scholarly journals Short term survival of critically ill COVID-19 Egyptian patients on assisted ventilation treated by either Dexamethasone or Tocilizumab

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Alaa Rashad ◽  
Sherif Mousa ◽  
Hanaa Nafady-Hego ◽  
Asmaa Nafady ◽  
Hamed Elgendy
Keyword(s):  
Critically Ill ◽  
Cox Regression ◽  
Ferritin Level ◽  
Short Term ◽  
Term Survival ◽  
Cox Regression Analysis ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Dexamethasone Group ◽  
Short Term Survival

AbstractTocilizumab (TCZ) and Dexamethasone are used for the treatment of critically ill COVID-19 patients. We compared the short-term survival of critically ill COVID-19 patients treated with either TCZ or Dexamethasone. 109 critically ill COVID-19 patients randomly assigned to either TCZ therapy (46 patients) or pulse Dexamethasone therapy (63 patients). Age, sex, neutrophil/ lymphocyte ratio, D-dimer, ferritin level, and CT chest pattern were comparable between groups. Kaplan–Meier survival analysis showed better survival in Dexamethasone group compared with TCZ (P = 0.002), patients didn’t need vasopressor at admission (P < 0.0001), patients on non-invasive ventilation compared to patients on mechanical ventilation (P<0.0001 ), and in patients with ground glass pattern in CT chest (P<0.0001 ) compared with those who have consolidation. Cox regression analysis showed that, TCZ therapy (HR = 2.162, 95% CI, 1.144–4.087, P <0.0001) compared with Dexamethasone group, higher neutrophil/Lymphocyte ratio (HR = 2.40, CI, 1.351–4.185, P = 0.003), lower PaO2/FiO2, 2 days after treatment, (HR = 1.147, 95% CI, 1.002–1.624, P < 0.0001) independently predicted higher probability of mortality. Dexamethasone showed better survival in severe COVID-19 compared to TCZ. Considering the risk factors mentioned here is crucial when dealing with severe COVID-19 cases.Clinical trial registration No clinicalTrials.gov: Nal protocol approved by Hospital Authorities, for data collection and for participation in CT04519385 (19/08/2020).

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

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.

scholarly journals Neutrophil-Lymphocyte Ratio and Circulating Tumor Cells Counts Predict Prognosis in Gastrointestinal Cancer Patients

2021 ◽  
Vol 11 ◽  
Author(s):  
Chengcheng Qian ◽  
Renjie Cai ◽  
Wenying Zhang ◽  
Jiongyi Wang ◽  
Xiaohua Hu ◽  
...  
Keyword(s):  
Tumor Cells ◽  
Circulating Tumor Cells ◽  
Gastrointestinal Cancer ◽  
Cox Regression ◽  
Disease Free Survival ◽  
Tumor Location ◽  
Cox Regression Analysis ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Related Data

PurposeThe purpose of this study is to explore the prognostic value of associating pre-treatment neutrophil–lymphocyte ratio (NLR) with circulating tumor cells counts (CTCs) in patients with gastrointestinal cancer.Materials and MethodsWe collected the related data of 72 patients with gastric cancer (GC) and colorectal cancer (CRC) who received different therapies from August 2016 to October 2020, including age, gender, primary tumor location, TNM stage, tumor-differentiation, NLR, CTCs, disease-free survival (DFS) and overall survival (OS). We chose the optimal cut-off value of NLR &gt;3.21 or NLR ≤3.21 and CTC &gt;1 or CTC ≤1 by obtaining receiver operating characteristic (ROC) curve. The Kaplan–Meier survival analysis and Cox regression analysis were used to analyze DFS and OS. To clarify the role of the combination of NLR and CTCs counts in predicting the prognosis, we analyzed the DFS and OS when associated NLR and CTCs counts.ResultsA high NLR (&gt;3.21) was associated with shorter DFS (P &lt;0.0001) and OS (P &lt;0.0001). Patients with high CTCs level (&gt;1) had shorter DFS (P = 0.001) and OS (P = 0.0007) than patients with low CTCs level. Furthermore, patients who had both higher NLR and higher CTCs counts had obvious shorter DFS (P &lt;0.0001) and OS (P &lt;0.0001).ConclusionsPatients with higher NLR and more CTCs respectively tended to have poor prognosis with shorter DFS and OS, which might be regarded as predictors of gastrointestinal cancer. In particular, associating NLR and CTCs counts might be a reliable predictor in patients with gastrointestinal cancer.

Predictive role of peritumoral CD3+ infiltration and neutrophil to lymphocyte ratio on overall survial in pateints affected by colorectal liver metastases treated with chemotherapy and surgery.

2018 ◽  
Vol 36 (5_suppl) ◽  
pp. 27-27
Author(s):  
Matteo Cimino ◽  
Matteo Donadon ◽  
Domenico Mavilio ◽  
Luca Di Tommaso ◽  
Massimo Roncalli ◽  
...  
Keyword(s):  
Liver Metastases ◽  
Colorectal Liver Metastases ◽  
Protective Factor ◽  
Cox Regression ◽  
Absolute Lymphocyte Count ◽  
Cox Regression Analysis ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Markers Of Inflammation

27 Background: Systemic and local inflammation plays an important role in many cancers and colorectal liver metastases (CRLM). While the role of local immune response mediated by CD3+ tumour infiltrating lymphocyte is well established new evidence on systemic inflammation and cancer such as neutrophil–lymphocyte ratio (NLR) are emerging. The aim of the study is to associate these two markers of inflammation to predict overall survival (OS) in patients affected by CRLM. Methods: From January 2006 to January 2013 128 consecutive patients affected by CRLM treated with chemotherapy and surgery were included in the study. CD3+ peritumoral infiltration was defined as the ratio of intra-tumoural\invasive-margin CD3+ infiltration evaluated with immunohistochemistry on CRLM tumor slides. NLR was calculated as neutrophil absolute count divided by the absolute lymphocyte count on blood sample. ROC curves were used to calculate a cut-off for each bio-markers related to OS . Associating the bio-markers two risk groups were determined: low risk (LRG) two protective bio-markers; high risk (HRG) no protective bio-markers. Results: After a median follow-up of 45 months, median OS was 44 months.Twenty-nine patients (22.6%) belong to the LRG whereas 99 patients (77,4) belong to HRG. Adjusted Cox regression analysis showed a worse OS for HRG patients (HR 2.74 p = 0.003 95%CI 1.40-5.37). Median OS was 80.8 vs 42.5 months for LRG vs HRG respectively. Conclusions: High CD3+ peritumoural infiltration associated with low NRL are two protective factor on OS for patients affected by CRLM.

scholarly journals Prognostic Value of the Neutrophil-to-Lymphocyte Ratio before and after Radiotherapy for Anaplastic Thyroid Carcinoma

Cancers ◽  
2021 ◽  
Vol 13 (8) ◽  
pp. 1913
Author(s):  
Jiyun Park ◽  
Jun Park ◽  
Jung-Hee Shin ◽  
Young-Lyun Oh ◽  
Hyun-Ae Jung ◽  
...  
Keyword(s):  
Thyroid Carcinoma ◽  
Prognostic Value ◽  
Cox Regression ◽  
Medical Center ◽  
Poor Response ◽  
Anaplastic Thyroid Carcinoma ◽  
Cox Regression Analysis ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Before And After

The neutrophil–lymphocyte ratio (NLR) is a marker of systemic inflammation, and its elevation has recently been associated with poor survival in many solid cancers. Leukocyte elevation and lymphocyte reduction are associated with a poor response to radiotherapy (RT). This study aimed to assess the prognostic value of NLR before and after RT for anaplastic thyroid carcinoma (ATC). This retrospective study analyzed 40 patients with ATC who received RT with available complete blood cell count data from November 1995 through May 2020 at Samsung Medical Center (Seoul, Korea). Patients were classified into two groups according to the NLR before and after RT. The median overall survival (OS) was 8.9 months (range, 3.5–18.2) in the low NLR group (<3.47) and 5.2 months (range, 2.7–7.5) months in the high NLR group (≥3.47). The association between NLR and OS was also observed in multivariable Cox regression analysis (hazard ratio, 3.18; 95% confidence interval, 1.15–8.85; p = 0.026). The OS curves differed significantly according to post-RT NLR (p = 0.036). A high NLR before and after RT may be significantly associated with poor OS in patients with ATC who receive RT.

scholarly journals POS0772 PREVALENCE AND RISK FACTORS FOR HERPES ZOSTER REACTIVATION IN 1542 PATIENTS WITH RHEUMATIC DISEASES

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 640.1-640
Author(s):  
C. C. Mok ◽  
L. Y. Ho ◽  
S. M. Tse ◽  
K. L. Chan ◽  
C. H. To
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Regression Analysis ◽  
Herpes Zoster ◽  
Rheumatic Diseases ◽  
Cox Regression ◽  
Cox Regression Analysis ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio

Objectives:To study the prevalence and risk factors of herpes zoster (HZ) infection in patients with rheumatic diseases.Methods:Medical records of patients with rheumatic diseases who attended our out-patient rheumatology clinics between 2019 March and 2019 August were retrospectively reviewed. Patients who were using biological or targeted DMARDs were excluded. Episodes of HZ infection since disease diagnosis were identified and the prevalence over time was calculated. Laboratory parameters (total white cell count, neutrophil-to-lymphocyte ratio, serum albumin, globulin & creatinine), history of diabetes mellitus and the highest doses of immunosuppressive medications within 6 months of the first episode of HZ infection were compared with those within 6 months of last follow-up in patients who did not have HZ infection. Cox regression analysis was performed to identify factors associated with the first HZ infection in all patients.Results:1542 patients were studied (88% women, age 46.4±15.0 years). The underlying diseases were systemic lupus erythematosus (SLE) (38%), rheumatoid arthritis (26%) and other rheumatic diseases (36%). After a total follow-up of 11,515 patient-years since diagnosis (7.5±7.0 years), 122 (7.9%) patients developed 146 episodes of HZ infection, giving an overall prevalence of 1.27/100-patient years. The prevalence rates of HZ in SLE, RA and non-SLE/RA patients were 1.70, 0.64 and 0.76 per 100 patient-years, respectively. Patients who experienced HZ reactivation were younger (41.6±14.7 vs 46.8±15.0 years; p<0.001), more likely to have SLE (74% vs 35%; p<0.001) and diabetes mellitus (17% vs 7.3%; p=0.01), and had a significantly lower albumin (38.6±5.6 vs 41.3±3.5; p<0.001) and higher neutrophil-to-lymphocyte ratio (4.9±6.2 vs 2.8±2.6; p<0.001). More patients with HZ reactivation were treated with prednisolone (54% vs 22%; p<0.001), azathioprine (20% vs 8%; p<0.001), mycophenolate mofetil [MMF] (21% vs 12%; p=0.006), cyclophosphamide [CYC] (4.9% vs 0.1%; p<0.001) and hydroxychloroquine (48% vs 34%; p=0.002) in the preceding 6 months compared with those who did not have HZ infection. Among those using immunosuppressive drugs, the doses of MMF (1.42±0.64 vs 1.02±0.31g; p=0.005) and prednisolone (15.6±15.9 vs 5.5±4.5mg; p<0.001) were significantly higher in those with HZ infection. The cumulative risk of having HZ reactivation in SLE patients at 24 and 48 months since diagnosis was 5.9% and 8.6%, respectively, which was significantly higher than that in non-SLE patients (1.9% and 2.5%, respectively; p<0.001 by log rank test). Cox regression analysis revealed that having a diagnosis of SLE (HR 1.97 [1.17-3.31]), albumin level (HR 0.93 [0.90-0.97] per g/L; p=0.001), serum creatinine (HR 0.995 [0.990-1.00] per umol/L), higher neutrophil/lymphocyte ratio (HR 1.08 [1.05-1.11]) and the use of CYC (HR 6.69 [2.56-17.5]) and prednisolone (HR 1.61 [1.02-2.45]) in the preceding 6 months were independently associated with the development of HZ infection.Conclusion:Reactivation of HZ is fairly common in patients with rheumatic diseases. Underlying SLE, prednisolone/cyclophosphamide therapy and the neutrophil/lymphocyte ratio, but not age, sex or other laboratory parameters, are the major risk factors for HZ reactivation.Disclosure of Interests:None declared

scholarly journals High-Altitude Is Associated with Better Short-Term Survival in Critically Ill COVID-19 Patients Admitted to the ICU

2020 ◽  
Author(s):  
Pablo R. Morocho Jaramillo ◽  
Katherine Simbaña-Rivera ◽  
Javier V. Velastegui Silva ◽  
Lenin Gómez-Barreno ◽  
Ana B. Ventimilla Campoverde ◽  
...  
Keyword(s):  
High Altitude ◽  
Critically Ill ◽  
Short Term ◽  
Term Survival ◽  
Short Term Survival

The clinical significance of neutrophil-lymphocyte ratio versus platelet-lymphocyte ratio in patients with metastatic gastric cancer.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e14686-e14686
Author(s):  
Suee Lee ◽  
Sung Yong Oh ◽  
Hyuk-Chan Kwon ◽  
Sung-Hyun Kim ◽  
Ji Hyun Lee ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Cox Regression ◽  
Performance Status ◽  
Prognostic Index ◽  
Metastatic Gastric Cancer ◽  
Hazard Ratio ◽  
Cox Regression Analysis ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Platelet Lymphocyte Ratio

e14686 Background: Several inflammatory response materials could be biomarkers for prediction of prognosis of cancer patients. The neutrophil/lymphocyte ratio (NLR), and the platelet/lymphocyte ratio (PLR) has been introduced for prognostic scoring system in several cancer. The objective of this study was to determine whether the neutrophil-lymphocyte ratio (NLR), or the platelet-lymphocyte ratio (PLR) are significant prognostic marker in metastatic gastric cancer. Methods: We analyzed 150 patients with metastatic gastric cancer who received mFOLFOX regimen as the first-line chemotherapy. The NLR and PLR were calculated from complete blood counts in baseline laboratory test before the first cycle chemotherapy. Results: The overall response rate was 34.7% and stable disease was 38.7%. The median progression-free survival (PFS) was 4.2 months (95% CI, 3.5-4.8 months) and the median overall survival (OS) was 13.1 months (95% CI, 10.6-15.5 months). Kaplan-Meier analysis and log-rank test revealed that higher NLR (≥3) was a good prognostic biomarker of OS (p=0.024), but not associated with PFS (p=0.838). The PLR was not associated with PFS and OS (p=0.373 and p=0.304, respectively). In Cox regression analysis for predicting OS, younger age, good performance status, response of chemotherapy, and lower NLR (<3) were independent prognostic markers (Hazard ratio 2.052, 95% CI 1.370-3.075, p<0.001, hazard ratio 8.467, 95% CI 1.937-37.017, p=0.005, hazard ratio 1.889, 95% CI 1.222-2.921, p=0.004, and hazard ratio 1.616, 95% CI 1.080-2.416, p=0.019, respectively). Conclusions: Although prognosis in metastatic gastric cancer was associated with age and performance status, the NLR might be simple and prognostic index for metastatic gastric cancer.

Development and validation of prognostic nomograms in patients with hepatocellular carcinoma: a population-based study

2021 ◽  
Author(s):  
Youya Zang ◽  
Peiyun Long ◽  
Ming Wang ◽  
Shan Huang ◽  
Chuang Chen
Keyword(s):  
Hepatocellular Carcinoma ◽  
Tumor Size ◽  
Cox Regression ◽  
Malignant Tumors ◽  
Disease Free Survival ◽  
Staging System ◽  
Cox Regression Analysis ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Tumor Capsule

Background: Hepatocellular carcinoma (HCC) is one of the most common malignant tumors. The existing staging system has a limited budget capacity for HCC recurrence. The authors aimed to establish and verify two nomogram models to predict disease-free survival (DFS) and overall survival (OS) in patients with HCC. Methods: Patients diagnosed with HCC between August 2011 and March 2016 were recruited. Data were randomly divided into a training cohort and a validation cohort. Based on univariate and multivariate Cox regression analysis, independent risk factors for DFS and OS were identified, and two nomogram models were established to predict patient survival. Results: Sex, tumor size, Barcelona Clinic Liver Cancer (BCLC) stage, tumor capsule, macrovascular invasion, AST-to-platelet ratio index, AST-to-lymphocyte ratio index, neutrophil–lymphocyte ratio and alpha-fetoprotein (AFP) were used to build the nomogram for DFS, while age, tumor size, BCLC stage, tumor capsule, macrovascular invasion, systemic immune-inflammation index, AST, total bilirubin and AFP were used to build the nomogram for OS. Calibration curves showed good agreement between the nomogram prediction and actual observation. C-indices in both nomograms were significantly higher than BCLC. Conclusion: The two nomograms improved the accuracy of individualized prediction of DFS and OS, which may help doctors screen patients with a high risk of recurrence to formulate individualized treatment plans.

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