Neutrophil-to-lymphocyte ratio as a predictive marker of metabolic syndrome

404 Background: The neutrophil to lymphocyte ratio (NLR) is a marker of inflammation. We evaluated whether NLR is independently prognostic when adjusted for the International mRCC Database Consortium (IMDC) model and evaluated change in NLR ("NLR conversion") as a predictive marker of response to targeted therapy. Methods: A total of 5,227 metastatic renal cell carcinoma (mRCC) patients treated with targeted therapy were included; 1,199 patients in the training cohort from the IMDC and 4028 patients as the validation cohort from pooled prospective randomized controlled trials involving targeted therapy. NLR was examined at initiation of first-line targeted therapy and at 6 weeks after. The prognostic role of NLR and NLR conversion on overall survival (OS) and progression free survival (PFS) was assessed using Cox regression models adjusting for IMDC prognostic score. Results: Median baseline NLR was 3.4 and 2.9 in the training and validation cohorts, respectively. NLR >3.0 at baseline was independently associated with OS and PFS in both the training and validation cohorts (Table). A decrease in NLR by week 6 was associated with longer OS (21.1 vs. 9.7 months; HR 0.57, p<0.001), PFS (8.8 vs. 4.6 months; HR 0.54, p<0.001), and higher objective response rates (35% vs. 13%, p<0.001) compared to patients without a decrease. A rise in NLR showed opposite effects for all three endpoints. These findings were also confirmed in the validation set. Conclusions: NLR is an independent prognostic factor after controlling for IMDC criteria. NLR conversion can be an early biomarker of benefit to targeted therapy. [Table: see text]

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Elevated Neutrophil-to-Lymphocyte Ratio in Metabolic Syndrome Is Associated with Increased Risk of Colorectal Adenoma

Metabolic Syndrome and Related Disorders ◽

10.1089/met.2017.0041 ◽

2017 ◽

Vol 15 (8) ◽

pp. 393-399 ◽

Cited By ~ 5

Author(s):

Jae Hyun Kim ◽

Kyoung Im Cho ◽

Young A. Kim ◽

Seun Ja Park

Keyword(s):

Metabolic Syndrome ◽

Colorectal Adenoma ◽

Neutrophil To Lymphocyte Ratio ◽

Lymphocyte Ratio ◽

Increased Risk

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Neutrophil to Lymphocyte Ratio: A Predictive Marker for Treatment Outcomes in Patients With Rectal Cancer Who Underwent Neoadjuvant Chemoradiation Followed by Surgery

Annals of Coloproctology ◽

10.3393/ac.2018.10.01 ◽

2019 ◽

Vol 35 (2) ◽

pp. 100-106 ◽

Cited By ~ 1

Author(s):

Byong Ho Jeon ◽

Ui Sup Shin ◽

Sun Mi Moon ◽

Jung Il Choi ◽

Mi-Sook Kim ◽

...

Keyword(s):

Rectal Cancer ◽

Treatment Outcomes ◽

Predictive Marker ◽

Neoadjuvant Chemoradiation ◽

Neutrophil To Lymphocyte Ratio ◽

Lymphocyte Ratio

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Monocyte to Lymphocyte Ratio, Neutrophil to Lymphocyte Ratio, and Red Cell Distribution Width are the Associates with Gouty Arthritis

Acta Medica (Hradec Kralove Czech Republic) ◽

10.14712/18059694.2019.132 ◽

2019 ◽

Vol 62 (3) ◽

pp. 99-104 ◽

Cited By ~ 1

Author(s):

Cengiz Kadiyoran ◽

Orhan Zengin ◽

Hilal Akay Cizmecioglu ◽

Abdurrahman Tufan ◽

Orhan Kucuksahin ◽

...

Keyword(s):

Gouty Arthritis ◽

Predictive Marker ◽

Strong Relationship ◽

Neutrophil To Lymphocyte Ratio ◽

Red Cell Distribution Width ◽

Red Cell ◽

Cell Distribution ◽

Distribution Width ◽

Lymphocyte Ratio ◽

Monocytes And Macrophages

Background: Neutrophils, monocytes, and macrophages activations are associated with a gout attack. Monocyte to lymphocyte ratio (MLR), neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), red cell distribution width (RDW), and mean platelet volume (MPV) are well-known inflammation markers. In this study, we aimed to investigate whether they could be a predictive marker to the gout attack. Material and Methods: A hundred and ten gout patients (male/female, 86/24) and 90 (male/female, 64/26) age-, gender-, and body mass index-matched volunteer controls were included in the study. Blood samples were obtained in the intercritical and attack period of the patients. Hemogram, serum uric acid (SUA), C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR) values were studied. Results: In the attack period NLR (p < 0.001), PLR (p < 0.05), MLR (p < 0.001), RDW (p < 0.05), MPV (p < 0.05), ESR (p < 0.001), CRP (p < 0.001) and SUA (p < 0.001) values were significantly higher than intercritical period values. According to the results of regression analysis; There was an independent strong relationship between the gout attack and SUA, (Beta [β] = 0.352, p < 0.001), ESR (β = 0.329, p < 0.001), CRP (β = 0.286, p < 0.001), MLR (β = 0.126, p < 0.001), RDW (β = 0.100, p = 0.003) and NLR (β = 0.082, p = 0.014). Conclusions: MLR, RDW, and NLR may be a strong predictive marker for a gout attack. MPV and PLR values in the gout attack may be associated with systemic inflammation.

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Prognostic Role of Neutrophil to Lymphocyte Ratio in COVID-19 Patients: Still Valid in Patients That Had Started Therapy?

Frontiers in Public Health ◽

10.3389/fpubh.2021.664108 ◽

2021 ◽

Vol 9 ◽

Author(s):

Monica Gelzo ◽

Sara Cacciapuoti ◽

Biagio Pinchera ◽

Annunziata De Rosa ◽

Gustavo Cernera ◽

...

Keyword(s):

Disease Severity ◽

Predictive Marker ◽

Predictive Markers ◽

Neutrophil To Lymphocyte Ratio ◽

Disease Stage ◽

Prognostic Role ◽

Clinical Expression ◽

Neutrophil Lymphocyte Ratio ◽

Lymphocyte Ratio

COVID-19 may appear with a widely heterogeneous clinical expression. Thus, predictive markers of the outcome/progression are of paramount relevance. The neutrophil/lymphocyte ratio (NLR) has been suggested as a good predictive marker of disease severity and mortality. Accordingly, we found that NLR significantly increased in parallel with the WHO severity stage in COVID-19 patients during the Ist wave (March-May 2020; n = 49), due to the significant reduction of lymphocyte and the significant increase of neutrophil in severe COVID-19 patients. While, we did not observe significant differences of NLR between the WHO severity stage among COVID-19 patients of the IInd wave (September 2020-April 2021; n = 242). In these patients, the number of lymphocytes and neutrophils did not change significantly between patients of different severity subgroups. This difference likely depends on the steroids therapy that the patients of the IInd wave performed before hospitalization while most patients of the Ist wave were hospitalized soon after diagnosis. This is also confirmed by serum interleukin (IL)-6 and myeloperoxidase (MPO) that gradually increased with the disease stage in patients of the Ist wave, while such biomarkers (whose production is inhibited by steroids) did not show differences among patients of the IInd wave in different stages. Thus, the NLR could be tested at diagnosis in naïve patients before starting therapies.

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