scholarly journals Significance of The Neutrophil-To-Lymphocyte Ratio in Predicting the Response of Neoadjuvant Chemotherapy in Osteosarcoma: A Multicenter Retrospective Study

2021 ◽  
Author(s):  
Tang Haijun ◽  
Liu Dehuai ◽  
Lu Jili ◽  
He Juliang ◽  
Ji Shuyu ◽  
...  
Keyword(s):  
Multivariate Analyses ◽  
Univariate Analysis ◽  
Complete Response ◽  
Neutrophil To Lymphocyte Ratio ◽  
Lower Percentage ◽  
Youden Index ◽  
Factors Affecting ◽  
Lymphocyte Ratio ◽  
Lower Stage ◽  
Index Sensitivity

Abstract Background At present, there is no validated predictive factor for early efficacy of neoadjuvant hemotherapy (NACT) in osteosarcoma. The purpose of this study was to investigate the significance of the neutrophil-to-lymphocyte ratio (NLR) in predicting the response of NACT in osteosarcoma. Methods Pathological complete response (pCR) was used to assess the efficacy of NACT. Receiver Operating Characteristic (ROC) curve and Youden index (sensitivity + specificity-1) were used to determine the optimal cut-off values of NLR. Univariate and multivariate analyses by logistic regression model were conducted to confirm the independent factors affecting the efficacy of NACT. Results The optimal cutoff value of NLR was 2.36 (sensitivity, 80.0%; specificity, 71.3%). Univariate analysis revealed that the smaller tumor volum, lower stage, lower NLR and lower PLR were more likely to achieve pCR. Multivariate analyses confirmed that NLR before treatment was an independent risk factor for pCR. Compared to patients with a high NLR, those with a low NLR showed more than 2-fold higher chance to achieve pCR (OR 2.82, 95% CI 1.36–5.17, p = 0.02). Conclusion NLR is a novel and effective factor predicting the response to NACT in osteosarcoma patients. Patients with higher NLR showed a lower percentage of pCR after NACT.

scholarly journals Significance of the neutrophil-to-lymphocyte ratio in predicting the response to neoadjuvant chemotherapy in extremity osteosarcoma: a multicentre retrospective study

BMC Cancer ◽  
2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Haijun Tang ◽  
Dehuai Liu ◽  
Jili Lu ◽  
Juliang He ◽  
Shuyu Ji ◽  
...  
Keyword(s):  
Neoadjuvant Chemotherapy ◽  
Predictive Factor ◽  
Multivariate Analyses ◽  
Univariate Analysis ◽  
Neutrophil To Lymphocyte Ratio ◽  
Lower Percentage ◽  
Youden Index ◽  
Lymphocyte Ratio ◽  
Lower Stage ◽  
Extremity Osteosarcoma

Abstract Background At present, no predictive factor has been validated for the early efficacy of neoadjuvant chemotherapy (NACT) in osteosarcoma. The purpose of this study was to investigate the significance of the neutrophil-to-lymphocyte ratio (NLR) in predicting the response to NACT in extremity osteosarcoma. Methods Pathological complete response (pCR) was used to assess the efficacy of NACT. Receiver operating characteristic (ROC) curves and the Youden index (sensitivity + specificity-1) were used to determine the optimal cut-off values of the NLR. Univariate and multivariate analyses using logistic regression models were conducted to confirm the independent factors affecting the efficacy of NACT. Results The optimal NLR cut-off value was 2.36 (sensitivity, 80.0%; specificity, 71.3%). Univariate analysis revealed that patients with a smaller tumour volume, lower stage, lower NLR and lower PLR were more likely to achieve pCR. Multivariate analyses confirmed that the NLR before treatment was an independent risk factor for pCR. Compared to patients with a high NLR, those with a low NLR showed a more than 2-fold higher likelihood of achieving pCR (OR 2.82, 95% CI 1.36-5.17, p = 0.02). Conclusion The NLR is a novel and effective predictive factor for the response to NACT in extremity osteosarcoma patients. Patients with a higher NLR showed a lower percentage of pCR after NACT.

The predictive value of neutrophil-to-lymphocyte ratio on overall survival and pathological complete response in breast cancer patients receiving neoadjuvant chemotherapy.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e12625-e12625
Author(s):  
Wenjie Tang ◽  
Linlin Wang ◽  
Jinming Yu ◽  
Yishan Yu
Keyword(s):  
Breast Cancer ◽  
Overall Survival ◽  
Neoadjuvant Chemotherapy ◽  
Longitudinal Analysis ◽  
Validation Cohort ◽  
Univariate Analysis ◽  
Complete Response ◽  
Neutrophil To Lymphocyte Ratio ◽  
Training Cohort ◽  
Lymphocyte Ratio

e12625 Background: Neutrophil-to-lymphocyte ratio (NLR) has been found to offer clear predictive utility for the overall survival (OS) and pathologic complete response (pCR) in breast cancer (BC) patients receiving neoadjuvant chemotherapy(NAC). However, previous studies mainly focused on pre-NLR. The aim of this study was to explore the role of pre-/post-NLR towards OS and longitudinal NLR kineticsonpCR for BC patients undergoing NAC. And we also tried to build a nomogram for OS prediction based on these parameters. Methods: In this study, we retrospectively collected 501 female patients with locally advanced BC receiving 4-8 cycles of NAC from 2009 to 2018. Clinicopathological characteristics, NLR at pre-, mid-(every two cycles of NAC) and post-treatment were collected. The primary endpoint was OS. Among the patients, 421 patients with available pre- and post-NLR were included in the survival analysis. These patients were randomly divided into a training cohort (n = 224) and a validation cohort (n = 197). Multivariate survival model was built by including all the significant prognostic factors from the univariate analysis in the training cohort, and a nomogram model was established by “R” version 3.4.3. The performance of the model was further tested in the validation cohort by the concordance index. The second endpoint was pCR. Longitudinal analysis of NLR was performed using a mixed-effects regression model to predict pCR among 176 patients who finished 8 cycles of NAC. Results: The median follow-up time was 43.2 months for 421 patients. In the training cohort, multivariate analysis revealed that ER status, clinical node stage , pCR , pre-NLR, and post-NLR (all Ps＜0.05) were independent predictors of OS. Nomogram for OS prediction was established by combining all these significant factors. The C-indexes of the nomogram were 0.764 and 0.693, respectively in the training and validation cohort. In the longitudinal analysis, patients achieved pCR experienced a reduction of NLR every 2 cycles (Coef = -0.032, std error = 0.014, P = 0.024). Conclusions: This study demonstrated the prognostic value of pre-NLR and post-NLR towards BC patients received NAC. Based on that , a novel nomogram was established to predict the 3- and 5- year OS for BC patients. And we also found patients who experienced a decline of NLR during NAC seems to be more likely to achieve pCR from chemotherapy. Routine assessment of NLR may be an easy and affordable tool for defining prognosis.

scholarly journals Association of Derived Neutrophil-To-Lymphocyte Ratio With Prognosis of Coronary Heart Disease After PCI

2021 ◽  
Vol 8 ◽  
Author(s):  
Gang-Qiong Liu ◽  
Wen-Jing Zhang ◽  
Jia-Hong Shangguan ◽  
Xiao-Dan Zhu ◽  
Wei Wang ◽  
...  
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Cox Regression ◽  
Univariate Analysis ◽  
Neutrophil To Lymphocyte Ratio ◽  
Major Adverse Cardiovascular Events ◽  
Lymphocyte Ratio ◽  
Coronary Syndrome ◽  
The Third

Aims: The present study aimed to investigate the prognostic role of derived neutrophil-to-lymphocyte ratio (dNLR) in patients with coronary heart disease (CHD) after PCI.Methods: A total of 3,561 post-PCI patients with CHD were retrospectively enrolled in the CORFCHD-ZZ study from January 2013 to December 2017. The patients (3,462) were divided into three groups according to dNLR tertiles: the first tertile (dNLR < 1.36; n = 1,139), second tertile (1.36 ≥ dNLR < 1.96; n = 1,166), and third tertile(dNLR ≥ 1.96; n = 1,157). The mean follow-up time was 37.59 ± 22.24 months. The primary endpoint was defined as mortality (including all-cause death and cardiac death), and the secondary endpoint was major adverse cardiovascular events (MACEs) and major adverse cardiovascular and cerebrovascular events (MACCEs).Results: There were 2,644 patients with acute coronary syndrome (ACS) and 838 patients with chronic coronary syndrome (CCS) in the present study. In the total population, the all-cause mortality (ACM) and cardiac mortality (CM) incidence was significantly higher in the third tertile than in the first tertile [hazard risk (HR) = 1.8 (95% CI: 1.2–2.8), p = 0.006 and HR = 2.1 (95% CI: 1.23–3.8), p = 0.009, respectively]. Multivariate Cox regression analyses suggested that compared with the patients in the first tertile than those in the third tertile, the risk of ACM was increased 1.763 times (HR = 1.763, 95% CI: 1.133–2.743, p = 0.012), and the risk of CM was increased 1.763 times (HR = 1.961, 95% CI: 1.083–3.550, p = 0.026) in the higher dNLR group during the long-term follow-up. In both ACS patients and CCS patients, there were significant differences among the three groups in the incidence of ACM in univariate analysis. We also found that the incidence of CM was significantly different among the three groups in CCS patients in both univariate analysis (HR = 3.541, 95% CI: 1.154–10.863, p = 0.027) and multivariate analysis (HR = 3.136, 95% CI: 1.015–9.690, p = 0.047).Conclusion: The present study suggested that dNLR is an independent and novel predictor of mortality in CHD patients who underwent PCI.

scholarly journals A High Neutrophil-to-Lymphocyte Ratio Predicts Higher Risk of Poststroke Cognitive Impairment: Development and Validation of a Clinical Prediction Model

2022 ◽  
Vol 12 ◽  
Author(s):  
Fei Zha ◽  
Jingjing Zhao ◽  
Cheng Chen ◽  
Xiaoqi Ji ◽  
Meng Li ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Prediction Model ◽  
Univariate Analysis ◽  
Density Lipoprotein ◽  
Neutrophil To Lymphocyte Ratio ◽  
Prognostic Information ◽  
Lymphocyte Ratio ◽  
Neuropsychological Assessments ◽  
Development And Validation ◽  
State Examination

ObjectivePoststroke cognitive impairment (PSCI) is a serious complication of stroke. The neutrophil-to-lymphocyte ratio (NLR) is a marker of peripheral inflammation. The relationship between the NLR and PSCI is far from well studied, and the thesis of this study was to assess the predictive value of the NLR in patients with PSCI, and establish and verify the corresponding prediction model based on this relationship.MethodsA total of 367 stroke patients were included in this study. Neutrophils, lymphocytes, and NLRs were measured at baseline, and clinical and neuropsychological assessments were conducted 3 months after stroke. The National Institutes of Health Scale (NIHSS) was used to assess the severity of stroke. A Chinese version of the Mini Mental State Examination (MMSE) was used for the assessment of cognitive function.ResultsAfter three months of follow-up, 87 (23.7%) patients were diagnosed with PSCI. The NLR was significantly higher in PSCI patients than in non-PSCI patients (P < 0.001). Patient age, sex, body mass index, NIHSS scores, and high-density lipoprotein levels also differed in the univariate analysis. In the logistic regression analysis, the NLR was an independent risk factor associated with the patients with PSCI after adjustment for potential confounders (OR = 1.67, 95%CI: 1.21–2.29, P = 0.002). The nomogram based on patient sex, age, NIHSS score, and NLR had good predictive power with an AUC of 0.807. In the validation group, the AUC was 0.816.ConclusionAn increased NLR at admission is associated with PSCI, and the model built with NLR as one of the predictors can increase prognostic information for the early detection of PSCI.

scholarly journals Serologic and Histologic Predictors of Long-Term Renal Outcome in Biopsy-Confirmed IgA Nephropathy (Haas Classification): An Observational Study

2019 ◽  
Vol 8 (6) ◽  
pp. 848 ◽  
Author(s):  
Shang-Feng Tsai ◽  
Ming-Ju Wu ◽  
Mei-Chin Wen ◽  
Cheng-Hsu Chen
Keyword(s):  
Risk Factors ◽  
Iga Nephropathy ◽  
Neutrophil To Lymphocyte Ratio ◽  
Renal Outcome ◽  
Categorical Variables ◽  
Youden Index ◽  
Renal Survival ◽  
Platelet To Lymphocyte Ratio ◽  
Predictive Values ◽  
Lymphocyte Ratio

Background and objective: The Haas classification of IgA nephropathy should be validated for Asian populations. More detailed and newer predictions regarding renal outcome of IgA nephropathy remains mandatory. Materials: We conducted a retrospective cohort study between January 2003 and December 2013. Clinical, Pathological, and laboratory data were all collected via available medical records. A Mann–Whitney U test was used for continuous variables and the Chi-square test was implemented for categorical variables. A Kaplan–Meier curve was put in place in order to determine patient survival and renal survival. The Youden index and Cox proportional hazard regression were used to investigate the possible factors for renal survival and predictive power. Results: All 272 renal biopsy-confirmed IgAN patients were enrolled for further studies. The univariate analysis showed that risk factors for poor renal outcome included stage 4–5 of Haas classification (HR = 3.67, p < 0.001), a poor baseline renal function (HR = 1.02 and p < 0.001 for higher BUN; HR = 1.14 and p < 0.001 for higher serum creatinine; HR = 0.95, p < 0.001 for higher eGFR), IgG ≤ 907 (HR = 2.29, p = 0.003), C3 ≤ 79.7 (HR = 2.76, p = 0.002), a higher C4 (HR = 1.02, p = 0.026), neutrophil-to-lymphocyte ratio > 2.75 (HR = 2.92, p < 0.001), and a platelet-to-lymphocyte ratio ≥ 16.06 (HR = 2.02, p = 0.012). A routine-checked markers, such as neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio, in order to predict the renal outcome, is recommended. Conclusions: This is the first study to demonstrate that Haas classification is also useful for establishing predictive values in Asian groups. A lower serum IgG (≤907 mg/dL) and serum C3 (≤79.7 mg/dL) were both risk factors for poor renal outcome. Additionally, this is the first study to reveal that serum C4 levels, an NLR > 2.75 and a PLR > 16.06, S could suggest poor renal outcome.

scholarly journals Clinical significance of neutrophil-to-lymphocyte ratio as a predictor of lymph node metastasis in gastric cancer

BMC Cancer ◽  
2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Toshiyuki Kosuga ◽  
Tomoki Konishi ◽  
Takeshi Kubota ◽  
Katsutoshi Shoda ◽  
Hirotaka Konishi ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Clinical Significance ◽  
Characteristic Curve ◽  
Neutrophil To Lymphocyte Ratio ◽  
Youden Index ◽  
Lymphocyte Ratio ◽  
Node Metastasis ◽  
Higher Sensitivity

Abstract Background Precise staging is indispensable to select the appropriate treatment strategy for gastric cancer (GC); however, the diagnostic accuracy of conventional modalities needs to be improved. This study investigated the clinical significance of the preoperative neutrophil-to-lymphocyte ratio (NLR) for the prediction of pathological lymph node metastasis (pN+) in GC. Methods This was a retrospective study of 429 patients with GC who underwent curative gastrectomy. The predictive ability of NLR for pN+ was examined in comparison with that of computed tomography. Results The preoperative NLR ranged from 0.6 to 10.8 (median, 2.0), and the optimal cut-off value for predicting pN+ was 1.6 according to the receiver operating characteristic curve with the maximal Youden index. Multivariate analysis identified a NLR ≥ 1.6 (odds ratio (OR) 3.171; 95% confidence interval (CI) 1.448–7.235, p = 0.004) and cN+ (OR 2.426; 95% CI 1.221–4.958, p = 0.011) to be independent factors associated with pN+ in advanced GC (cT2-T4). On the other hand, a NLR ≥ 1.6 was not useful for predicting pN+ in early GC (cT1). In advanced GC, a NLR ≥ 1.6 detected pN+ with a higher sensitivity (84.9%) and negative predictive value (NPV) (63.9%) than conventional modalities (50.0 and 51.7%, respectively). When the subjects were limited to those with advanced GC with cN0, the sensitivity and NPV of a NLR ≥ 1.6 for pN+ increased further (90.7 and 81.0%, respectively). Conclusion The preoperative NLR may be a useful complementary diagnostic tool for predicting pN+ in advanced GC because of its higher sensitivity and NPV than conventional modalities.

Role of progesterone receptor status (PR) as predictive factor of pathological complete response (pCR) to neoadjuvant chemotherapy (NACT) in breast cancer (BC) patients (pts)

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 637-637
Author(s):  
J. M. Perez Garcia ◽  
C. Saura ◽  
E. Muñoz ◽  
G. Sanchez-Olle ◽  
P. Gomez ◽  
...  
Keyword(s):  
Predictive Factor ◽  
Multivariate Analyses ◽  
Histological Grade ◽  
Statistical Significance ◽  
Univariate Analysis ◽  
Complete Response ◽  
Her 2 ◽  
Few Data

637 Background: While estrogen receptor (ER) negativity has been consistently associated to higher pCR rates after NACT in BC, few data regarding the association of PR with pCR has been reported. PR positivity has been related to taxol resistance in in vitro chemosensitivity assays. Our aim was to investigate the putative role of PR in the prediction of pCR in a cohort of BC pts receiving NACT. Methods: Medical reports of all pts receiving NACT and breast surgery between 2004 and 2006 in our institution were reviewed. Baseline clinical and histological features, along with type of preoperative therapy were examined as variables for association with pCR (no invasive tumor in breast and axilla) using univariate and multivariate analyses. Results: 128 pts were included. 73.4% received anthracycline and taxanes (A&Tx) based CT and 9.4% also received trastuzumab (T). PR+ (≥ 10%) was significantly associated with low histological grade (HG), low Ki67 (<10%), HER-2- (Herceptest 0,1,or 2 with FISH-) and ER+ (≥10%). Overall pCR rate was 18.8%. No PR+ patient achieved pCR. In univariate analysis, high HG, ER-, PR-, HER-2-, high Ki67, T therapy, and number of CT cycles were significantly associated with pCR. In multivariate analysis only HER-2 and PR status were statistically significant. Similarly, PR and HER-2 status were independently related to pCR in the subgroup of pts receiving A&Tx (N = 94, 20.2%pCR). In the HER-2- subgroup (n = 89, 9%pCR) only ER independently predicted pCR, while in the HER-2+ subgroup (n = 33, 42.4%pCR, 57.1%pCR with T), both PR- and T therapy were the only predictive factors for pCR in the univariate and multivariate analyses. When the 24 HER-2+ pts treated with A&Tx (23 taxol/1 taxotere) ± T were separately analyzed, only PR retained statistical significance in the multivariate model. Conclusions: In our cohort of BC pts treated with NACT, PR status independently predicts pCR in the whole population as well as in the A&Tx-treated and in the HER-2+ subgroups. In the HER-2+ pts receiving A&Tx ± T PR negativity was the only factor associated with pCR. PR status merits further investigation as a predictive factor for pCR to NACT, in particular in HER-2+ population. No significant financial relationships to disclose.

scholarly journals Neutrophil-lymphocyte Ratio as a Predictor of Delirium in Older Hospitalized Patients: A Prospective Cohort Study

2020 ◽  
Author(s):  
Yanli Zhao ◽  
Jirong Yue ◽  
Taiping Lin ◽  
Xuchao Peng ◽  
Dongmei Xie ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Hospitalized Patients ◽  
Youden Index ◽  
Multivariable Logistic Regression Analysis ◽  
Characteristic Analysis ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Cut Point ◽  
Index Sensitivity ◽  
Sensitivity Specificity

Abstract Background: Delirium is a common neuropsychiatric syndrome in older hospitalized patients. Previous studies have suggested that inflammation and oxidative stress contribute to the pathophysiology of delirium. However, it remains unclear whether neutrophil-lymphocyte ratio (NLR), an indicator of systematic inflammation, is associated with delirium. This study aimed to investigate the value of NLR as a predictor of delirium among older hospitalized patients.Methods: We conducted a prospective study of 740 hospitalized patients aged 70 years at the West China Hospital of Sichuan University. Neutrophil and lymphocyte counts were collected within 24 hours after hospital admission. Delirium was assessed on admission and every 48 hours thereafter. We used the Receiver operating characteristic analysis to assess the ability of the NLR for predicting delirium. The optimal cut-point value of the NLR was determined based on the highest Youden index (sensitivity + specificity - 1). Patients were categorized according to the cut-point value and quartiles of NLR, respectively. We then used logistic regression to identify the unadjusted and adjusted associations between NLR as a categorical variable and delirium. Results: The optimal cut-point value of NLR for predicting delirium was 3.626 (sensitivity: 75.2%; specificity: 63.4%; Youden index: 0.386). The incidence of delirium was significantly higher in patients with NLR >3.626 than NLR ≤3.626 (24.5% vs 5.8%; P<0.001). Significantly fewer patients in the first quartile of NLR experienced delirium than in the 3rd (4.3% vs 20.0%; P<0.001) and 4th quartiles of NLR (4.3% vs 24.9%; P<0.001). Multivariable logistic regression analysis showed that NLR was independently associated with delirium.Conclusions: NLR is a simple and practical marker that can predict the development of delirium in older hospitalized patients.

scholarly journals Neutrophil-to-Lymphocyte Ratio is a Prognostic Predictive Factor for Local Advanced Lower Rectal Cancer Treated with Curative Surgical Treatment after Neoadjuvant Chemoradiotherapy: A Single-Center Retrospective Cohort Study

2021 ◽  
Author(s):  
Ryosuke Nakagawa ◽  
Shimpei Ogawa ◽  
Yuji Inoue ◽  
Takeshi Ohki ◽  
Yoshiko Bamba ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Univariate Analysis ◽  
Locally Advanced ◽  
Neoadjuvant Chemoradiotherapy ◽  
Operation Time ◽  
Neutrophil To Lymphocyte Ratio ◽  
Lower Rectal Cancer ◽  
Curative Surgery ◽  
Lymphocyte Ratio ◽  
Significant Difference

Abstract Background: The neutrophil-to-lymphocyte ratio (NLR) correlates with relapse-free survival (RFS) and may be a predictor of recurrence in patients after curative surgery for colorectal cancer. This study aimed to analyze the long-term oncological outcomes of locally advanced lower rectal cancer treated with curative surgery after neoadjuvant chemoradiotherapy (nCRT) to examine the prognostic value of the NLR and to evaluate the fluctuation of pre- and post-CRT NLR as recurrence risk factors.Methods: Fifty-two patients who underwent curative surgery were enrolled between 2009 and 2016. A cut-off pre-CRT NLR of 3.20 was used based on receiver-operating characteristic curve analysis. The primary outcome was RFS. Factors influencing recurrence after treatment according to fluctuations between the pre- and post-CRT NLR were also analyzed.Results: Univariate analysis was performed using 17 clinicopathological factors thought to affect RFS. A significant difference was found in the pre-CRT NLR (hazard ratio [HR]: 7.626, 95% confidence interval [CI]: 2.760-21.06, p<0.0001), operation time (HR: 2.949, 95% CI: 1.137-7.646, p=0.0261), and pathological T stage (HR: 8.342, 95% CI: 2.458-28.306 p=0.0007). RFS according to the pre-CRT NLR using Kaplan–Meier analysis showed that the group with pre-CRT ≥3.20 had a lower 5-year RFS (p=0.001). A lower pre-CRT NLR resulted in a significantly higher recurrence rate, regardless of the increase or decrease in the pre- and post-CRT NLR.Conclusions: The pre-CRT NLR may be a predictor of prognosis in patients with locally advanced lower rectal cancer after nCRT.

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