Neutrophil-to-Monocyte-Plus-Lymphocyte Ratio as a Potential Marker for Discriminating Pulmonary Tuberculosis from Nontuberculosis Infectious Lung Diseases

2019 ◽  
Vol 50 (3) ◽  
pp. 286-291 ◽  
Author(s):  
You La Jeon ◽  
Woo-In Lee ◽  
So Young Kang ◽  
Myeong Hee Kim
Keyword(s):  
Confidence Interval ◽  
Pulmonary Tuberculosis ◽  
Lung Diseases ◽  
Blood Count ◽  
Complete Blood Count ◽  
Area Under The Curve ◽  
Molecular Study ◽  
Statistical Strength ◽  
Lymphocyte Ratio ◽  
Potential Marker

AbstractObjectiveTo determine whether NMLR has more statistical strength than NLR in discriminating TB from non-TB infectious lung diseases.MethodsAmong patients who underwent 3 or more TB culture tests with molecular study between January 2016 and December 2017, 110 patients with TB, and 159 patients diagnosed with non-TB infectious lung diseases were enrolled. The original complete blood count (CBC) parameters and modified CBC indices, including NLR and NMLR, were analyzed.ResultsThe NLR and NMLR were significantly lower in TB patients than in patients with other infectious lung diseases. However, the area under the curve (AUC) for NMLR (0.90; 95% confidence interval [CI], 0.86–0.93) was significantly greater than that for NLR (0.88 [0.84–0.92]).ConclusionsThe neutrophil-to-monocyte-plus-lymphocyte ratio (NMLR) can be used as a new index that is more powerful than neutrophil-to-lymphocyte ratio (NLR) in discriminating tuberculosis (TB) from non-TB infectious lung diseases.NMLR had more statistical strength than NLR in discriminating TB from non-TB infectious lung diseases.

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

Uro ◽  
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.

scholarly journals The Significance of inflammation markers in complete blood count in patients with fibromyalgia

2020 ◽  
Vol 7 (1) ◽  
pp. 364-367
Author(s):  
Gülşah Karataş ◽  
Ramazan Gündüz
Keyword(s):  
Vitamin D ◽  
Inflammatory Disease ◽  
Blood Count ◽  
Complete Blood Count ◽  
Chronic Fatigue ◽  
Control Group ◽  
Inflammation Markers ◽  
Diagnostic Significance ◽  
Lymphocyte Ratio ◽  
Vitamin D Levels

Objective:  Fibromyalgia is a chronic pain disorder mostly seen in women, it mainly characterized by diffuse body pain accompanied by chronic fatigue and depression-like mood disorders. Its etiology still remains unknown but in some studies, fibromyalgia has been reported to be an inflammatory disease several cytokines shown to be responsible for the possible inflammatory basis of the disease. No laboratory marker is currently available to diagnose the disease. We aimed to investigate the diagnostic significance of inflammation markers in fibromyalgia, including platelet-to-lymphocyte ratio (PLR), neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte (MLR) ratio, and mean platelet volume (MPV). Material and Methods: This retrospective and case-control study included 188 patients who were followed up and treated for fibromyalgia in physical therapy and rehabilitation outpatient clinic from 2017 through 2019 and 64 age-matched healthy controls. The PLR, NLR, MLR, MPV and vitamin D were calculated from the results of complete blood count test. The differences between the two groups were examined. Results: The mean age, hemoglobin levels, and erythrocyte sedimentation rates were not different between the groups. In fibromyalgia group, the values of PLR (p = 0.031), NLR (p = 0.044), MLR (p = 0.023), and MPV (p = 0.013) were higher than those in control group, whereas vitamin D levels were significantly lower (p = 0.021). In multivariate regression analysis, PLR, NLR and MLR were not found to be independent predictors (p> 0.05). Conclusion: The findings of this study reveal that NLR, MLR, PLR, and MPV are not independent markers for the diagnosis of fibromyalgia, suggesting that fibromyalgia does not appear to be an inflammatory disease.

scholarly journals Higher Neutrophil-lymphocyte Ratio in TB/HIV Co-infection Compared to Pulmonary Tuberculosis

2021 ◽  
Vol 13 (4) ◽  
pp. 375-82
Author(s):  
Nuni Sulastri ◽  
Bachti Alisjahbana ◽  
Resvi Livia ◽  
Edhyana Sahiratmadja
Keyword(s):  
Pulmonary Tuberculosis ◽  
Complete Blood Count ◽  
Inflammatory Marker ◽  
Cross Sectional Study ◽  
High Ratio ◽  
Sectional Study ◽  
Cross Sectional ◽  
Pulmonary Tb ◽  
Neutrophil Lymphocyte Ratio ◽  
Potential Marker

BACKGROUND: Neutrophils and lymphocytes play a significant role in inflammation and a high ratio of neutrophils over lymphocytes (NLR) has been used as an inflammatory marker to predict the severity of various diseases. Here we compared the NLR among pulmonary tuberculosis and TB/HIV co-infection.METHODS: A retrospective cross-sectional study was conducted, included patients with pulmonary TB without cavitation TB (n=50), with cavitation TB (n=50) and HIV co-infection (n=27). Complete blood count was examined, including neutrophils and lymphocyte. NLR was calculated and compared between groups. RESULTS: Neutrophils were significantly higher (p=0.004) in TB with cavitation compared to those with no cavitation (8.27±1.45 x103/μL vs. 6.61±1.4 x103/μL, respectively); whereas the lymphocytes were similar in both groups, resulting in a significantly higher NLR (p=0.009) in pulmonary TB with cavitation compared to pulmonary TB with no cavitation (5.98±1.85 vs. 4.42±1.86, respectively). On the contrary, both neutrophils as well as lymphocyte were significantly lower in TB/HIV compared to pulmonary TB, which for neutrophil were 5.14±2.19 x103/μL vs. 7.4±1.45 x103/μL, respectively (p=0.003) and for lymphocyte (1.02 ±0.57 x103/μL vs. 1.57±0.64 x103/μL, respectively (p=0.001), resulting in a significantly higher (p=0.041) NLR value in TB/HIV (6.05±2.67) compared to pulmonary TB (5.16±1.88).CONCLUSION: High NLR in pulmonary TB with cavitation as well as in TB with HIV co-infection may be of great interest for biomarker in TB severity. Further study confirming NLR as potential marker is imperative.KEYWORDS: lymphocyte, neutrophil, NLR, tuberculosis, TB/HIV

scholarly journals RADIOTHERAPY EFFECT ON COMPLETE BLOOD COUNT PARAMETER IN PATIENTS WITH NASOPHARYNGEAL CARCINOMA

2020 ◽  
Vol 2 (01) ◽  
pp. 07-09
Author(s):  
Achmad Chusnu Romdhoni ◽  
Firas Farisi Alkaff ◽  
Mega Kahdina ◽  
Melinda Masturina ◽  
Ristra Ramadhani
Keyword(s):  
Nasopharyngeal Carcinoma ◽  
Outpatient Clinic ◽  
Medical Records ◽  
Blood Count ◽  
Complete Blood Count ◽  
Hemoglobin Concentration ◽  
Rank Test ◽  
Mean Corpuscular Hemoglobin ◽  
Lymphocyte Ratio ◽  
Radiotherapy Treatment

Introduction: Nasopharyngeal carcinoma (NPC) is the most common malignant tumor of the nasopharynx. Radiotherapy is a therapy of choice for NPC that has been recognized for a long time and used in various centers of the world. However, radiotherapy is known to still have an adverse effect. It is common practice to evaluate Complete Blood Count (CBC) before, during, and after radiotherapy. However, there has been no study regarding the effect of radiotherapy on all CBC parameters. This study aims to analyze the effect of radiotherapy on CBC in NPC patients before and after radiotherapy treatment. Material and methods: This study was an observational study using secondary data from medical records at the radiotherapy outpatient clinic at Dr. Soetomo General Hospital Surabaya. The subject of this study was patients with NPC who underwent a full cycle of radiotherapy treatment on radiotherapy outpatient clinic in 2016. Patients with incomplete medical records and did not finish the radiotherapy treatment were excluded. A paired T-test and Wilcoxon signed-rank test were used for statistical analysis. Results: There were 105 patients included in this study. Mean Corpuscular Hemoglobin Concentration (MCHC), total leucocyte, lymphocyte, and thrombocyte was significantly decreased after a full cycle of radiotherapy (all p <0.05). Eosinophil, basophil, neutrophil, monocyte, Neutrophil to Lymphocyte ratio (NLR), and Platelet to Lymphocyte ratio (PLR) was significantly increased after a full cycle of radiotherapy (all p <0.05). Conclusion: Radiotherapy had a significant effect on the CBC parameter in NPC patients.

scholarly journals The Correlation between Complete Blood Count Parameters and Appendix Diameter for the Diagnosis of Acute Appendicitis

Healthcare ◽  
2020 ◽  
Vol 8 (1) ◽  
pp. 39 ◽  
Author(s):  
Emin Daldal ◽  
Hasan Dagmura
Keyword(s):  
Acute Appendicitis ◽  
Laboratory Tests ◽  
Blood Count ◽  
Complete Blood Count ◽  
Lymphoid Hyperplasia ◽  
White Blood Count ◽  
C Reactive Protein ◽  
Distribution Width ◽  
Lymphocyte Ratio ◽  
Reactive Protein

Acute appendicitis is one of the most common causes of acute abdominal diseases seen between the ages of 10 and 19, mostly seen in males. The lifetime risk of developing acute appendicitis is 8.6% for males and 6.7% for females. We aimed to investigate the efficacy of the complete blood count parameters, C-reactive protein, and Lymphocyte-C-reactive Protein Ratio laboratory tests in the diagnosis of acute appendicitis, as well as their relationship with appendix diameter. We retrospectively examined all patients who underwent appendectomy between 1 January 2012 and 30 June 2019 in the General Surgery Clinic of Gaziosmanpasa University Faculty of Medicine. Laboratory tests, imaging findings, age, and gender were recorded. Lymphoid hyperplasia is considered as normal appendix—in other words, as negative appendicitis. The distribution of Lymphoid hyperplasia and appendicitis rates were statistically different in the groups formed according to appendix diameter (≤6 and >6 mm) (p < 0.001). We found a significant correlation between appendix diameter and WBC (White blood count), Lymphocyte, Neutrophil, RDW(Red blood cell distribution width), NLR(Neutrophil to lymphocyte ratio), and PLT/L (Platelet to lymphocyte ratio), MPV (Mean platelet volume) and RDW were significantly different in patients with an appendix diameter of ≤6 mm (p = 0.007, p = 0.006, respectively). WBC, Neutrophil, PDW, and NLR values were significantly different between appendicitis and hyperplasia groups in patients with an appendix diameter of >6 mm. The sensitivity of the NLR score (cutoff = 2.6057) in the diagnosis of appendicitis was 86.1% and selectivity was 50% in these patients. Complete blood count parameters evaluation with the clinical findings revealed that NLR is an important parameter that may help the diagnosis of acute appendicitis with an appendix diameter of >6 mm. In patients whose pathological results indicated acute appendicitis but who had a diameter of ≤6 mm, we found an elevated MPV and low RDW values.

6 Complete Blood Count and Derived Indices: Evolution Pattern and Prognostic Value in Adult Burned Patients

2020 ◽  
Vol 41 (Supplement_1) ◽  
pp. S7-S7
Author(s):  
Ignacio Aramendi ◽  
Laura Moreno ◽  
Julio R Cabrera ◽  
Martin Angulo ◽  
Gimena dos Santos ◽  
...  
Keyword(s):  
Blood Count ◽  
Thermal Injury ◽  
Complete Blood Count ◽  
Total Body Surface Area ◽  
Distribution Width ◽  
Major Health Problem ◽  
Lymphocyte Ratio ◽  
Inflammatory Status ◽  
Evolution Pattern ◽  
Thermal Injuries

Abstract Introduction Thermal injuries represent a major health problem. Biomarkers capable of predicting burned patients outcomes are missing. Certain parameters of complete blood count (CBC) such as red cell distribution width (RDW) and mean platelet volume (MPV), as well as neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and RDW-to-platelet ratio (RPR) have been associated with inflammatory status and outcome in diverse medical conditions. The aim of this study was to describe the evolution pattern of these parameters in adult burned patients. Methods Adult burned patients admitted to the National Burn Center of a University Hospital between May 2017 and March 2018 were included. Patients characteristics and outcomes were recorded, as well as CBC parameters on days 1, 3, 5 and 7 after thermal injury. Results Eighty-eight patients were included. Total body surface area burned was 14 [7–23] %, and mortality was 15%. Non-survivors presented higher RDW (days 3, 5 and 7; P &lt; 0.01) and MPV (days 3 and 7; P &lt; 0.01). NLR decreased after admission in all patients (P &lt; 0.01), but was higher in non-survivors compared to survivors on days 1 and 7 (P &lt; 0.01). On day 3, PLR was higher in survivors than in non-survivors (P &lt; 0.05). In deceased patients, RPR was significantly higher on days 3, 5 and 7 (P &lt; 0.01). There was a significant correlation between NLR on admission and burn extension and severity. Kaplan-Meier analysis revealed that NLR, PLR and RPR could identify patients with increased mortality. Conclusions Basic CBC parameters and derived indices could be useful as biomarkers to determine prognosis in adults with thermal injuries. Applicability of Research to Practice The study allowed us to identify basic CBC parameters and indices that behave differently in survivors and non-survivors. Interestingly, the CBC profile that differentiates survivors and non-survivors varies at each time point. A particular combination of CBC parameters might be used as a prognostic indicator depending on evolution time since thermal injury.

Toward Personalized Radiation Therapy of Liver Metastasis: Importance of Serial Blood Biomarkers

2021 ◽  
pp. 315-325
Author(s):  
Ali Ajdari ◽  
Yunhe Xie ◽  
Christian Richter ◽  
Maximilian Niyazi ◽  
Dan G. Duda ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Liver Metastasis ◽  
Likelihood Ratio ◽  
Blood Count ◽  
Stereotactic Body Radiation Therapy ◽  
Complete Blood Count ◽  
Blood Biomarkers ◽  
Serial Blood ◽  
Lymphocyte Ratio ◽  
Stereotactic Body Radiation

PURPOSE To assess the added value of serial blood biomarkers in liver metastasis stereotactic body radiation therapy (SBRT). MATERIALS AND METHODS Eighty-nine patients were retrospectively included. Pre- and midtreatment blood samples were analyzed for potential biomarkers of the treatment response. Three biomarker classes were studied: gene mutation status, complete blood count, and inflammatory cytokine concentration in plasma. One-year local failure (LF) and 2-year overall survival (OS) were chosen as study end points. Multivariate logistic regression was used for response prediction. Added predictive benefit was assessed by quantifying the difference between the predictive performance of a baseline model (clinicopathologic and dosimetric predictors) and that of the biomarker-enhanced model, using three metrics: (1) likelihood ratio, (2) predictive variance, and (3) area under the receiver operating characteristic curve (AUC). RESULTS The most important predictors of LF were mutation in KRAS gene (hazard ratio [HR] = 2.92, 95% CI, [1.17 to 7.28], P = .02) and baseline and midtreatment concentration of plasma interleukin-6 (HR = 1.15 [1.04 to 1.26] and 1.06 [1.01 to 1.13], P = .01). Absolute lymphocyte count and platelet-to-lymphocyte ratio at baseline as well as neutrophil-to-lymphocyte ratio at baseline and before fraction 3 (HR = 1.33 [1.16 to 1.51] and 1.19 [1.09 to 1.30]) had the most significant association with OS ( P = .0003). Addition of baseline GEN and inflammatory plasma cytokine biomarkers in predicting LF, respectively, increased AUC by 0.06 (from 0.73 to 0.79) and 0.07 (from 0.77 to 0.84). In predicting OS, inclusion of midtreatment complete blood count biomarkers increased AUC from 0.72 to 0.80, along with significant boosts in likelihood ratio and predictive variance. CONCLUSION Inclusion of serial blood biomarkers leads to significant gain in predicting response to liver metastasis stereotactic body radiation therapy and can guide treatment personalization.

scholarly journals Are preoperative complete blood count parameters in peripheral nerve sheath tumors useful diagnostic tools?

2021 ◽  
Vol 32 (2) ◽  
pp. 340-346
Author(s):  
Mesut Mısırlıoğlu ◽  
Aliekber Yapar ◽  
Erdem Aras Sezgin ◽  
Emin Kürşat Bulut ◽  
Galip Beltir ◽  
...  
Keyword(s):  
Peripheral Nerve ◽  
Blood Count ◽  
Complete Blood Count ◽  
Control Group ◽  
Histopathological Diagnosis ◽  
Lymphocyte Ratio ◽  
Nerve Sheath Tumors ◽  
Peripheral Nerve Sheath Tumors ◽  
Nerve Sheath ◽  
Pre Treatment

Objectives: This study aims to evaluate the diagnostic value of complete blood count (CBC) parameters in patients with peripheral nerve sheath tumors (PNSTs). Patients and methods: A total of 181 patients (83 males, 98 females; median age: 44 years; range, 15 to 83 years) who underwent surgical treatment for PNSTs in our tertiary oncology center between January 2010 and December 2019 were retrospectively analyzed. Eighty-two patients were diagnosed with a neurofibroma, 79 with a schwannoma, and 20 with a malignant PNST (MPNST). The patient group was evaluated as malignant (n=20) and benign (n=161). Age- and sex-matched patients admitted to our outpatient clinic of orthopedic and traumatology with non-specific symptoms other than tumor, infection, fracture, and rheumatological or hematological diseases were included as the control group (n=165). Data including age, sex, definitive histopathological diagnosis, and pre-treatment CBC values were obtained from the hospital records. Pre-treatment CBC values such as neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and lymphocyte-to-monocyte ratio (LMR) were calculated for both malignant and benign groups and control groups. Diagnostic values of NLR, PLR, and LMR between PNST groups were assessed using the receiver operating characteristic (ROC) curve analysis. Results: Neurofibroma, schwannoma, and MNPST groups had significantly higher median NLR, compared to the control group (p<0.001), while the median LMR was significantly lower in these groups (p<0.05). However, the median PLR was higher only in the MPNST group, compared to the control group (p<0.001). Post-hoc analyses revealed that median NLR, PLR, and LMR ratios were similar in PNST groups, compared to the control group. In addition, the median NLR, PLR, and LMR ratios were similar between malignant and benign patient groups. The highest area under the curve (AUC) was found for NLR (AUC=0.756) and LMR (AUC=0.716) in the MPNST group. Conclusion: Our study results suggest that NLR, PLR, and LMR may have an added value in the early diagnosis of PNSTs and are valuable for differentiating patients from healthy individuals, although their value in differential diagnosis is still unclear.

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