جستجوی مقالات مرتبط با کلیدواژه « neutrophil-lymphocyte ratio » در نشریات گروه « پزشکی »

Inflammation, when associated with cancer, has been shown to correlate with a worse prognosis. Neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and monocyte-lymphocyte ratio (MLR) serve as markers of inflammation. This study aims to investigate the influence of pretreatment NLR, PLR, and MLR on treatment outcomes and their correlation with sarcopenia in patients with locally advanced head and neck squamous cell carcinoma (LA-HNSCC) undergoing definitive chemoradiotherapy.
In this retrospective study, 240 LA-HNSCC patients who received a radiotherapy dose of 70 Gy/35 fractions over 7 weeks in conjunction with chemotherapy were enrolled. Pretreatment NLR, PLR, and MLR were determined. Sarcopenia was evaluated by measuring skeletal muscle mass at the C3 level using radiotherapy planning computed tomography scans. The impact of NLR, PLR, and MLR on complete response rate and disease-free survival was calculated. The median follow-up duration for patients was 26 months.
Inflammatory markers were notably higher in elderly patients, females, and those with laryngeal primary tumours. Patients achieving a complete response exhibited lower values than those who did not. Patients with significant sarcopenia demonstrated elevated mean values of inflammatory markers. Patients with NLR<3, PLR<145, and MLR<0.4 experienced more favorable outcomes regarding complete response rate and disease-free survival.
Inflammatory markers such as NLR, PLR, and MLR are independent prognostic factors in HNSCC patients. Elevated values are associated with sarcopenia and inferior treatment outcomes, indicative of more aggressive tumour behavior. These markers are straightforward to calculate and should be routinely employed for early prognosis assessment.

Atopic dermatitis (AD) is a prevalent, chronic, inflammatory skin disorder that primarily affects children, with just a few cases persisting into adulthood. Many theories exist to ascertain the relationship between atopic dermatitis and systemic inflammation. Neutrophil lymphocyte ratio (NLR), platelet lymphocyte ratio (PLR), and Mean platelet volume (MPV) are biomarkers of systemic inflammation, which in turn are related to atopic dermatitis. The present study aimed to assess the association between atopic dermatitis and NLR, PLR, and MPV values by calculating NLR, PLR, and MPV ratio and correlating their levels with the disease duration and severity of AD in pediatric atopic dermatitis. This cross-sectional study included 165 pediatric atopic dermatitis patients who met the clinical confirmation criteria of the U.K. working party. The patients with co-existing conditions such as molluscum contagiosum, impetigo, hand-foot and-mouth disease, and eczema herpeticum were excluded. The mean ± SD values of NLR, PLR, and MPV were compared after the severity groups were classified using SCOR Atopic Dermatitis (SCORAD). The association of SCORAD and disease duration with NLR, PLR, and MPV levels was evaluated. Significant differences were noted between severity groups based on NLR, PLR, and MPV values. PLR and NLR had a positive correlation with the SCORAD score, whereas MPV was negatively correlated. In addition, NLR had a positive correlation with disease duration. PLR exhibited a higher diagnostic accuracy in predicting high SCORAD with a 100% sensitivity and specificity cut-off value of > 172. NLR, PLR, and MPV were cost-effective, feasible, andwidely available tests to detect systemic inflammation in AD with high sensitivity and specificity.

 Osteoarthritis (OA) is a chronic disorder characterized by inflammation, cartilage degeneration and bone remodelling with molecular derangements followed by anatomic and physiologic elements. The aim of the study was to assess the alterations of biomarkers in patients who underwent total knee replacement (TKR) for OA.

 A cross-sectional retrospective analysis was carried out on 206 participants who underwent either unilateral or bilateral TKR for knee OA from January 2017 to December 2020. Data regarding medical and surgical history, demographic characteristics, X-ray findings, complete blood count (CBC), plasma glucose and high-sensitive C-reactive protein (hsCRP) were collected and analysed. Ethics approval was obtained. Based on the normality of distribution appropriate statistical tools were used. P value≤0.05 was considered statistically significant.

 Body mass index was significantly higher in participants who underwent bilateral TKR rather than unilateral TKR. Females were affected at a younger age compared to males. Hypothyroid participants had unilateral than bilateral TKR. Neutrophil lymphocyte ratio was higher in bilateral rather than unilateral TKR (P=0.038). Males had higher monocyte lymphocyte ratio (P≤0.001), especially in individuals 61-80 years of age as well as in obese individuals.

 The use of markers such as total leukocyte count, differential count, neutrophil to lymphocyte (NLR), monocyte to lymphocyte ratios (MLR) and hsCRP are cost-effective and could predict the severity of the disease. These markers could be used to screen individuals at risk for developing OA of the knee and help in assessing the prognosis; thus allowing surgeons to decide on the appropriate management of the disease.

Carbon monoxide (CO) poisoning is a widespread cause of morbidity and mortality, with delayed neurological Sequelae  (DNS) among the most severe consequences of this silent killer. To study the relationship between neutrophil-lymphocyte ratio (NLR), ischemia-modified albumin (IMA), and severity of acute CO poisoning as well as their role in predicting delayed neurological manifestations.Patients and Sixty acutely CO-intoxicated patients were admitted to Alexandria Poison Center, Egypt. NLR and IMA were assessed. Six months after discharge, all patients were subjected to neuropsychometric testing using Mini-Mental Status Examination (MMSE). Brain magnetic resonance imaging (MRI) was conducted on cognitively impaired patients. NLR was abnormally high in most patients and the mean serum level of IMA was significantly elevated in acutely CO-intoxicated patients compared to the control group (P<0.001). NLR and IMA were significantly related to neurological manifestations and other laboratory parameters. Patients were subdivided into DNS group (n = 16) and non-DNS group (n = 44), according to MMSE and brain MRI done after six months, with significant elevation of NLR and IMA in DNS group (p<0.001). The accuracy of DNS prediction parameters was measured using the area under the receiver operating characteristics curve. Excellent accuracy was detected for IMA and NLR. The studied markers of NLR and IMA assessed on admission could be employed as useful biomarkers for correlating with acute CO poisoning severity and predicting the outcome including the possibility of development of DNS.

Nephrotic syndrome (NS) is the most common pediatric chronic kidney disease characterized by massive proteinuria, hypoalbuminemia, edema, and hyperlipidemia. Corticosteroids, as the mainstay of treatment, resolve symptoms in most patients. However, some patients experience a relapsing-remitting course. Currently, there is no specific biomarker for the prediction of steroid response in patients with NS. The neutrophil/lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR) are inexpensive, readily accessible parameters that are proved to be related to the inflammatory state in many disorders.

We evaluated NLR and PLR ratios before and after steroid therapy in 50 pediatric patients with NS in a single pediatric referral center. Data analysis was carried out using SPSS software and the significance level was considered as 0.05.

Medical response to steroid was compatible with steroid-dependent (SD) nephrotic syndrome (NS) in 30% (n=15), steroid-resistant (SR) NS in 12% (n=6), steroid-sensitive (SS) NS in 36% (n=18), and frequently relapsing (FR) NS in 22% (n=11). Fourteen patients (29.2%) did not experience recurrence. Before and after steroid therapy, the mean PLRs were 10.9 and 11.7 and the mean NLRs were 1.9 and 2.2, respectively, which were not statistically different (P>0.05).

We do not recommend NLR and PLR as predictors of steroid response in pediatric patients with NS.

The "Severe Acute Respiratory Syndrome Coronavirus 2 disease has caused globally a challenging and threatening pandemic (COVID-19), with massive health and economic losses [1]. In India national vaccination campaigns kick started officially on January 16, 2021, and the vaccines were prioritized for frontline workers and susceptible groups. Individual vaccination can prevent or minimise a number of outcomes, including lab confirmed infection, symptomatic illness, infectivity rate, or a combination of these [2-3]. India had initially approved two vaccines under the trade name Covishield and Covaxin against COVID.

Demonstrate the efficacy of a single / two -dose schedule of COVID vaccine in the prevention of ICU mortality.

In this retrospective study, we included all COVID 19 confirmed patients who were admitted in covid designated ICU from March 15 to July 31 2021. Demographic, clinical, laboratory and radiological data were collected from all patients received in ICU. Primary outcome was to assess the mortality outcome in vaccinated COVID patients. Secondary outcome measured were to find an association between severity of the pneumonia and comorbidities, PaO2/Fio2 ratio, Neutrophil lymphocyte ratio, D dimer and CT severity score.

319 patients were enrolled in the study. 252 patients were not vaccinated.59 had received the first dose and 8 patients had received both the doses. The mortality among vaccinated patients were less compared to nonvaccinated and significant (p value 0.030). Mortality among single and double dose vaccinated patients couldn’t be made out because only 8 patients had received both the doses. Among the demographic profile, difference in age between vaccinated and unvaccinated was statistically significant. (64.39 ±11.916/ 54.18±14.124 p<.001. Among comorbidities hypertension, diabetes, obesity was associated with significant mortality. Admission saturation and mean PaO2/FiO2 ratio were high among vaccinated and significant. Neutrophil lymphocyte ratio, D dimer CT severity score were high among non vaccinated compared to vaccinated. There is no difference in mode of oxygen delivery in both vaccinated and non vaccinated patient. Days of ICU stayal was less among vaccinated.

Effectiveness of vaccine against SARS-CoV-2 infection after the first dose of immunisation is convincingly evident. However second dose of immunization should be continued to attain total protection.

Lupus nephritis (LN) is one of the most serious complications of systemic lupus erythematosus (SLE).The neutrophil to lymphocyte ratio (NLR) is a promising predictor and prognostic factor. An increased NLR is associated with a poor prognosis of several inflammatory diseases. To evaluate the value of NLR in the diagnosis and pre-assessment of the disease severity of LN. This retrospective study included 88 patients with LN, 51 SLE patients without kidney involvement, 79 patients with primary chronic nephritis (CN), and 52 healthy controls (HC). The differences among these four groups and diagnostic value of NLR for patients with LN were evaluated. The NLR of patients with LN before treatment was significantly higher than that of the other three groups. NLR positively correlated with C-reactive protein (CRP), complement 3(C3), C4, and serum creatinine (SCr) (CRP: r=0.337, p=0.007; C3: r=0.222, p=0.042; C4: r=0.230, p=0.035; SCr: r=0.408, p <0.0001) but negatively correlated with total serum IgG (r=-0.226, p=0.041). The level of NLR increased with the severity of renal dysfunction NLR (area under the curve: 0.785, 95% CI: 0.708-0.862) was useful for the diagnosis of LN, and its optimal cut-off value was 5.44 (sensitivity: 65.9%, specificity: 86.3%). NLR would be useful for the diagnosis of LN and reflects the severity of renal dysfunction Therefore, evaluating NLR before treatment could help clinicians to identify potential renal involvement in patients with SLE and distinguish LN from CN.

In this study, we aimed to determine if neutrophil to lymphocyte ratio could predict long term morbidity and mortality in patients who hospitalized for non-ST segment elevation acute coronary syndrome (NSTE-ACS) and had coronary slow flow on coronary angiography.

In this observational study, 111 patients who presented with NSTE-ACS and diagnosed with coronary slow flow phenomenon on angiographic examination were included. Neutrophil to lymphocyte ratio (NLR) calculated as the ratio of the number of neutrophils to the number of lymphocytes. Patients classified into three groups according to NLR values. The term coronary slow flow phenomenon was depicted by calculating Thrombolysis in Myocardial Infarction frame count.Patients were followed up and the occurrence of recurrent angina, recurrent myocardial infarction, and long-term mortality was determined using medical records, phone calls, or face-to-face interviews. P values <0.05 considered to indicate statistical significance.

Recurrent angina and myocardial infarction occurred more frequently in the highest NLR tertile compared with middle and lowest NLR tertiles. High NLR group (NLR≥ 3.88 n=38) was significantly associated with younger age and smoking status. WBC, troponin I and CRP levels increased as the NLR tertile increased. Recurrent myocardial infarction and angina showed strong relationship with increasing NLR values. In multivariate regression analyses smoking and high NLR levels were independent predictors of recurrent myocardial infarction (HR:4.64 95%CI 0.95-22.52 P=0.04, HR: 1.48 95%CI 1.16-1.90 P<0.01 respectively) in the long term follow up.

Our study demonstrated that high NLR values can be a valuable prognostic tool in the long term follow up of patients who presented with NSTE-ACS and diagnosed with slow flow phenomenon on coronary angiography.

COVID-19 is a newly emerging pandemic viral disease. Multiple management guidelines were introduced; nevertheless, their efficacy is still under debate. Thus, the presences of prognostic factors are essential for predicting which patients will need more invasive treatments. 

The study aims to investigate the prognostic accuracy of neutrophil-lymphocyte ratio in COVID-19 infection. 

This is a prospective study done in Al-Ain Hospital in the United Arab Emirates. All the Covid-19 patients presenting to the hospital were enrolled over 1 month from 20/3 to 20/4/2020. We gathered information about their age, sex, mode of transmission, and calculated their Neutrophils/Lymphocytes ratio (NLR) from the first complete blood picture on admission. We divided the patients into two groups: those whose age was 50 years and above and the those aged less than 50 years. We chose the best NLR cut-off value based on the Youden index and receiver operating characteristic (ROC) curve analysis and the target endpoint was presence or absence of intensive care unit (ICU) admission. 

The study revealed that 48 patients (14%) needed ICU admission, while 296 patients (86%) were admitted to a ward or quarantine facilities. When the patient's age was > 50, and NLR was ≥ 3.10, it showed a sensitivity of 95.24% and a specificity of 92.86% for predicting the need for ICU admission. When NLR was ≥ 4.21, and the patient's age was < 50, the sensitivity and specificity were 70.3% and 93.7%, respectively. 

NLR proved to be highly specific and sensitive in helping to identify patients who need more invasive care among people over 50 years of age with COVID-19.

The neutrophil-to-lymphocyte ratio (NLR), as an indicator of the systemic inflammatory response, predicts adverse outcomes in many malignancies. We investigated its prognostic significance in patients with nonmetastatic renal cell carcinoma.

We retrospectively evaluated data of 196 consecutive non-metastatic RCC patients who underwent radical or partial nephrectomy between 2010 and 2012 at a single center. Overall survival (OS) was assessed using the Kaplan-Meier method and compared using the log-rank test. We applied univariate and multivariate Cox regression models to evaluate the prognostic value of dichotomized NLR for OS.

At a median follow up of 68 months, high NLR (≥ 2,69) correlated with worse survival outcome (P = .006 in log-rank test) and higher tumor stage (P = .035). Univariate and multivariate analysis identified elevated NLR (P = .039), as well as age (P = .002), high Fuhrmann grade (P = .002) and high pathologic T stage (P < .001), as significantly associated with overall survival.

In our cohort, an elevated neutrophil-to-lymphocyte ratio is significantly associated with worse OS on univariate and multivariate analysis. Consequently, the NLR is an easily acquired biomarker, which may be useful in pretreatment patient risk stratification.

The literature reveals lots of information about the relationship between inflammatory markers and many diseases. In this study, we aimed to determine the relationship between erectile dysfunction and the neutrophil- lymphocyte ratio (NLR), which is a simple and nonspecific inflammatory marker. Ninety patients with erectile dysfunction (ED) and ninety-four healthy subjects were included in this study from our internal medicine and urology clinics. As diagnosis criteria, we used the first 5 questions of International Index for Erectile Function. The duration of erectile dysfunction was asked and recorded. Height, weight and waist circumference of patients were measured. We performed total blood count, sedimentation, C-reactive protein, and blood chemistry. There were statistically significant differences between the control [1,038 (0,507-1,92)] and ED [59,5 (52,0-68,0)] groups in terms of NLR (P < .001). According to the multivariate logistic regression analysis, Duration of ED (Cut off: 7,5 month) predicted ED with 78,8% sensitivity and 63,1% specificity (AUC: < ,001, 95% CI 1,030 (1,010-1,050), P = .003). Moreover, NLR (Cut off: 1,574) predicted ED with 81,8% sensitivity and 67,0% specificity (AUC: < 0,001, 95% CI 1,994 (1,139-3,490), P = .016) according to the multivariate logistic regression analysis. It was found that the neutrophil-lymphocyte ratio was higher in patient group than the control group. Also, the neutrophil-lymphocyte ratio (NLR) predicted ED and it might be helpful in diagnosing erectile dysfunction.

In addition to histopathological parameters, evaluation of associated hematological factors is essential for devising a sensitive prognostic scale in glioma. Increased neutrophil-lymphocyte ratio (NLR), a marker of systemic inflammatory response, has recently been associated with worse outcome in various cancers. Given that glioma progression is characterized by inflammation, aggressive angiogenesis, and invasion, increased levels of systemic human-chitinase-3-like-one protein (YKL-40) have also been linked to poor prognosis. The aim of the present study was to assess the plausible association of YKL-40, NLR, and platelet count with increasing tumor grade, and evaluate their status as independent prognostic factors in terms of overall survival (OS) in therapy naive patients with diffuse glioma. Plasma levels of both biochemical markers in 72 diffuse gliomas, median age 42 years, were compared with 36 controls. Comparison of YKL-40, NLR, and PC with respect to tumor grade was found to be significant for each of the markers (P < 0.0001) while an inverse significant correlation was seen for YKL-40 and NLR with OS (r = -0.4619, P < 0.0001, and r = -0.5561, P < 0.0001, respectively). NLR was the best performing marker with AUC 0.9417 at 97% specificity. In addition, YKL-40 had a positive correlation with NLR (r = 0.4902, P < 0.0001), indicating that expression of both markers was linked to inflammation and tumor progression as they were significantly correlated with tumor grade. Expression of YKL-40 and NLR was independently associated with worse survival (HR 1.0062, P = 0.039, and HR 1.1787, P = 0.0003, respectively), thus establishing their clinical utility as prognosticators for diffuse gliomas.

Postoperative mechanical ventilation is required in patients undergoing congenital heart surgery. However, the duration of mechanical ventilation may be extended as a result in some patients. Inflammation is a normal and expected process following surgery and the intensive care process. However, increased and prolonged inflammation increases the risk of mortality and morbidity. The neutrophil lymphocyte ratio (NLR) can be used as a new marker of inflammation in cardiovascular diseases. The aim of our study was to evaluate the association between NLR and successful extubation in pediatric patients undergoing cardiovascular surgery with prolonged intubation.
Pre-extubation blood samples were used for the baseline data. Extubation failure was defined as reintubation within 24 hours of extubation for study purposes. Total white blood cell (WBC), neutrophil and lymphocyte count were recorded pre-extubation, and the NLR was calculated.
Ninety-nine patients who had undergone congenital heart surgery were classified. Statistically significant differences were observed with regard to the blood results for the two groups for WBC (P = 0.001), neutrophil count (P = 0.001), lymphocyte count (P = 0.003), and NLR (P = 0.001). Following multivariate logistic regression analysis, the NLR, WBC, neutrophil count, lymphocyte count remained significant predictors of successful extubation.
The NLR was found to vary significantly in children in whom extubation failed compared to that in children in whom extubation was successful (following prolonged intubation) and was also predictive of successful extubation in our study.