcriptase Polymerase Chain Reaction (RT-PCR) in assessment of COVID-19 in pregnant cohort.

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Role of pre-treatment neutrophil to lymphocyte ratio as a diagnostic marker of malignancy in breast carcinoma patients: a study in a tertiary care centre

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20184700 ◽

2018 ◽

Vol 6 (12) ◽

pp. 3887

Author(s):

Shruti Srivastava ◽

Chandrashekhar Indoria

Keyword(s):

Breast Neoplasm ◽

Complete Blood Count ◽

Tertiary Care ◽

Breast Mass ◽

Tissue Remodelling ◽

Tertiary Care Centre ◽

Neutrophil Lymphocyte Ratio ◽

Lymphocyte Ratio ◽

Significant Difference ◽

Malignant Breast

Background: Inflammation is closely associated with cancer. Inflammation maintains and promotes cancer growth by causing tumor tissue remodelling and angiogenesis. It also helps in metastasis and helps tumor cells to survive by suppressing anti-cancer innate immune response. Recent studies have suggested use of Neutrophil lymphocyte ratio (NLR) for evaluation of systemic inflammation. Present study was undertaken with an aim to compare NLR among patients with malignant breast neoplasm with and without metastasis.Methods: This was a cross sectional observational study comprising of 179 women with breast neoplasm. Patients were categorized into two subgroups of benign proliferative breast mass and malignant breast mass (with or without metastasis). Data was collected from pre intervention complete blood count reports of all patients. To obtain NLR values neutrophil count were divided by lymphocyte counts. A comparison of NLR values in different subgroups of the patients was performed.Results: Mean neutrophil values in benign and malignant subgroups were 64.02±7.9 and 70.75±9.2 respectively. Mean lymphocyte count in benign and malignant subgroups was 27.527±7.565 and 20.220±7.354 respectively. Difference in mean values for neutrophils and lymphocytes was not significant in benign and malignant subgroups. Significant difference was present in values of NLR among benign and malignant subgroups, but within malignant subgroup no significant difference was present among patients with or without metastasis.Conclusions: Present study findings supported that pre-intervention Neutrophil Lymphocyte ratio is a promising biomarker of malignancy.

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The prognostic and diagnostic significance of the neutrophil-to-lymphocyte ratio in hepatocellular carcinoma: a prospective controlled study

British Journal of Cancer ◽

10.1038/s41416-021-01445-3 ◽

2021 ◽

Author(s):

Philip J. Johnson ◽

Sofi Dhanaraj ◽

Sarah Berhane ◽

Laura Bonnett ◽

Yuk Ting Ma

Keyword(s):

Hepatocellular Carcinoma ◽

Regression Analysis ◽

Prognostic Factor ◽

Cox Regression ◽

Prognostic Models ◽

Controlled Study ◽

Cox Regression Analysis ◽

Neutrophil Lymphocyte Ratio ◽

Lymphocyte Ratio ◽

Significant Difference

Abstract Background The neutrophil–lymphocyte ratio (NLR), a presumed measure of the balance between neutrophil-associated pro-tumour inflammation and lymphocyte-dependent antitumour immune function, has been suggested as a prognostic factor for several cancers, including hepatocellular carcinoma (HCC). Methods In this study, a prospectively accrued cohort of 781 patients (493 HCC and 288 chronic liver disease (CLD) without HCC) were followed-up for more than 6 years. NLR levels between HCC and CLD patients were compared, and the effect of baseline NLR on overall survival amongst HCC patients was assessed via multivariable Cox regression analysis. Results On entry into the study (‘baseline’), there was no clinically significant difference in the NLR values between CLD and HCC patients. Amongst HCC patients, NLR levels closest to last visit/death were significantly higher compared to baseline. Multivariable Cox regression analysis showed that NLR was an independent prognostic factor, even after adjustment for the HCC stage. Conclusion NLR is a significant independent factor influencing survival in HCC patients, hence offering an additional dimension in prognostic models.

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Can Hematological Parameters Play a Role in the Differential Diagnosis of Adrenal Tumors?

Uro ◽

10.3390/uro1020006 ◽

2021 ◽

Vol 1 (2) ◽

pp. 39-44

Author(s):

Mehmet Gürkan Arıkan ◽

Göktan Altuğ Öz ◽

Nur Gülce İşkan ◽

Necdet Süt ◽

İlkan Yüksel ◽

...

Keyword(s):

Differential Diagnosis ◽

Inflammatory Markers ◽

Blood Count ◽

Complete Blood Count ◽

Low Cost ◽

Easy Access ◽

Adrenal Tumors ◽

Tumor Diameter ◽

Lymphocyte Ratio ◽

Significant Difference

There have been few studies reported with conflicting results in the use of neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), redcell-distribution-width (RDW), etc. for predicting prognosis and differential diagnosis of adrenal tumors. The aim of this study is to investigate the role of inflammatory markers through a complete blood count, which is an easy access low-cost method, for the differential diagnosis of adrenocortical adenoma (ACA), adrenocortical carcinoma (ACC), and pheochromocytoma. The data of patients who underwent adrenalectomy between the years of 2010–2020 were retrospectively analyzed. Systemic hematologic inflammatory markers based on a complete blood count such as neutrophil ratio (NR), lymphocyte ratio (LR), NLR, PLR, RDW, mean platelet volume (MPV), and maximum tumor diameter (MTD) were compared between the groups. A statistically significant difference was found between the three groups in terms of PLR, RDW, and MTD. With post-hoc tests, a statistically significant difference was found in PLR and MTD between the ACA and ACC groups. A statistically significant difference was found between the ACA and pheochromocytoma groups in PLR and RDW values. In conclusion, it could be possible to plan a more accurate medical and surgical approach using PLR and RDW, which are easily calculated through an easy access low-cost method such as a complete blood count, together with MTD in the differential diagnosis of ACC, ACA, and pheochromocytoma.

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Immature granulocyte and other hematological inflammatory parameters in patients with migraine headache

10.51271/kmj-0025 ◽

2021 ◽

pp. 101-104

Keyword(s):

Complete Blood Count ◽

Control Group ◽

Age And Gender ◽

Neutrophil Lymphocyte Ratio ◽

Lymphocyte Ratio ◽

Inflammatory Parameters ◽

Group Data ◽

Healthy Control ◽

Immature Granulocyte ◽

And Gender

Background: Today, many hypotheses have been proposed in the pathogenesis of migraine. The inflammatory hypothesis is one of them. The immature granulocyte count (IGC) is also an inflammatory parameter which importance has been understood recently. There are no studies evaluating IGC in migraine. The aim of the study to investigate the levels of IGC and other hematological inflammatory parameters in migraine. Material and Method: Materials and Methods: Forty-eight patients diagnosed with migraine who applied to Kastamonu Training and Research Hospital Neurology outpatient clinic between 07.01.2020 and 10.01.2021 were included in the study. 42 people with similar age and gender distribution were included for the control group. Data on laboratory tests, age and gender of patients were obtained from the hospital Laboratory Information System (LIS). CBC parameters of the patients at the first admission and before any treatment, calculated with an automated hematological analyzer (XN-1000-Hematology-analyzer-Sysmex Corporation, Japan) were analyzed. Using Complete Blood Count (CBC) data, neutrophil count (NEUT#), neutrophil percentage (NEUT%), lymphocyte percentage (LYMPH%), and IGC were recorded. Neutrophil lymphocyte ratio (NLR), platelet lymphocyte ratio (PLR), and systemic immune inflammation index (SII) values were calculated with the formula. Results: In our study, NLR and IGC was significantly higher than the healthy control group (p=0.002, p=0.025). PLR was also found to be high, but it was not statistically significant (p=0.063). Conclusion: The significantly higher NLR and IGC levels in migraine patients compared to the healthy controls support the role of inflammation in etiopathogenesis.

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Prediction of Troponin elevation in Non- ST Acute Coronary Syndrome Patients presenting to The Emergency Department Using Neutrophil-lymphocyte ratio

QJM ◽

10.1093/qjmed/hcab090.035 ◽

2021 ◽

Vol 114 (Supplement_1) ◽

Author(s):

Sarah Mohamed Mahmoud ◽

Bassam Sobhy ◽

Ramy Raymond

Keyword(s):

Emergency Department ◽

Acute Coronary Syndrome ◽

Complete Blood Count ◽

P Value ◽

Troponin Elevation ◽

Positive Group ◽

Neutrophil Lymphocyte Ratio ◽

Lymphocyte Ratio ◽

Coronary Syndrome

Abstract Background The neutrophil–lymphocyte ratio (NLR) is considered an independent predictor of mortality and myocardial infarction (MI) in stable coronary artery disease (SCAD). Also NLR have prognostic value in patients with acute coronary syndromes (ACSs). However the diagnostic power of NLR in patients suspected of ACS is still under study Objective is to determine the ability of neutrophil-lymphocyte ratio to predict troponin elevation in patients presenting to emergency department with acute coronary syndrome Material and Methods From June 2018 to March 2019, 100 patients were enrolled who presented to the ER with NST-ACS. Patients were divided into 2 groups based upon the troponin positivity in the 12- to 24-hour follow-up. Baseline Complete blood count with calculation of NLR is done Results The study population was divided into 2 groups: troponin- negative group (n = 50) and troponin-positive group (n = 50). Mean age was 55.8 ± 11.3. 77% of the patients were male. No significance difference in the level of hemoglobin, WBCs and platelets between the 2 groups. The neutrophil count was significantly higher in the troponin-positive group (p < 0.001). The median admission. NLR was significantly higher in the troponin-positive group (2 vs. 3.9, P < 0.001). A cutoff point of 3.4 for NLR measured on admission had 84% sensitivity and 84% specificity in predicting follow-up troponin positivity. A highly significant correlation was found between NLR and level of troponin change (p value <0.01) Conclusion NLR can be used as a diagnostic tool in the differentiation of patients with acute coronary syndrome. NLR is a non-expensive, simple and available parameter that can be used in diagnosis of NSTEMI.

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Platelet-to-lymphocyte ratio (PLR) and Plateletcrit (PCT) in young patients with morbid obesity

Revista da Associação Médica Brasileira ◽

10.1590/1806-9282.65.9.1182 ◽

2019 ◽

Vol 65 (9) ◽

pp. 1182-1187 ◽

Cited By ~ 3

Author(s):

Emrah Erdal ◽

Mehmet İnanir

Keyword(s):

Morbid Obesity ◽

Healthy Subjects ◽

Complete Blood Count ◽

Young Patients ◽

Obese Group ◽

Platelet To Lymphocyte Ratio ◽

Distribution Width ◽

Lymphocyte Ratio ◽

Platelet Counts ◽

Significant Difference

SUMMARY OBJECTIVE To compare the complete blood counts, namely the plateletcrit (PCT) and Platelet-To-Lymphocyte Ratio (PLR) of healthy subjects and those with morbid obesity in the young population. METHODS We included 45 patients with morbid obesity (body mass index -BMI - greater than or equal to 45 kg/m2) and 45 healthy subjects (BMI less than or equal to 25 kg/m2) in our study. Blood samples were obtained from the participants following a 12-hour fasting period. Then we evaluated the levels of hemoglobin (Hb), hematocrit (HCT), red cell distribution width (RDW), mean platelet volume (MPV), white blood cell (WBC), PLR, platelet counts, and PCT in the complete blood count. RESULTS The morbid obesity group had significantly higher platelet counts and PCT values (p<0.001), and PLR values (p=0.033). The value of WBC was also higher in the obese group (p=0.001). MPV was lower in the obesity group but not statistically significant (p=0.815). No significant difference was found between hemoglobin and hematocrit values in these groups; but RDW valuewere higher and statistically significant in the obese group (p=0.001). CONCLUSION PLR or PCT may be more useful as a marker in determining an increased thrombotic state and inflammatory response in morbid obesity.

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Assessment of the hemogram parameters in patients with paroxysmal supraventricular tachycardia: a retrospective study

Revista da Associação Médica Brasileira ◽

10.1590/1806-9282.66.10.1371 ◽

2020 ◽

Vol 66 (10) ◽

pp. 1371-1375

Author(s):

Mehmet Cosgun ◽

Yilmaz Gunes ◽

Isa Sincer ◽

Asli Kurtar Mansiroglu

Keyword(s):

Retrospective Study ◽

Supraventricular Tachycardia ◽

University Hospital ◽

Control Group ◽

Paroxysmal Supraventricular Tachycardia ◽

Monocyte Count ◽

Neutrophil Lymphocyte Ratio ◽

Lymphocyte Ratio ◽

Markers Of Inflammation ◽

Significant Difference

SUMMARY OBJECTIVE: Inflammation has been suggested as a potential mechanism in the pathogenesis of arrhythmia. Hemogram parameters such as monocyte count to high-density lipoprotein cholesterol ratio (MHR), neutrophil/lymphocyte ratio (NLR), and monocyte/lymphocyte ratio (MLR) have been considered to be markers of inflammation and new cardiovascular risk predictors. This retrospective study aimed to investigate the relationship between MHR, NLR, and MLR in patients with paroxysmal supraventricular tachycardia (PSVT). METHODS: A retrospective study conducted at a university hospital in Bolu, Turkey, between 2017 and 2019. Our study included 196 patients who underwent electrophysiological study (EPS) due to palpitation or documented PSVT on electrocardiography (ECG). Patients having documented atrioventricular nodal re-entrant tachycardia (AVNRT) on ECG or inducible AVNRT on EPS were included in the PSVT group (n=130), and patients with palpitation but without inducible arrhythmia on EPS (n=66) were included in the control group. Routine biochemical and hemogram tests were performed before the EPS procedure. RESULTS: When hemogram parameters were compared, there was no statistically significant difference in MHR values [0.010 (0.001-0.030) vs 0.010 (0.001-0.020) p =0.67]. Additionally, both NLR [2.21(0.74-11.36) vs 1.98(0.72-24.87) p=0.13] and MLR [0.25 (0.03-1.05) vs 0.24(0.07-1.39) p=0.41] were not statistically significant between the two groups. CONCLUSION: There is no significant difference in PSVT patients regarding hemogram parameters including white blood cell subtypes, MLR, NLR, and MHR. Therefore the evaluation of hemogram parameters may not be clinically relevant for PSVT patients.

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The effect of insulin resistance on inflammation markers in individuals with obesity

Medical Science and Discovery ◽

10.36472/msd.v8i10.620 ◽

2021 ◽

Vol 8 (10) ◽

pp. 619-622

Author(s):

Hasan Atlı ◽

Erhan Önalan ◽

Burkay Yakar ◽

Deccane Duzenci ◽

Emir Dönder

Keyword(s):

Insulin Resistance ◽

Body Mass Index ◽

Body Mass ◽

Normal Body Mass Index ◽

Low Grade ◽

Inflammation Markers ◽

Predictive Values ◽

Lymphocyte Ratio ◽

Normal Body ◽

Significant Difference

Objective: Obesity has recently been recognized as a chronic low-grade inflammation condition. We aimed to compare the predictive values of insulin resistance and inflammatory indices in individuals with obesity. Materials and Methods: 124 people who had a health check for obesity-related risk factors in our hospital between June 2018 and September 2019 were included in the study. Inflammatory markers of the patients were evaluated. Results: The study group consists of a total of 224 people, and we compared the demographic data and laboratory parameters of the individuals. C-reactive protein (CRP) levels of obese individuals were statistically higher than those with normal body mass index (p <0.001). There was no statistically significant difference between the groups in terms of neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) values, among other inflammation markers. A positive and statistically significant correlation was found between body mass index and CRP level (r = 0.334, p <0.001). There was no significant correlation between body mass index and NLR and PLR. Conclusion: As a result, CRP levels of obese individuals were statistically higher than individuals with normal body mass index. No statistically significant difference was found between the groups in terms of NLR and PLR values among other inflammation markers.

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ROLE OF HEMATOLOGICAL PARAMETERS IN EARLY DIAGNOSIS OF COVID-19 IN A TERTIARY CARE CENTRE

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v5i6.1960 ◽

2021 ◽

Vol 5 (6) ◽

Author(s):

Angira Saha ◽

Sakar Saxena ◽

Romi Srivastava ◽

Sanjeev Narang

Keyword(s):

Early Diagnosis ◽

Hematological Parameters ◽

Tertiary Care ◽

Tertiary Care Centre ◽

College Hospital ◽

Neutrophil Lymphocyte Ratio ◽

Lymphocyte Ratio ◽

Platelet Lymphocyte Ratio ◽

Significant Difference

Aim: To evaluate the role of biomarkers from blood samples of COVID-19 patients admitted in Index Medical College Hospital & R.C. Material & Methods: Hematological parameters such as Neutrophil lymphocyte ratio (NLR), Platelet lymphocyte ratio (PLR) & Systemic Inflammatory Index (SII) were studied in RT-PCR positive patients to evaluate the utility of these parameters for early diagnosis of COVID-19. Results: The study showed that there was statistically significant difference in test groups in reference to Neutrophil lymphocyte ratio (NLR) & SII values (p<0.05). But no statistically significant difference was observed between test groups in reference to Platelet lymphocyte ratio (PLR) values (p>0.05). Conclusion: Leukocyte, Neutrophil, NLR & SII values can be used in the early diagnosis of COVID-19. Keywords: NLR, SII, Leukocyte, Neutrophil

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