Combination of Neutrophil to Lymphocyte Ratio and Glasgow Prognostic Score Improves Prognostic Accuracy in Lung Transplantation: Validation of 9 Preoperative Prognostic Scoring Methods

Abstract Context Serum inflammation-based scores reflect systemic inflammatory response and/or patients’ nutritional status, and may predict clinical outcomes in cancer. While these are well-described and increasingly used in different cancers, their clinical usefulness in the management of patients with endocrine tumors is less known. Evidence acquisition A comprehensive PubMed search was performed using the terms “endocrine tumor”, “inflammation”, “serum inflammation-based score”, “inflammatory-based score”, “inflammatory response-related scoring”, “systemic inflammatory response markers”, “Neutrophil-to-lymphocyte ratio”, “Neutrophil-to-platelet ratio”, “Lymphocyte-to-monocyte ratio”, “Glasgow Prognostic Score”, “Neutrophil-Platelet Score”, “Systemic Immune-Inflammation Index”, and “Prognostic Nutrition Index” in clinical studies. Evidence synthesis The Neutrophil-to-Lymphocyte Ratio and the Platelet-to-Lymphocyte Ratio are the ones most extensively investigated in patients with endocrine tumors. Other scores have also been considered in some studies. Several studies focused in finding whether serum inflammatory biomarkers may stratify the endocrine tumor patients’ risk and detect those at risk for developing more aggressive and/or refractory disease, particularly after endocrine surgery. Conclusions In this review, we summarize the current knowledge on the different serum inflammation-based scores and their usefulness in predicting the phenotype, clinical aggressiveness, disease outcomes and prognosis in patients with endocrine tumors. The value of such serum inflammation-based scores in the management of patients with endocrine tumors has been emerging over the last decade. However, further research is necessary to establish useful markers and their cut-offs for routine clinical practice for individual diseases.

Download Full-text

Neutrophil-to-Lymphocyte Ratio Has a Close Association With Gangrenous Appendicitis in Patients Undergoing Appendectomy

International Surgery ◽

10.9738/cc161.1 ◽

2013 ◽

Vol 97 (4) ◽

pp. 299-304 ◽

Cited By ~ 45

Author(s):

Mitsuru Ishizuka ◽

Takayuki Shimizu ◽

Keiichi Kubota

Keyword(s):

Confidence Interval ◽

Clinical Features ◽

Odds Ratio ◽

Prognostic Score ◽

Univariate Analysis ◽

Open Appendectomy ◽

Glasgow Prognostic Score ◽

Neutrophil To Lymphocyte Ratio ◽

Lymphocyte Ratio ◽

Gangrenous Appendicitis

Abstract The purpose of this study was to clarify the clinical features most closely associated with gangrenous appendicitis. From among 314 patients who had undergone open appendectomy in our collected database, 222 for whom sufficient data were evaluable were enrolled. The results of univariate analysis revealed that age (≤40/>40 years), sex (female/male), fever (≤37°/>37°C), the serum levels of C-reactive protein and albumin, the Glasgow prognostic score (0, 1/2), and the neutrophil-to-lymphocyte ratio (NLR) (≤8/>8) were associated with gangrenous appendicitis. Among these 7 clinical features, multivariate analysis disclosed that age (≤40/>40 years) (odds ratio, 3.435; 95% confidence interval 1.744–6.766; P < 0.001) and NLR (≤8/>8) (odds ratio, 3.016; 95% confidence interval 1.535–5.926; P = 0.001) were associated with gangrenous appendicitis. The sensitivity and specificity of these two clinical features were 65% and 27%, and 73% and 39%, respectively. NLR (>8) shows a significant association with gangrenous appendicitis in patients undergoing appendectomy.

Download Full-text

Abstract 11752: Prognostic Value of Neutrophil to Lymphocyte Ratio in Patients Admitted With Acute Decompensated Heart Failure; A Comparison With Platelet to Lymphocyte Ratio and Glasgow Prognostic Score

Circulation ◽

10.1161/circ.132.suppl_3.11752 ◽

2015 ◽

Vol 132 (suppl_3) ◽

Author(s):

Takahisa Yamada ◽

Takashi Morita ◽

Yoshio Furukawa ◽

Shunsuke Tamaki ◽

Yusuke Iwasaki ◽

...

Keyword(s):

Heart Failure ◽

Prognostic Value ◽

Acute Decompensated Heart Failure ◽

Prognostic Score ◽

Glasgow Prognostic Score ◽

Decompensated Heart Failure ◽

Neutrophil To Lymphocyte Ratio ◽

Platelet To Lymphocyte Ratio ◽

Lymphocyte Ratio ◽

Coronary Syndrome

Backgrounds: Inflammation plays a critical role in the outcomes of heart failure. As indicators of the systemic inflammatory response, the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) have been proposed to predict the poor outcome in patients (pts) with acute coronary syndrome. Furthermore, as another systemic inflammation-based score, the Glasgow Prognostic Score (GPS) has recently been reported to provide prognostic information in pts with heart failure. However, there is no information available on the comparison of prognostic impacts of these systemic inflammatory indices in pts admitted with acute decompensated heart failure (ADHF). Methods and Results: We studied 305 consecutive ADHF pts discharged with survival. At the admission and discharge, NLR and PLR were measured and GPS (0,1 and 2) was also obtained by combining elevated CRP (>1mg/dl) and hypoalbuminemia(<3.5g/dl) (none=0, either=1, and both=2). During a follow up period of 4.2±3.3 yrs, 96 pts died. Neither NLR nor PLR at the admission showed an association with mortality. At multivariate Cox analysis, NLR at the discharge (p=0.01) was significantly associated with mortality, independently of age, systolic blood pressure, prior heart failure hospitalization, and serum sodium level, although PLR (p=0.01) and GPS (p=0.02) at the discharge showed a significant association with mortality at univariate analysis. By ROC analysis, AUC of NLR at the discharge was 0.705 (0.639-0.772, p<0.0001), which was greater than those of PLR (0.615[0.544-0.687], p=0.002) and GPS (0.567[0.490-0.644], p=0.09) at the discharge. Pts with highest tertile of NLR (>2.2) had a increased risk of mortality than middle tertile (NLR=2.2-1.5; HR 2.0 [1.3-3.3]) and lowest tertile (NLR<1.5: HR 4.4 [2.5-7.9]). Conclusion: NLR at the discharge provides more valuable prognostic value for the prediction of total mortality than PLR and GPS in ADHF pts.

Download Full-text

Systemic Inflammatory Reaction in Gastric Cancer: Biology and Practical Implications of Neutrophil to Lymphocyte Ratio, Glasgow Prognostic Score and Related Parameters

Gastric Cancer ◽

10.5772/intechopen.69723 ◽

2017 ◽

Cited By ~ 2

Author(s):

Ilze Strumfa ◽

Tatjana Bogdanova ◽

Arturs Kalva ◽

Boriss Strumfs ◽

Roberts Rumba ◽

...

Keyword(s):

Gastric Cancer ◽

Inflammatory Reaction ◽

Cancer Biology ◽

Prognostic Score ◽

Glasgow Prognostic Score ◽

Neutrophil To Lymphocyte Ratio ◽

Lymphocyte Ratio ◽

Systemic Inflammatory Reaction ◽

Practical Implications

Download Full-text

Role of Inflammatory and Immune-Nutritional Prognostic Markers in Patients Undergoing Surgical Resection for Biliary Tract Cancers

Cancers ◽

10.3390/cancers13143594 ◽

2021 ◽

Vol 13 (14) ◽

pp. 3594

Author(s):

Simone Conci ◽

Tommaso Campagnaro ◽

Elisa Danese ◽

Ezio Lombardo ◽

Giulia Isa ◽

...

Keyword(s):

Biliary Tract ◽

Cox Regression ◽

Prognostic Score ◽

Prognostic Index ◽

Glasgow Prognostic Score ◽

Postoperative Mortality ◽

Prognostic Nutritional Index ◽

Term Survival ◽

Lymphocyte Ratio

The relationship between immune-nutritional status and tumor growth; biological aggressiveness and survival, is still debated. Therefore, this study aimed to evaluate the prognostic performance of different inflammatory and immune-nutritional markers in patients who underwent surgery for biliary tract cancer (BTC). The prognostic role of the following inflammatory and immune-nutritional markers were investigated: Glasgow Prognostic Score (GPS), modified Glasgow Prognostic Score (mGPS), Prognostic Index (PI), Neutrophil to Lymphocyte ratio (NLR), Platelet to Lymphocyte ratio (PLR), Lymphocyte to Monocyte ratio (LMR), Prognostic Nutritional Index (PNI). A total of 282 patients undergoing surgery for BTC were included. According to Cox regression and ROC curves analysis for survival, LMR had the best prognostic performances, with hazard ratio (HR) of 1.656 (p = 0.005) and AUC of 0.652. Multivariable survival analysis identified the following independent prognostic factors: type of BTC (p = 0.002), T stage (p = 0.014), N stage (p < 0.001), histological grading (p = 0.045), and LMR (p = 0.025). Conversely, PNI was related to higher risk of severe morbidity (p < 0.001) and postoperative mortality (p = 0.005). In conclusion, LMR appears an independent prognostic factor of long-term survival, whilst PNI seems associated with worse short-term outcomes.

Download Full-text

Pre-radiosurgery leucocyte ratios and modified glasgow prognostic score predict survival in non-small cell lung cancer brain metastases patients

Journal of Neuro-Oncology ◽

10.1007/s11060-020-03660-z ◽

2020 ◽

Author(s):

Anna Cho ◽

Helena Untersteiner ◽

Dorian Hirschmann ◽

Fabian Fitschek ◽

Christian Dorfer ◽

...

Keyword(s):

Brain Metastases ◽

Cox Regression ◽

Prognostic Score ◽

Gamma Knife Radiosurgery ◽

Glasgow Prognostic Score ◽

Lymphocyte Ratio ◽

Risk Of Death ◽

Lymphocyte To Monocyte Ratio ◽

Modified Glasgow Prognostic Score ◽

Nsclc Patients

Abstract Introduction The predictive value of the pre-radiosurgery Neutrophil-to-Lymphocyte Ratio (NLR), Platelet-to-Lymphocyte Ratio (PLR), Lymphocyte-to-Monocyte Ratio (LMR) and the modified Glasgow Prognostic Score (mGPS) was assessed for the first time in a homogenous group of NSCLC brain metastaes (BM) patients. Methods We retrospectively evaluated 185 NSCLC-BM patients, who were treated with Gamma Knife Radiosurgery (GKRS). Patients with immunotherapy or targeted therapy were excluded. Routine laboratory parameters were reviewed within 14 days before GKRS1. Results Median survival after GKRS1 was significantly longer in patients with NLR < 5 (p < 0.001), PLR < 180 (p = 0.003) and LMR ≥ 4 (p = 0.023). The Cox regression model for the continuous metric values revealed that each increase in the NLR of 1 equaled an increase of 4.3% in risk of death (HR: 1.043; 95%CI = 1.020–1.067, p < 0.001); each increase in the PLR of 10 caused an increase of 1.3% in risk of death (HR: 1.013; 95%CI = 1.004–1.021; p = 0.003) and each increase in the LMR of 1 equaled a decrease of 20.5% in risk of death (HR: 0.795; 95%CI = 0.697–0.907; p = 0.001). Moreover, the mGPS group was a highly significant predictor for survival after GKRS1 (p < 0.001) with a HR of 2.501 (95%CI = 1.582–3.954; p < 0.001). NLR, PLR, LMR values and mGPS groups were validated as independent prognostic factors for risk of death after adjusting for sex, KPS, age and presence of extracranial metastases. Conclusion NLR, PLR, LMR and mGPS represent effective and simple tools to predict survival in NSCLC patients prior to radiosurgery for brain metastases.

Download Full-text

The prognostic significance of inflammation-based scores in patients with ampullary carcinoma after pancreaticoduodenectomy

10.21203/rs.3.rs-23444/v2 ◽

2020 ◽

Author(s):

Shuxin Sun ◽

Chaobin He ◽

Jun Wang ◽

Xin Huang ◽

Jiali Wu ◽

...

Keyword(s):

Prognostic Value ◽

Prognostic Score ◽

Prognostic Significance ◽

Prognostic Index ◽

Glasgow Prognostic Score ◽

Prognostic Nutritional Index ◽

Significant Prognostic Factor ◽

Entire Cohort ◽

Lymphocyte Ratio ◽

Survival Differences

Abstract Background Growing evidence indicates that systemic inflammatory response plays an important role in cancer development and progression. Several inflammatory markers have been reported to be associated with the clinical outcomes in patients with various types of cancer. This study was designed to evaluate the prognostic value of the inflammatory indexes in patients suffering from ampullary cancer (AC) who underwent pancreaticoduodenectomy (PD). Methods We retrospectively reviewed a database of 358 patients with AC who underwent PD between 2009 and 2018. R software was used to compare the area under the time-dependent receiver operating characteristic (ROC) curves (AUROCs) of the inflammation-based indexes, including the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), modified Glasgow Prognostic Score (mGPS), prognostic nutritional index (PNI) and prognostic index (PI), in terms of their predictive value of survival. The survival differences of these indexes were compared by Kaplan-Meier method and univariate and multivariate analyses were performed to determine the prognostic factors of progress-free survival (PFS) and overall survival (OS). Results The estimated 1-, 2-, and 3-year OS and PFS rates were 83.9%, 65.8%, 55.2% and 58.0%, 42.8%, 37.8%, respectively, for the entire cohort. The survival differences were significant in terms of OS and PFS when they were stratified by these inflammation-based indexes. The comparisons of AUROCs of these inflammation-based indexes illustrated that NLR and PI displayed highest prognostic value, compared to other indexes. When NLR and PI were combined, NLR-PI showed even higher AUROC values and was identified as a significant prognostic factor in terms of OS and PFS. Conclusion Specific inflammatory indexes, such as NLR, PLR and PI, were found to be able to predict the OS or PFS of patients. As a novel inflammatory index, the level of NLR-PI, which can be regarded as a more useful prognostic index, exhibited strong predictive power for predicting prognosis of patients with AC after PD procedure.

Download Full-text

Glasgow Prognostic Score Is Superior to Other Inflammation-Based Scores in Predicting Survival of Diffuse Large B-Cell Lymphoma

Blood ◽

10.1182/blood.v126.23.1454.1454 ◽

2015 ◽

Vol 126 (23) ◽

pp. 1454-1454

Author(s):

Xiaoxiao Hao ◽

Yongqiang Wei ◽

Fen Huang ◽

Xiaolei Wei ◽

Yuankun Zhang ◽

...

Keyword(s):

B Cell ◽

Cell Lymphoma ◽

Prognostic Score ◽

Univariate Analysis ◽

Glasgow Prognostic Score ◽

B Cell Lymphoma ◽

Prognostic Scores ◽

Lymphocyte Ratio ◽

Large B Cell Lymphoma ◽

Large B Cell

Abstract Inflammation-based prognostic scores, such as the glasgow prognostic score (GPS), prognostic index(PI), prognostic nutritional index(PNI), neutrophil lymphocyte ratio(NLR), platelet lymphocyte ratio(PLR) was related to survival in many solid tumors. Recent study showed that GPS can be used to predict outcome in diffuse large B-cell lymphoma(DLBCL). However other inflammation related scores had not been reported in DLBCL, and it also remained unknown which of them was more useful to evaluate the survival in DLBCL. In this retrospective study, a number of 252 newly diagnosed and histologically proven DLBCL patients from January 2003 to December 2014 were included. An elevated GPS, PI, NLR, PNI and PLR were all associated with decreased overall survival(p=0.000, p=0.000, p=0.006, p=0.001 and p=0.001, respectively) and event-free survival (p=0.000, p=0.000, p=0.011, p=0.001 and p=0.009, respectively) in univariate analysis. Multivariate analysis indicated that GPS(RR=1.768, 95%CI=1.043-3.000, p =0.034) remained an independent prognostic predictor in DLBCL. The area under the curve of GPS (0.735, 95%CI=0.645-0.824) was greater than that of PI(0.710, 95%CI=0.621-0.799), PNI(0.600, 95%CI=0.517-0.683), NLR(0.572, 95%CI=0.503-0.642), and PLR(0.599, 95%CI=0.510-0.689) by Harrell's C-statistics. Especially in the DLBCL patients treated with R-CHOP, GPS also remained the most powerful inflammation-based prognostic score when comparing with PI, NLR, PNI and PLR (p=0.004, p=0.000, respectively for OS and EFS). In conclusion, these results indicate that Inflammation-based prognostic scores such as GPS, PI, NLR, PNI and PLR can be used to evaluate the outcome in DLBCL patients. Among them, GPS is the most powerful tool in predicting survival in DLBCL patients, even in the rituximab era. Disclosures No relevant conflicts of interest to declare.

Download Full-text