scholarly journals The Optimal Cutoff Value of Neutrophil/Lymphocyte Ratio in Severe Grades of Diabetic Retinopathy Short Title: NLR in Diabetic Retinopathy

2019 ◽  
Author(s):  
Çağrı İlhan
Keyword(s):  
Diabetic Retinopathy ◽  
Optimal Cutoff ◽  
Cutoff Value ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio

Prognostic value of neutrophil-lymphocyte ratio during palliative chemotherapy in patients with unresectable gallbladder adenocarcinoma.

2018 ◽  
Vol 36 (4_suppl) ◽  
pp. 253-253
Author(s):  
Jae Woo Lee ◽  
Sang Hyub Lee ◽  
Jun Hyuk Son ◽  
Jinwoo Kang ◽  
Woo Hyun Paik ◽  
...  
Keyword(s):  
Overall Survival ◽  
Prognostic Marker ◽  
Palliative Chemotherapy ◽  
Optimal Cutoff ◽  
Cutoff Value ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Gallbladder Adenocarcinoma ◽  
Auc Value ◽  
Over Time

253 Background: Neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) is a valuable prognostic marker in several kinds of solid tumors. This study aimed to evaluate the NLR, PLR and change of NLR and PLR over time as a prognostic marker in unresectable gallbladder cancer (GBC) which is treated with palliative chemotherapy. Methods: A total of 163 patients with pathologically confirmed unresectable GBC were enrolled. Baseline and post 1-cycle chemotherapy NLR and PLR were used in analysis. The changes in NLR and PLR were defined as the ratio of post chemotherapy value to baseline value. The relation between survival time and NLR and PLR changes were analyzed. Results: NLR and PLR had AUC value of 0.679, 0.660 in predicting 1-year overall survival (OS) and NLR 1.96 and PLR 111 were the optimal cutoff value with the highest sum of sensitivity and specificity. NLR change and PLR change had AUC value of 0.517, 0.519 in predicting 1-year OS and NLR change 0.4, PLR change 0.6 were the optimal cutoff value. Patients with NLR lower than 1.96 had better OS (16.1 months vs. 9.5 months, p < 0.001) and similarly patients with PLR lower than 111 had better OS (17.3 months vs. 9.5 months, p < 0.001). However, NLR change lower than 0.4 didn’t show better OS (9.2 months vs. 11.6 months, p = 0.178), and the same with PLR change lower than 0.6 (8.5 months vs. 11.3 months, p = 0.138). Conclusions: Baseline NLR and PLR is a valuable predictor of overall survival in unresectable GBC undergoing palliative chemotherapy, whereas NLR and PLR change over time is not.

scholarly journals Baseline neutrophil–lymphocyte ratio holds no prognostic value for esophageal and junctional adenocarcinoma in patients treated with neoadjuvant chemotherapy

2019 ◽  
Vol 33 (6) ◽  
Author(s):  
S J M van Hootegem ◽  
B M Smithers ◽  
D C Gotley ◽  
S Brosda ◽  
I G Thomson ◽  
...  
Keyword(s):  
Neoadjuvant Chemotherapy ◽  
Roc Curve ◽  
Prognostic Value ◽  
Gastroesophageal Junction ◽  
Optimal Cutoff ◽  
Cutoff Value ◽  
Cox Regression Analysis ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Gastroesophageal Junction Adenocarcinoma

SUMMARY Background: Several studies have reported that neutrophil–lymphocyte ratio (NLR) can predict survival in esophageal and gastroesophageal junction adenocarcinoma, as it reflects systemic inflammation. Hence, we aimed to determine whether baseline NLR holds prognostic value for esophageal adenocarcinoma patients treated with neoadjuvant chemotherapy (nCT) followed by surgery. Methods: We studied the data of 139 patients that received nCT before undergoing esophagectomy with curative intent, all identified from a prospectively maintained database (1998–2016). Pretreatment hematology reports were used to calculate the baseline NLR. A receiver operating characteristic curve (ROC-curve) was plotted to determine an optimal cutoff value. NLR quartiles were used to display possible differences between groups in relation to overall survival (OS) and disease-free survival (DFS) using the method of Kaplan–Meier. Cox regression analysis was performed to assess the prognostic value of NLR. Results: The median OS and DFS times were 46 months (interquartile range [IQR]: 19–166) and 30 months (IQR: 13–166], respectively, for the entire cohort. The ROC-curve showed that NLR has no discriminating power for survival status (area under the curve = 0.462) and therefore no optimal cutoff value could be determined. There were no statistically significant differences in median OS times for NLR quartiles: 65 (Q1), 32 (Q2), 45 (Q3), and 46 months (Q4) (P = 0.926). Similarly, DFS showed no difference between quartile groups, with median survival times of 27 (Q1), 19 (Q2), 36 (Q3), and 20 months (Q4) (P = 0.973). Age, pN, pM, and resection margin were independent prognostic factors for both OS and DFS. On the contrary, NLR was not associated with OS or DFS in univariable and multivariable analyses. Conclusion: Baseline NLR holds no prognostic value for esophageal and gastroesophageal junction adenocarcinoma patients treated with nCT in this study, in contrast to other recently published papers. This result questions the validity of NLR as a reliable prognostic indicator and its clinical usefulness in these patients.

scholarly journals Neutrophil/Lymphocyte Ratio as Predictor of Anastomotic Leak after Gastric Cancer Surgery

Diagnostics ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. 799
Author(s):  
Dumitru Radulescu ◽  
Vlad Dumitru Baleanu ◽  
Vlad Padureanu ◽  
Patricia Mihaela Radulescu ◽  
Silviu Bordu ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Anastomotic Leakage ◽  
Anastomotic Leak ◽  
Peripheral Blood ◽  
Gastric Resection ◽  
Cutoff Value ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Gastric Cancer Patients

Introduction. Neutrophil/lymphocyte ratio (NLR) is known as a prognostic for the outcome of the patients with gastric cancer. As no definite risk marker for anastomotic leakage after gastric resection was identified, we investigated the possible role of NLR. Methods. Peripheral blood count for neutrophils and lymphocytes was done at the patient’s admission. We retrospectively evaluated 204 gastric cancer patients, who underwent gastric resection, comparing the values of NLR between the group of patients with anastomotic leakage and those without complications. Results. Using the ROC curve, we found the cutoff value of NLR, which permitted the comparison of the group with low NLR, presenting increased NLR. The cutoff value for NLR was 3.54. Between the two groups, we could observe statistically significant differences in developing fistula (p < 0.01) and complications leading to death (p < 0.025). The odds ratio for patients with NLR greater than 3.54 to develop anastomotic leak was 17.62, compared to those with lower NLR. Conclusion. Peripheral blood NLR proved to be a predictor for anastomotic leakage.

SAT0379 C-REACTIVE PROTEIN TO ALBUMIN RATIO IS ASSOCIATED WITH DISEASE ACTIVITY IN PATIENTS WITH AXIAL SPONDYLOARTHRITIS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1137.1-1138
Author(s):  
Z. Zhong ◽  
Y. Huang ◽  
Q. Huang ◽  
T. LI
Keyword(s):  
Disease Activity ◽  
Active Group ◽  
Control Group ◽  
C Reactive Protein ◽  
Optimal Cutoff ◽  
Albumin Ratio ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Reactive Protein ◽  
Optimal Cutoff Point

Background:C-reactive protein to albumin ratio (CAR) has emerged as a significant biomarker to evaluate and predict systemic inflammation[1]. However, the role of CAR in patients with axial spondyloarthritis (axSpA) remains unknown.Objectives:The aim of this study was to investigate the relationship between CAR and disease activity of axSpA.Methods:A total of 241 patients and 61 healthy controls from Guangdong Second Provincial General Hospital from December 2015 to August 2019 were retrospectively recruited in this study. Patients were divided into two groups, with 176 patients in remission group (BASDAI<4) and 65 patients in active group (BASDAI≥4). Erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), albumin (ALB), CAR, neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR) and monocyte-lymphocyte ratio (MLR) were detected. The correlations between CAR, NLR, PLR, MLR and disease activity were analyzed by the Spearman’s correlations analysis. Receiver operation characteristic (ROC) curves were performed to evaluate the discriminative utility of these parameters for disease activity of axSpA. Furthermore, the evaluation of the risk factors of axSpA was conducted using binary logistic regression analysis.Results:CAR, ESR, CRP, NLR, PLR and MLR in axSpA patients were significantly higher than those in the control group (p<0.05 for each), while ALB was significantly lower (p<0.001). Similarly, CAR in remission group was higher than that in control group (p<0.001) and was lower than that in active group (p<0.001). Besides, there were significantly positive correlations between CAR and ESR (r=0.702, P<0.001), CRP (r=0.996, P<0.001), BASDAI (r=0.329, p<0.001) and BASFI (r=0.328, P<0.001). Furthermore, ROC suggested that the area under the curve (AUC) of CAR was 0.701, which was the highest. The optimal cutoff point of CAR was 0.3644, with sensitivity and specificity of 58.5% and 79.0%. Logistic analysis results revealed that elevated CAR and MLR were independent risk factors for axSpA (EXP (B) =15.546, 95%CI: 5.898-40.979, P<0.001; EXP (B) =2.206, 95%CI: 1.077-4.519, P=0.031, respectively).Conclusion:CAR was increased in axSpA patients especially in active group, and significantly correlated with disease activity. CAR may serve as a novel inflammatory marker of monitoring disease activity in patients with axSpA.References:[1]He, Y., et al., Correlation between albumin to fibrinogen ratio, C-reactive protein to albumin ratio and Th17 cells in patients with rheumatoid arthritis. Clin Chim Acta, 2020. 500: p. 149-154.Fig 1.ROC curve analysis of the discriminative values of the parameters for disease activity of axSpATable 1.Discriminative values of the parameters for disease activity of axSpAAUC95% CIOptimal cutoff pointSpecificitySensitivityCAR0.7010.623-0.7780.364479.0%58.5%NLR0.4500.365-0.5343.16584.1%18.5%PLR0.5280.448-0.608127.38542.6%69.2%MLR0.4680.384-0.5530.38592.6%16.9%ESR0.6850.612-0.75815.552.3%76.9%CRP0.6910.614-0.76910.8571.6%63.1%CAR, C-reactive protein to albumin ratio; NLR, neutrophil-lymphocyte ratio; PLR, platelet-lymphocyte ratio; MLR, monocyte-lymphocyte ratio; CRP, C reactive protein; ESR, erythrocyte sedimentation rate; AUC, areas under the ROC curveDisclosure of Interests:None declared

scholarly journals Neutrophil to Lymphocyte Ratio as a predictor for diagnosis of early Periprosthetic Joint Infection

2020 ◽  
Author(s):  
BaoZhan Yu ◽  
Jun Fu ◽  
Wei Chai ◽  
LiBo Hao ◽  
Jiying Chen
Keyword(s):  
Hip Arthroplasty ◽  
Periprosthetic Joint Infection ◽  
Predictive Value ◽  
Joint Infection ◽  
Neutrophil To Lymphocyte Ratio ◽  
Optimal Cutoff ◽  
Musculoskeletal Infection ◽  
Cutoff Value ◽  
Lymphocyte Ratio ◽  
Total Knee

Abstract Background Periprosthetic joint infection (PJI) is a catastrophic complication after total knee or hip arthroplasty. The diagnosis of PJI is very difficult, especially in the early postoperative period. The value of the neutrophil to lymphocyte ratio (NLR) is useful for diagnosing infectious diseases. The objective of this study was to investigate the accuracy of the NLR for the diagnosis of early PJI after total knee or hip arthroplasty. Methods We retrospectively evaluated consecutive primary total knee or hip arthroplasty and identified the patients who readmitted within the first 90 days postoperatively between January 2011 and October 2018. There were 20 cases diagnosed early PJI and 101 uninfected cases on the basis of the modified Musculoskeletal Infection Society (MSIS) criteria. The serum parameters including C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), white blood-cell (WBC) count, NLR, interleukin-6 (IL-6) were compared between the two groups. Receiver operating characteristic curves were generated to estimate the optimal cutoff values for each parameter. The sensitivity, specificity, positive predictive value and negative predictive value for each parameter were calculated. Results The CRP, ESR, WBC, NLR and IL-6 values were all significally higher in the infected group than the uninfected group. The mean CRP (infected = 59.06, uninfected = 10.09), ESR (infected = 35, uninfected = 17), WBC(infected = 7.95 × 109,uninfected = 6.16 × 109), NLR (infected = 4.89, uninfected = 2.18), IL-6 (infected = 40.68, uninfected = 7.46).. The best parameter for the diagnosis of early PJI was IL-6 (AUC = 81.4%; optimal cutoff value 8.07 pg/ml) followed by the NLR (AUC = 80.2%; optimal cutoff value 2.13), CRP (AUC = 79.3%; optimal cutoff value 9.27 mg/l), ESR (AUC = 74.4%; optimal cutoff value 22 mm/h) and WBC (AUC = 63.2%; optimal cutoff value 8.91 × 109). Conclusions This study is the first to show that NLR values are more accurate than CRP and may be considered as useful parameters for the diagnosis of early PJI because it is a cheap and convenient parameter to be calculated in daily practice without extra costs.

scholarly journals Prognostic Implications of the Peripheral PLR and NLR in Predicting pCR after NACT in Breast Cancer Patients

2021 ◽  
Author(s):  
Xiaoyan Jin ◽  
Ke Wang ◽  
Xuan Shao ◽  
Jian Huang
Keyword(s):  
Breast Cancer ◽  
Logistic Regression ◽  
Neoadjuvant Therapy ◽  
Cancer Patients ◽  
Prognostic Significance ◽  
Breast Cancer Patients ◽  
Optimal Cutoff ◽  
Cutoff Value ◽  
Lymphocyte Ratio ◽  
Cutoff Values

Abstract Background: Inflammatory response is extremely important in tumor progression, and it is very difficult to identify prognostic indicators for neoadjuvant therapy in breast cancer patients. The aim of this study was to mine the potential prognostic significance of the platelet-to-lymphocyte ratio (PLR) and neutrophil-to-lymphocyte ratio (NLR) in breast cancer patients receiving anthracycline- or taxane-based neoadjuvant chemotherapy (NACT).Methods: Sixty-seven women diagnosed with breast cancer who received neoadjuvant therapy were enrolled in the study and then underwent surgeries. Before starting NACT, the PLR and NLR were calculated. The optimal cutoff value was calculated using receiver operating characteristic curve analyses, and the ROC curve analysis indicated that 106.3 and 2.464 were the best cutoff values for the PLR and NLR, respectively. The optimal cutoff values for the NLR and PLR were used to divide patients into low and high NLR groups and low and high PLR groups. Independent prognostic biomarkers and value the of PLR and NLR were assessed with univariate and multivariate logistic regression models. The connection between the NLR/PLR and pathological complete response (pCR), together with other clinical/pathological factors, was evaluated by Fisher's exact test or Pearson's x2 as appropriate.Results: Logistic regression model analyses revealed that patients with a high PLR correlated remarkably with better pCR than those with a low PLR. The results indicated that by using the cutoff value of 106.3, PLR had prognostic significance. However, there was no significant difference in NLR if analyzed separately. However, by combining PLR and NLR, the NLRhigh and PLRhigh subgroups achieved a significantly higher rate of pCR than the NLRIow/PLRIow subgroup (OR 0.153, 95% CI 0.068-0.876, p=0.008). Therefore, the combination of NLRhigh/PLRhigh was an independent prognostic factor different from common factors, such as PLR, Ki-67, and chemotherapy regimen.Conclusions: The PLR may serve as a potential marker of the efficacy of neoadjuvant therapy in breast cancer, enabling oncologists to intervene earlier. Peripheral blood NLR and PLR can reflect the immune status of patients. High levels of both of them may indicate immune activation status and predict the pCR rate of NACT treatment in breast cancer patients.

scholarly journals The Neutrophil-Lymphocyte Ratio as an Early Predictive Marker of the Severity of Post-Endoscopic Retrograde Cholangiopancreatography Pancreatitis

Medicina ◽  
2021 ◽  
Vol 58 (1) ◽  
pp. 13
Author(s):  
Sang Hoon Lee ◽  
Tae Yoon Lee ◽  
Young Koog Cheon
Keyword(s):  
Acute Pancreatitis ◽  
Endoscopic Retrograde Cholangiopancreatography ◽  
Prognostic Markers ◽  
Area Under The Curve ◽  
Predictive Marker ◽  
Optimal Cutoff ◽  
Endoscopic Retrograde ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Index Of Severity

Background and objectives: Factors predictive of severe non-iatrogenic acute pancreatitis have been investigated, but few studies have evaluated prognostic markers of severe post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP). The neutrophil–lymphocyte ratio (NLR) has been studied for predicting severe acute pancreatitis. We examined the predictive value of NLR in patients with PEP. Materials and Methods: From January 2012 to August 2021, 125 patients who developed PEP were retrospectively evaluated. The NLR was measured before, and on days 1 and 2 after, ERCP. PEP was categorized as mild, moderate, or severe according to consensus guidelines, based on the prolongation of planned hospitalization. Patients were divided into two groups, mild-to-moderate vs. severe PEP. Results: We analyzed 125 patients with PEP, 18 (14.4%) of whom developed severe PEP. The baseline NLR was similar between the two groups (2.26 vs. 3.34, p = 0.499). The severe PEP group had a higher NLR than the mild/moderate PEP group on days 1 (11.19 vs. 6.58, p = 0.001) and 2 (15.68 vs. 5.32, p < 0.001) post-ERCP. The area under the curve of the NLR on days 1 and 2 post-ERCP for severe PEP was 0.75 (95% confidence interval (CI), 0.64–0.86)) and 0.89 (95% CI, 0.81–0.97), respectively; NLR on day 2 had greater power to predict severe PEP. The optimal cutoff value of the NLR on days 1 and 2 after ERCP for prediction of severe PEP was 7.38 (sensitivity, 72%; specificity, 69%) and 8.17 (sensitivity, 83%; specificity, 83%), respectively. In a multivariate analysis, a Bedside Index of Severity in Acute Pancreatitis score ≥3 (odds ratio (OR) 9.07, p = 0.012) and NLR on day 2 > 8.17 (OR 18.29, p < 0.001) were significantly associated with severe PEP. Conclusions: The NLR on day 2 post-ERCP is a reliable prognostic marker of severe PEP.

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