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Linbo Tang,1 Xinjing Li,2 Yongbin Wang,1 Yuanhe Tong1 1Department of Radiation Oncology, Longyan First Affiliated Hospital of Fujian Medical University, Longyan, Fujian, 364000, People’s Republic of China; 2Department of Pathology, Longyan First Affiliated Hospital of Fujian Medical University, Longyan, Fujian, 364000, People’s Republic of ChinaCorrespondence: Yuanhe Tong, Department of Radiation Oncology, Longyan First Affiliated Hospital of Fujian Medical University, Longyan, 364000, People’s Republic of China, Email tyhlongyan@126.comPurpose: Inflammatory markers in the blood have been linked to tumor prognosis, but their specific prognostic significance in nasopharyngeal carcinoma (NPC) patients undergoing intensity-modulated radiotherapy (IMRT) is not well established. This study aims to evaluate the prognostic value of the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and lymphocyte-to-monocyte ratio (LMR) in this patient population.Patients and Methods: A total of 406 non-metastatic NPC patients were included in the study. NLR, PLR, and LMR were stratified according to their average values. The Kaplan-Meier method was used to estimate progression-free survival (PFS) and overall survival (OS). Cox multivariate regression analysis was performed to evaluate the associations of NLR, PLR, and LMR with PFS and OS.Results: Patients with NLR > 2.78 had worse PFS (P = 0.008) and OS (P < 0.001); PLR > 162.48 was related to lower PFS (P = 0.018) but not OS (P = 0.29); LMR > 5.05 showed no significant difference in PFS and OS compared to LMR ≤ 5.05 (P values were 0.13 and 0.94, respectively). Multivariate analysis indicated that NLR was an independent prognostic factor for PFS (HR, 1.674; 95% CI, 1.006– 2.784; P = 0.047) and OS (HR, 4.143; 95% CI, 2.111– 8.129; P = 0.000), while PLR and LMR did not demonstrate significant associations with PFS and OS.Conclusion: This study identifies NLR as a novel and independent prognostic indicator for NPC patients receiving IMRT, offering valuable insights that could inform future clinical decision-making. In contrast, PLR and LMR did not demonstrate significant prognostic value in this context.Keywords: nasopharyngeal carcinoma, inflammatory markers, neutrophil to lymphocyte ratio, platelet to lymphocyte ratio, lymphocyte to monocyte ratio, prognosis

Purpose: In this study, we aimed to compare blood inflammation markers, namely the neutrophil-to-lymphocyte ratio (NLR), plateletto- lymphocyte ratio (PLR), and lymphocyte-to-monocyte ratio (LMR) between patients with IMT and healthy individuals. Material and Methods: Forty-two patients with IMT and 50 healthy controls of similar age and gender without comorbidities were included in the study. Inflammation markers in the blood values of patients and controls were examined. Results: The mean age of the patients with IMT was 60.27 ± 8.47 years, and that of the control group was 60.70 ± 10.38 years. The mean NLR, PLR, LMR, and red cell distribution width (RDW) values were 2.68 ± 0.98, 137 ± 30.30, 4.17 ± 0.98, and 13.85 ± 1.01% respectively, in the IMT group and 1.57 ± 0.32, 100.72 ± 16.78, 4.52 ± 1.29, and 12.93 ± 0.95% respectively, in the control group. In the IMT group, the NLR, PLR and RDW values were statistically significantly higher, and the LMR value statistically significantly lower compared to the control group (p < 0.001, p < 0.001, p = 0.01, p < 0.001, respectively). Conclusion: This study is the first to compare inflammation markers in the blood values of patients with IMT and healthy controls. In this study, the patients with IMT presented with statistically significantly higher NLR, PLR, and RDW values and a statistically significantly lower LMR compared to the control group. We consider that the damage caused by inflammation and oxidative stress to Müller cells is effective in the pathogenesis of IMT. [ABSTRACT FROM AUTHOR]

Background: This study aimed to investigate the value of the peripheral blood neutrophil-to-lymphocyte ratio (NLR) and lymphocyte-to-monocyte ratio (LMR) in the prognosis of patients with multiple myeloma (MM). Methods: Before treatment, the NLR and LMR and all clinical indicators of 168 patients, diagnosed with MM at the Affiliated Hospital of Southwest Medical University from April 2013 to April 2022, were retrospectively analyzed, and the patients were grouped according to their median NLR counts and median LMR counts. Differences between the groups were compared by using the chi-squared (χ²) test, the Kaplan-Meier survival curve and Logrank test were used for survival analysis and difference comparison, and the COX proportional risk model was constructed to analyze the factors affecting the prognosis of the MM patients. The test level was α = 0.05. Results: The groups were divided into high NLR group (> 2.19) and low NLR group (≤ 2.19) and high LMR group (> 3.45) and low LMR group (≤ 3.45), according to the median NLR and LMR values. The clinical stage, blood β2 microglobulin, and serum creatinine levels in the high NLR group were higher than in the low NLR group, and the differences between the groups were statistically significant (p < 0.05). The clinical stage and blood β2 microglobulin in the low LMR group were higher than in the high LMR group, and the differences between the groups were statistically significant (p < 0.05). The Cox univariate and multivariate analyses showed that peripheral blood NLR < 2.19 and LMR ≤ 3.45 were independent risk factors for the prognosis in patients with MM (p < 0.05). Conclusions: High NLR and low LMR counts of peripheral blood suggest a poor prognosis; NLR and LMR may be prognostic indicators in MM patients. [ABSTRACT FROM AUTHOR]

Abstract Purpose This study aimed to investigate clinical diagnostic values of mSEPT9 combined with NLR, PLR and LMR in CRC. Methods 329 subjects composed of 120 CRC patients, 105 polyps patients and 104 healthy participants were prospectively recruited. Clinicopathologic features were collected and analyzed. Plasma samples were collected for mSEPT9, NLR, PLR and LMR test. The sensitivity, specificity and AUC of each biomarker separately or in combination were estimated by the ROC curve. Results The levels of NLR, PLR and the PDR of mSEPT9 in CRC patients were significantly higher than those in non-CRC subjects, while LMR was the opposite. The PDR of mSEPT9 in CRC patients was significantly correlated with age, tumor size, tumor stage and M stage. ROC curve analysis demonstrated moderate diagnostic values of mSEPT9, NLR, PLR and LMR in CRC patients with AUC of 0.78 (Se = 0.68, and Sp = 0.89), 0.78 (Se = 0.68, and Sp = 0.83), 0.80 (Se = 0.68, and Sp = 0.81), and 0.77 (Se = 0.72, and Sp = 0.73), respectively. Moreover, combination of these four biomarkers dramatically enhanced the diagnostic accuracy of CRC (AUC = 0.92, Se = 0.90, and Sp = 0.87), especially for CRC patients with large tumors (AUC = 0.95) or distal metastasis (AUC = 0.95). Conclusion mSEPT9, NLR, PLR and LMR showed the potential to be reliable biomarkers for the diagnosis of CRC. And the combined application of these biomarkers further improved the diagnostic accuracy of CRC significantly.

Introduction: In the relentless global battle against the Coronavirus Disease-2019 (COVID-19) pandemic, accurate prediction of disease severity remains a critical challenge, with profound implications for patient outcomes and healthcare resource allocation. As the virus continues to evolve and pose new threats, the need for reliable prognostic indicators becomes increasingly urgent. Effective identification of patients at high-risk of developing severe illness not only facilitates timely intervention and personalised treatment strategies but also optimises healthcare resource utilisation. In this context, the exploration of novel biomarkers and predictive models holds immense promise for enhancing ones understanding of disease progression and improving clinical decision-making. Aim: To study the association between haematological parameters, including Neutrophil-to-Lymphocyte Ratio (NLR), Lymphocyte-to-Monocyte Ratio (LMR), and Platelet-to-Lymphocyte Ratio (PLR), with Computed Tomography Scan Severity Score (CTSS) in COVID-19 patients. Materials and Methods: A prospective cohort study was conducted from March 2021 to July 2022 at Government General Hospital (GGH) Nizamabad, Telangana, India. The study encompassed all three COVID-19 waves, included a sample size of 159 Reverse Transcriptase Polymerase Chain Reaction (RT-PCR) positive patients, excluding pregnant women and children under 10 years. Upon admission, CTSS and ratios of NLR, LMR, and PLR were recorded in an MS Excel sheet before any medical intervention and then analysed using Statistical Package for Social Sciences (SPSS) software 22.0. Results: The study comprised 159 patients with a mean age of 50.86±13.89 years (ranging from 16 to 85), predominantly male 90 (56.61%). The highest infection rate 85 (53.45%) was in the 41-60 years age group. The NLR was significantly elevated from a mean value of 4.58 to 11.24 (r value=0.78, p-value=

Summary: Objectives: The systemic inflammatory response is strongly involved in the progression of malignant tumors, and it is useful for predicting survival time and determining therapeutic effects. The inflammatory biomarkers, neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), and platelet-to-lymphocyte ratio (PLR) are used to assess post-treatment survival and recurrence in various malignant tumors.(Walsh et al., 2005; Burt et al., 2011; Smith et al., 2009) 1,2,3 These indicators may be effective as predictive markers for head and neck malignancies. Methods: The participants were 125 glottic laryngeal and supraglottic cancer cases who received primary treatment in our department from 2010 to 2016. The NLR, LMR, and PLR for each patient were calculated in addition to the association with overall survival (OS) rate, disease-specific survival (DSS) rate, and laryngeal preservation rate for tumor location, T and N classification, TNM stage classification, treatment, and smoking. We investigated whether inflammatory biomarkers are useful for predicting prognosis. Results: The cutoff values for NLR, LMR, and PLR on the ROC curve were 1.88, 5.57, and 108, respectively. Multivariate analysis with LMR 5.57 as the cutoff value showed significant differences in OS, DSS, and laryngeal preservation. However, setting the cutoff values for NLR 1.88 and PLR 108 showed significant differences only in OS and laryngeal preservation. Conclusion: LMR may be a total survival predictor of laryngeal cancer, including OS, DSS, and laryngeal preservation.

Purpose: This study aimed to investigate clinical diagnostic values of mSEPT9 combined with NLR, PLR and LMR in CRC. Methods: 329 subjects composed of 120 CRC patients, 105 polyps patients and 104 healthy participants were prospectively recruited. Clinicopathologic features were collected and analyzed. Plasma samples were collected for mSEPT9, NLR, PLR and LMR test. The sensitivity, specificity and AUC of each biomarker separately or in combination were estimated by the ROC curve. Results: The levels of NLR, PLR and the PDR of mSEPT9 in CRC patients were significantly higher than those in non-CRC subjects, while LMR was the opposite. The PDR of mSEPT9 in CRC patients was significantly correlated with age, tumor size, tumor stage and M stage. ROC curve analysis demonstrated moderate diagnostic values of mSEPT9, NLR, PLR and LMR in CRC patients with AUC of 0.78 (Se = 0.68, and Sp = 0.89), 0.78 (Se = 0.68, and Sp = 0.83), 0.80 (Se = 0.68, and Sp = 0.81), and 0.77 (Se = 0.72, and Sp = 0.73), respectively. Moreover, combination of these four biomarkers dramatically enhanced the diagnostic accuracy of CRC (AUC = 0.92, Se = 0.90, and Sp = 0.87), especially for CRC patients with large tumors (AUC = 0.95) or distal metastasis (AUC = 0.95). Conclusion: mSEPT9, NLR, PLR and LMR showed the potential to be reliable biomarkers for the diagnosis of CRC. And the combined application of these biomarkers further improved the diagnostic accuracy of CRC significantly. [ABSTRACT FROM AUTHOR]

Introduction: In the relentless global battle against the Coronavirus Disease-2019 (COVID-19) pandemic, accurate prediction of disease severity remains a critical challenge, with profound implications for patient outcomes and healthcare resource allocation. As the virus continues to evolve and pose new threats, the need for reliable prognostic indicators becomes increasingly urgent. Effective identification of patients at highrisk of developing severe illness not only facilitates timely intervention and personalised treatment strategies but also optimises healthcare resource utilisation. In this context, the exploration of novel biomarkers and predictive models holds immense promise for enhancing ones understanding of disease progression and improving clinical decision-making. Aim: To study the association between haematological parameters, including Neutrophil-to-Lymphocyte Ratio (NLR), Lymphocyte-to-Monocyte Ratio (LMR), and Platelet-to-Lymphocyte Ratio (PLR), with Computed Tomography Scan Severity Score (CTSS) in COVID-19 patients. Materials and Methods: A prospective cohort study was conducted from March 2021 to July 2022 at Government General Hospital (GGH) Nizamabad, Telangana, India. The study encompassed all three COVID-19 waves, included a sample size of 159 Reverse Transcriptase Polymerase Chain Reaction (RT-PCR) positive patients, excluding pregnant women and children under 10 years. Upon admission, CTSS and ratios of NLR, LMR, and PLR were recorded in an MS Excel sheet before any medical intervention and then analysed using Statistical Package for Social Sciences (SPSS) software 22.0. Results: The study comprised 159 patients with a mean age of 50.86±13.89 years (ranging from 16 to 85), predominantly male 90 (56.61%). The highest infection rate 85 (53.45%) was in the 41-60 years age group. The NLR was significantly elevated from a mean value of 4.58 to 11.24 (r value=0.78, p-value=<0.001), and LMR notably reduced from 8.27 to 3.80 (r value=0.67, p-value=0.003) in correlation with the severity as indicated by CTSS. Although PLR values were higher in severe cases, increasing from 173.07 in mild cases to 272.29 in severe cases, there was no significant correlation with CTSS (r-value=-0.78, p-value=0.177). Conclusion: CTSS emerges as a valuable radiological biomarker for predicting COVID-19 severity. However, due to its cost and limited availability in grassroots-level hospitals, there is a need for alternative severity prediction models. Present study proposes a predictive model using NLR and LMR biomarkers as alternatives to CTSS for assessing COVID-19 severity. [ABSTRACT FROM AUTHOR]

This study explored the associations between peripheral immunity with cerebral small vessel diseases. Older adults without dementia from the Alzheimer's Disease Neuroimaging Initiative were investigated. Peripheral blood was obtained, and magnetic resonance imaging was performed to measure cerebral microbleeds (CMB), lacunar infarctions (LI), and white matter hyperintensities (WMH). Multivariable-adjusted regression models, linear mixed-effects models, and the Spearman correlations were used to evaluate the associations. At baseline, individuals with greater neutrophils (odds ratio [OR] =1.10, 95% confidence interval [CI] 1.00–1.20, p =0.042) and monocytes (OR=1.12, 95% CI 1.02–1.22, p =0.016) had higher WMH volume. On the contrary, a higher lymphocyte-to-monocyte ratio (LMR) was related to lower WMH volume (OR=0.91, 95% CI 0.82–1.00, p =0.041). Longitudinally, higher neutrophils (ρ=0.084, p =0.049) and NLR (ρ=0.111, p =0.009) predicted accelerated progression of WMH volume, while a greater LMR (ρ=−0.101, p =0.018) was linked to slower growth of WMH volume. Nevertheless, associations between peripheral immunity with CMB or LI were not observed at baseline and follow-up. Our study found that peripheral immune indexes could serve as convenient noninvasive biomarkers of WMH. • Participants with higher LMR at baseline had a lower risk of WMH. • Lower LMR or higher NLR at baseline predicted faster WMH progression longitudinally. • Innate immunity and adaptive immunity may play opposite roles in CSVD. [ABSTRACT FROM AUTHOR]

The systemic inflammatory response is strongly involved in the progression of malignant tumors, and it is useful for predicting survival time and determining therapeutic effects. The inflammatory biomarkers, neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), and platelet-to-lymphocyte ratio (PLR) are used to assess post-treatment survival and recurrence in various malignant tumors.(Walsh et al., 2005; Burt et al., 2011; Smith et al., 2009) 1,2,3 These indicators may be effective as predictive markers for head and neck malignancies. The participants were 125 glottic laryngeal and supraglottic cancer cases who received primary treatment in our department from 2010 to 2016. The NLR, LMR, and PLR for each patient were calculated in addition to the association with overall survival (OS) rate, disease-specific survival (DSS) rate, and laryngeal preservation rate for tumor location, T and N classification, TNM stage classification, treatment, and smoking. We investigated whether inflammatory biomarkers are useful for predicting prognosis. The cutoff values for NLR, LMR, and PLR on the ROC curve were 1.88, 5.57, and 108, respectively. Multivariate analysis with LMR 5.57 as the cutoff value showed significant differences in OS, DSS, and laryngeal preservation. However, setting the cutoff values for NLR 1.88 and PLR 108 showed significant differences only in OS and laryngeal preservation. LMR may be a total survival predictor of laryngeal cancer, including OS, DSS, and laryngeal preservation. [ABSTRACT FROM AUTHOR]

Background: The neutrophil-to-lymphocyte ratio (NLR) and lymphocyte-to-monocyte ratio (LMR) are inflammatory biomarkers. Until now, it is unknown the impact of opioid dosage on perioperative immunity in glioma patients. The aim of this study was to explore the effect of intraoperative opioid dosage on perioperative immune perturbations using NLR and LMR as inflammatory biomarkers and evaluate the correlation between inflammatory biomarkers and pathological grade of glioma. Methods: The study included 208 patients with primary glioma who underwent glioma resection from February 2012 to November 2019 at Harbin Medical University Cancer Hospital. Complete blood count (CBC) was collected at 3 time points: one week before surgery, and 24 hours and one week after surgery. Patients were divided into high-dose and low-dose groups, based on the median value of intraoperative opioid dose. The relationships between perioperative NLR, LMR and intraoperative opioid dosage were analyzed using repeated measurement analysis of variance (ANOVA). Correlations between preoperative various factors and pathological grade were analyzed by Spearman analysis. Receiver operating characteristic (ROC) curves were performed to assess the predictive performance of the NLR and LMR for pathological grade. Results: The NLR (P=0.020) and lower LMR (P=0.037) were statistically significant different between high-dose and low-dose groups one week after surgery. The area under the curve (AUC) of the NLR to identify poor diagnosis was 0.685, which was superior to the LMR (AUC: 0.607) and indicated a correlation between the NLR with pathological grade. The preoperative NLR (P=0.000), LMR (P=0.009), age (P=0.000) and tumor size (P=0.001) exhibited a significant correlation with the pathological grade of glioma. Conclusion: Intraoperative opioids in the high-dose group were associated with higher NLR and lower LMR in postoperative glioma patients. The preoperative NLR and LMR demonstrated predictive value for distinguishing between high-grade and low-grade gliomas. [ABSTRACT FROM AUTHOR]

Acute ischemic stroke (AIS) is a leading cause of death and long-term disability worldwide. Thromboinflammation plays an important role in the pathophysiology of stroke. The peripheral blood cell count ratios (PBCCR): neutrophil‐to‐lymphocyte ratio (NLR), platelet‐to‐lymphocyte ratio (PLR), and lymphocyte‐to‐monocyte ratio (LMR), are global inflammatory indicators with prognostic value for the clinical outcome after stroke. We aimed to determine the relationship between NLR, PLR, or LMR and the functional outcome three months post-stroke. A prospective, hospital-based study, including 141 participants with AIS, was conducted at a referral stroke center in North-Eastern Bulgaria. The PBCCRs were obtained during the first 24 hours after stroke onset. Stroke severity was measured using the NIHSS scale, and functional outcome was assessed with the modified Rankin Scale (mRS) at discharge and 3 months post-stroke. We found significantly lower total lymphocyte counts, and higher NLR, PLR, and C-reactive protein in the poor-outcome group (mRS>3) three months post-stroke. A positive correlation was found between the NIHSS score and mRS score on discharge, NLR, and PLR with the worse outcome on the third month. The receiver operating characteristic (ROC) curves showed the predictability of NLR (AUC, 0.626, 95%CI: 0.524–0.724, p = 0.018), and for PLR– (AUC, 0.613, 95%CI: 0.510–0.716, p = 0.031). The optimal cutoff value for NLR was 2.68 (sensitivity 77.8% and specificity 60.4%), and for PLR - 122.6 (sensitivity 77.8% and specificity 61.5%). Neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio are simple, widely available, and cost-effective biomarkers with high prognostic value for the clinical outcome three months post-stroke. [ABSTRACT FROM AUTHOR]

Background: Inflammation plays a pivotal role in the pathogenesis of Parkinson's disease (PD). However, the correlation between peripheral inflammatory markers and the severity of PD remains unclear. Methods: The following items in plasma were collected for assessment among patients with PD (n = 303) and healthy controls (HCs; n = 303) were assessed for the neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR) and neutrophil-to-high-density-lipoprotein ratio (NHR) in plasma, and neuropsychological assessments were performed for all patients with PD. Spearman rank or Pearson correlation was used to evaluate the correlation between the NLR, the LMR and the NHR and the severity of PD. Receiver operating characteristic (ROC) curves were used to evaluate the diagnostic performance of the NLR, LMR and NHR for PD. Results: The plasma NLR and NHR were substantially higher in patients with PD than in HCs, while the plasma LMR was substantially lower. The plasma NLR was positively correlated with Hoehn and Yahr staging scale (H&Y), Unified Parkinson's Disease Rating Scale (UPDRS), UPDRS-I, UPDRS-II, and UPDRS-III scores. Conversely, it exhibited a negative relationship with Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) scores. Furthermore, the plasma NHR was positively correlated with H&Y, UPDRS, UPDRS-I, UPDRS-II and UPDRS-III scores. Moreover, negative associations were established between the plasma LMR and H&Y, UPDRS, UPDRS-I, UPDRS-II, and UPDRS-III scores. Finally, based on the ROC curve analysis, the NLR, LMR and NHR exhibited respectable PD discriminating power. Conclusion: Our research indicates that a higher NLR and NHR and a lower LMR may be relevant for assessing the severity of PD and appear to be promising disease-state biomarker candidates. [ABSTRACT FROM AUTHOR]

Abstract Background and purpose Whether symptomatic unruptured intracranial aneurysms (UIAs) lead to change in circulating inflammation remains unclear. This study aims to evaluate the role of hematological inflammatory indicators in predicting symptomatic UIA. Methods Adult patients diagnosed with saccular intracranial aneurysm from March 2019 to September 2023 were recruited retrospectively. Clinical and laboratory data, including the white blood cells (WBC), neutral counts (NEUT), lymphocyte counts (LYM), and monocyte counts (MONO) of each patient, were collected. The neutrophil-to-lymphocyte ratio (NLR) and lymphocyte-to-monocyte ratio (LMR) were calculated as NLR = NEUT/LYM, LMR = LYM/MONO, SII = PLT*NEUT/LYM. The hematological inflammatory indicators were compared in symptomatic saccular and asymptomatic UIA patients. Multivariable logistic regression analyses were performed to explore the factors predicting symptomatic UIA. Results One hundred and fifty UIA patients with a mean age of 58.5 ± 12.4 were included, of which 68% were females. The NLR and LMR were significantly associated with symptomatic UIA, and the association remained in small UIAs (

Objective: It is known that coronavirus disease-2019 (COVID-19) showed a clinical course with milder symptoms in children than in adults. However, a multisystem inflammatory syndrome in children (MIS-C), which developed 2-4 weeks after COVID-19 infection, emerged in April 2021. Other respiratory viruses such as influenza, respiratory syncytial virus, and parainfluenza spread worldwide after loosening pandemic restrictions. Pediatricians were challenged to distinguish COVID-19, MIS-C, and other viral infections from each other. Herein, we have aimed to determine basic, simple hematological parameters that can predict the prognosis and outcomes of the patients with COVID-19 and MIS-C. Method: In this study, 300 pediatric inpatients including those with MIS-C, COVID-19, and other respiratory virus infections admitted to Ege University Faculty of Medicine between January 2018 and September 2021, were retrospectively evaluated. Results: The neutrophil-to-lymphocyte ratio (NLR), neutrophil-to-monocyte ratio (NMR), derived NLR, and the systemic inflammatory index were higher in the MIS-C patients compared to others. The lymphocyte-to-monocyte ratio (LMR) and platelet-to-lymphocyte ratio (PLR) were lower in children with COVID-19 disease than those with MIS-C (p

Abstract This study aimed to investigate the potential of inflammatory markers, including platelet‐to‐lymphocyte ratio (PLR), neutrophil‐to‐lymphocyte ratio (NLR), lymphocyte‐to‐monocyte ratio (LMR), and C‐reactive protein‐to‐lymphocyte ratio (CLR), in identifying sacroiliitis. Present retrospective study was conducted at the Abant Izzet Baysal University Hospital, including patients diagnosed with sacroiliitis between August 2020 and March 2023. Control subjects with normal sacroiliac joints were also included. Sacroiliitis patients were further categorized into active and chronic sacroiliitis groups. Demographic data and laboratory characteristics, such as erythrocyte sedimentation rate (ESR), C‐reactive protein (CRP), and various blood parameters, were recorded. Inflammatory markers were calculated, including PLR, NLR, LMR, and CLR. Statistical analyses were performed to compare the study groups and evaluate the diagnostic performance of these markers. A total of 226 subjects, including 132 sacroiliitis patients and 94 control subjects, were included in the study. Serum CRP levels were significantly higher in sacroiliitis patients compared to the control group. NLR, PLR, and CLR values were elevated in sacroiliitis patients, while LMR was decreased. There were significant correlations between these markers and established inflammatory markers. Receiver operating characteristic (ROC) analysis demonstrated moderate diagnostic performance for NLR, PLR, LMR and CLR in detecting sacroiliitis. Inflammatory markers, specifically NLR, PLR, LMR and CLR, showed significant differences between sacroiliitis patients and the control group. In addition PLR is useful in distinguishing active and chronic sacroiliitis. These markers, in conjunction with established inflammatory markers, may serve as supportive diagnostic tools for sacroiliitis.

BACKGROUNDS: Early and accurate diagnosis of pediatric pneumonia in primary health care can reduce the chance of long-term respiratory diseases, related hospitalizations and mortality while lowering medical costs. The aim of this study was to assess the value of blood biomarkers, clinical symptoms and their combination in assisting discrimination of pneumonia from upper respiratory tract infection (URTI) in children. METHODS: Both univariate and multivariate logistic regressions were used to build the pneumonia screening model based on a retrospective cohort, comprised of 5211 children (age ≤ 18 years). The electronic health records of the patients, who had inpatient admission or outpatient visits between February 15, 2012 to September 30, 2018, were extracted from the hospital information system of Zhejiang Provincial Peoples Hospital, Hangzhou, Zhejiang Province, China. The children who were diagnosed with pneumonia and URTI were enrolled and their clinical features and levels of blood biomarkers were compared. Using the area under the ROC curve, both two screening models were evaluated under 80% (training) versus 20% (test) cross-validation data split for their accuracy. RESULTS: In the retrospective cohort, 2548 of 5211 children were diagnosed with the defined pneumonia. The univariate screening model reached predicted AUCs of 0.76 for lymphocyte/monocyte ratio (LMR) and 0.71 for neutrophil/lymphocyte ratio (NLR) when identified overall pneumonia from URTI, attaining the best performance among the biomarker candidates. In subgroup analysis, LMR and NLR attained AUCs of 0.80 and 0.86 to differentiate viral pneumonia from URTI, and AUCs of 0.77 and 0.71 to discriminate bacterial pneumonia from URTI respectively. After integrating LMR and NLR with three clinical symptoms of fever, cough and rhinorrhea, the multivariate screening model obtained increased predictive values, reaching validated AUCs of 0.84, 0.95 and 0.86 for distinguishing pneumonia, viral pneumonia and bacterial pneumonia from URTI respectively. CONCLUSIONS: Our study demonstrated that combining LMR and NLR with critical clinical characteristics reached promising accuracy in differentiating pneumonia from URTI, thus could be considered as a useful screening tool to assist the diagnosis of pneumonia, in particular, in community healthcare centers. Further researches could be conducted to evaluate the models clinical utility and cost-effectiveness in primary care scenarios to facilitate pneumonia diagnosis, especially in rural settings.

Inflammation is a hallmark of tumors and plays an important role in tumorigenesis, progression, metastasis and prognosis. Neutrophils, platelets, monocytes/macrophages and lymphocytes are the important components of the solid tumor-associated microenvironment such as lung cancer, and exert pro- and anti-inflammatory effects through multiple mechanisms. Their associated neutrophil-to-lymphocyte ratio, platelet-to-lymphocyteratio and lymphocyte-to-monocyte ratio can reflect the body inflammatory status and the balance between pro- and anti-tumor effects. They are the promising indicators for lung cancer screening, monitoring disease progression, efficacy and prognosis assessment. This paper reviews the relationship among inflammation, immunity and lung cancer, and the application of novel inflammatory markers in lung cancer. [ABSTRACT FROM AUTHOR]

Objective: It is known that coronavirus disease-2019 (COVID-19) showed a clinical course with milder symptoms in children than in adults. However, a multisystem inflammatory syndrome in children (MIS-C), which developed 2-4 weeks after COVID-19 infection, emerged in April 2021. Other respiratory viruses such as influenza, respiratory syncytial virus, and parainfluenza spread worldwide after loosening pandemic restrictions. Pediatricians were challenged to distinguish COVID-19, MIS-C, and other viral infections from each other. Herein, we have aimed to determine basic, simple hematological parameters that can predict the prognosis and outcomes of the patients with COVID-19 and MIS-C. Method: In this study, 300 pediatric inpatients including those with MIS-C, COVID-19, and other respiratory virus infections admitted to Ege University Faculty of Medicine between January 2018 and September 2021, were retrospectively evaluated. Results: The neutrophil-to-lymphocyte ratio (NLR), neutrophil-to-monocyte ratio (NMR), derived NLR, and the systemic inflammatory index were higher in the MIS-C patients compared to others. The lymphocyte-to-monocyte ratio (LMR) and platelet-to-lymphocyte ratio (PLR) were lower in children with COVID-19 disease than those with MIS-C (p<0.05). Conclusions: In this study, we have shown that commonly used hematological tests, especially higher values of NLR, NMR for children with MIS-C, and lower levels of LMR for children with COVID-19, are significant and can help to determine the possible disease course of children at an early stage. [ABSTRACT FROM AUTHOR]

Background: Inflammation has been associated with tumor development and circulating inflammatory biomarkers have been proposed as possible predictors of recurrence of several solid tumors. However, the role of inflammation markers in differentiated thyroid carcinoma (DTC) is still uncertain. Objective: This meta-analysis aimed to assess the prognostic value of neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), and platelet-to-lymphocyte ratio (PLR) in patients with DTC. Methods: Studies investigating the association between survival and preoperative circulating inflammatory markers in DTC patients were included. The primary outcome was disease-free survival (DFS). Cumulative logarithms of the hazard ratio (log-HRs) with 95% CI were calculated through the inverse variance method using a random-effects model. Results: A total of 7599 patients with a mean age of 48.89 (95% CI 44.16–53.63) were included. The estimated pooled log-HRs for DFS were 0.07 for NLR (95% CI -0.12–0.26; p = 0.43), -0.58 for LMR (95% CI -1.21–0.05; p = 0.06), and 0.01 (95% CI 0–0.01; p = 0.21) for PLR. Conclusions: Our meta-analysis showed no association between NLR, PLR, LMR and DFS in DTC; however, more prospective data are needed to better define the association between inflammatory status and prognosis of DTC. [ABSTRACT FROM AUTHOR]

Abstract Objective Pretreatment systemic inflammation and nutrition‐based prognostic indices (SINBPI) have demonstrated significance. This study investigated the prognostic value of pretreatment SINBPI for patients with oropharyngeal cancer and identified unfavorable prognostic markers. Methods We retrospectively reviewed the data of 124 patients with oropharyngeal squamous cell carcinoma (OPSCC) who received definitive treatment between January 2010 and December 2018. The prognostic utility of the neutrophil‐to‐lymphocyte ratio, platelet‐to‐lymphocyte ratio (PLR), lymphocyte‐to‐monocyte ratio (LMR), prognostic nutritional index, and high‐sensitivity modified Glasgow prognostic score (HS‐mGPS) was assessed for disease‐free survival (DFS), disease‐specific survival (DSS), and overall survival (OS) using univariate and multivariate analyses. Results Multivariate analyses revealed that human papillomavirus (HPV) status and HS‐mGPS were significantly associated with DFS, DSS, and OS. Patients with a HS‐mGPS of 2 had a significantly higher rate of treatment‐related deaths than those with a HS‐mGPS of 0 or 1. The combination of the HS‐mGPS and PLR had more accurate predictive ability in DFS and OS compared with the HS‐mGPS alone, and the combination of the HS‐mGPS and LMR had more accurate predictive ability in DSS and OS. Conclusion Our results indicated that the HS‐mGPS was a useful prognostic marker for patients with OPSCC, and combined markers consisting of the HS‐mGPS and PLR or LMR may provide more accurate prognostic predictions. Level of Evidence: 3.

Background: Metabolic syndrome is a critical health concern associated with an elevated risk of chronic health problems including cardiovascular disease and diabetes. There are shreds of evidence that novel inflammatory ratios including neutrophil-to-lymphocyte, platelet-to-lymphocyte and lymphocyte-to-monocyte ratios serve as prognostic biomarkers for metabolic syndrome (MetS). This hypothesis was investigated in a cohort of the Iranian population. Methods: selection of MetS + subjects was based on the National Cholesterol Education Program Adult Treatment Panel III criteria 3 (NCEP ATP 3). The control group consisted of participants negative for any of the five MetS criteria. Demographic and laboratory data were extracted from the Tabari cohort study. Results: A total of 1930 subjects including 965 Mets positive and 965 MetS criteria negative participants were evaluated. Diabetes (84.8%), hypertension (48.9%), hypertriglyceridemia (81.7%), low HDL cholesterol (70.3%), and high waist circumference (78.9%) were observed in patients. There were no differences between NLR (1.66±0.71 vs. 1.69±0.72 P=0.42), LMR (11.23±3.13 vs. 11.30±11.99, P= 0.86) and PLR (113.85±68.67 vs 114.11±35.85, P=0.91) between case and control groups, respectively. Logistic regression analysis revealed no association between ratios and MetS risk even after adjusting for potential confounders including age, gender, living place, and BMI. Conclusion: In a relatively large population from Northern Iran, no association was observed between CBC-derived inflammatory ratios and the presence of MetS.

BackgroundInflammation plays a pivotal role in the pathogenesis of Parkinson’s disease (PD). However, the correlation between peripheral inflammatory markers and the severity of PD remains unclear.MethodsThe following items in plasma were collected for assessment among patients with PD (n = 303) and healthy controls (HCs; n = 303) were assessed for the neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR) and neutrophil-to-high-density-lipoprotein ratio (NHR) in plasma, and neuropsychological assessments were performed for all patients with PD. Spearman rank or Pearson correlation was used to evaluate the correlation between the NLR, the LMR and the NHR and the severity of PD. Receiver operating characteristic (ROC) curves were used to evaluate the diagnostic performance of the NLR, LMR and NHR for PD.ResultsThe plasma NLR and NHR were substantially higher in patients with PD than in HCs, while the plasma LMR was substantially lower. The plasma NLR was positively correlated with Hoehn and Yahr staging scale (H&Y), Unified Parkinson’s Disease Rating Scale (UPDRS), UPDRS-I, UPDRS-II, and UPDRS-III scores. Conversely, it exhibited a negative relationship with Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) scores. Furthermore, the plasma NHR was positively correlated with H&Y, UPDRS, UPDRS-I, UPDRS-II and UPDRS-III scores. Moreover, negative associations were established between the plasma LMR and H&Y, UPDRS, UPDRS-I, UPDRS-II, and UPDRS-III scores. Finally, based on the ROC curve analysis, the NLR, LMR and NHR exhibited respectable PD discriminating power.ConclusionOur research indicates that a higher NLR and NHR and a lower LMR may be relevant for assessing the severity of PD and appear to be promising disease-state biomarker candidates.

Purpose of the Study: To assess the association of inflammatory markers with known risk factors and short-term outcome of well-differentiated thyroid cancer. Materials and Methods: Well-differentiated nonmetastatic thyroid cancer patients diagnosed and treated between September 2015 and December 2019 at Kasturba Hospital, Manipal, India, were retrieved for the study. Patients' presurgical blood parameters were noted, and neurtrophil-to-lymphocyte ratio (NLR) and lymphocyte-to-monocyte ratio (LMR) were calculated. Clinicopathological details along with tumor markers at baseline and at 6 months' follow-up were tabulated. Patients were categorized as complete disease clearance if their clinical examination was normal, stimulated thyroglobulin (Tg) was <1 ng/ml, Anti-thyroglobulin antibodies <65 IU/L or showing a decreasing trend, and follow-up I-131 whole-body scan was negative. The association of the inflammatory markers with known risk factors and short-term outcomes were compared. Results: A total of 272 patients were analyzed in the study. The median NLR in our study cohort was 2.55 (mean = 3.96 with standard deviation [SD] =4.20) and the median LMR was 3.72 (mean = 3.79 with SD = 1.94). The disease clearance rate of our study cohort was 73.9%. The median NLR (2.4 vs. 3.1) and LMR (3.13 vs. 3.93) were significantly different among the patients with complete disease clearance and those with persistent disease (P = 0.008 and P = 0.003, respectively). The known risk factors such as multifocality (P = 0.04), tumor size (P = 0.013), lymph node metastases (P = 0.001), and baseline Tg (P ≤ 0.001) were significantly associated with persistent disease at 6 months. The NLR showed a positive correlation and LMR had a negative correlation with the known risk factors, however, the associations were not statistically significant. Conclusions: The NLR and LMR are simple yet potential prognostic tools in well-differentiated thyroid cancer. [ABSTRACT FROM AUTHOR]

Background and Purpose: The aim of this study was to explore the relationship between functional prognosis and the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR) and systemic inflammatory response index (SIRI) in patients with acute ischemic stroke (AIS) at discharge.Methods: A total of 861 patients with AIS were enrolled between January 2019 and December 2021. Blood cell counts were collected on admission. Logistic regression analysis was performed to assess the relationship between NLR, PLR, LMR, SIRI and adverse functional outcomes (modified Rankin scale score of 3– 6) at discharge. We also used receiver operating characteristic (ROC) curves to estimate the overall ability of NLR, PLR, LMR and SIRI to judge short-term functional outcomes. Associations between NLR, PLR, LMR, and SIRI with length of hospital stay were analyzed by Spearman correlation test.Results: A total of 194 patients (22.5%) had poor functional outcomes at discharge. Multivariate logistic regression analysis showed that NLR (odds ratio [OR], 1.060; 95% confidence interval [CI] 1.004– 1.120, P=0.037), PLR (OR, 1.003; 95% CI 1.000– 1.005, P=0.018), LMR (OR, 0.872; 95% CI 0.774– 0.981, P=0.023) and SIRI (OR, 1.099; 95% CI 1.020– 1.184, P=0.013) were independent factors for poor functional outcome. The odds ratios of the highest versus lowest quartiles of NLR, PLR and SIRI were 2.495 (95% CI 1.394– 4.466), 1.959 (95% CI 1.138– 3.373) and 1.866 (95% CI 1.106– 3.146), respectively. The odds ratio of the lowest versus highest quartile of LMR was 2.300 (95% CI 1.331– 3.975). The areas under the curve (AUCs) of the NLR, PLR, LMR, and SIRI to discriminate poor functional prognosis were 0.644, 0.587, 0.628, and 0.651, respectively. NLR, LMR, and SIRI were related with the length of hospital stay (P< 0.05).Conclusion: NLR, PLR, LMR, and SIRI were associated with functional outcome at discharge in AIS patients. NLR, LMR and SIRI were related to hospitalization days in patients with AIS. [ABSTRACT FROM AUTHOR]

As inflammation plays a significant role in the development of coronary artery disease, we hypothesized that there may be a relation between the systemic immune inflammation index (SII) and saphenous vein graft disease (SVGD). The study population consisted of 716 consecutive patients who underwent elective coronary angiography (CAG) >1 year after bypass grafting. The patients were divided into 2 groups depending on the extent of SVG patency. SII value was significantly higher in the SVGD(+) group compared with the SVGD(−) group (P <.001). In multivariate logistic regression analysis, SII (P <.001, odds ratio (OR) = 3.27, 95% CI = 1.94–5.65) and neutrophil-to-lymphocyte ratio (NLR) (P <.001, OR = 2.08, 95% CI = 1.59–3.11) were found to be independent predictors of SVGD. An SII value of >935 (x103/ml) has 89.2% sensitivity and 70.6% specificity for the prediction of the SVGD, and an NLR value of >4.15 has 54.6% sensitivity and 68.5% specificity for the prediction of the SVGD. The AUC of SII was found to be greater than the AUC of NLR (P =.002), platelet-to-lymphocyte ratio (PLR) (P =.009), lymphocyte-to-monocyte ratio (LMR) (P =.013), MPV (P =.011), and C-reactive protein (CRP) (P =.034) in predicting SVGD. In conclusion, we demonstrated that SII, which is among the new inflammation indexes, is a more reliable predictor in determining SVGD than the NLR, PLR, and LMR. [ABSTRACT FROM AUTHOR]

Objective: Pretreatment systemic inflammation and nutrition‐based prognostic indices (SINBPI) have demonstrated significance. This study investigated the prognostic value of pretreatment SINBPI for patients with oropharyngeal cancer and identified unfavorable prognostic markers. Methods: We retrospectively reviewed the data of 124 patients with oropharyngeal squamous cell carcinoma (OPSCC) who received definitive treatment between January 2010 and December 2018. The prognostic utility of the neutrophil‐to‐lymphocyte ratio, platelet‐to‐lymphocyte ratio (PLR), lymphocyte‐to‐monocyte ratio (LMR), prognostic nutritional index, and high‐sensitivity modified Glasgow prognostic score (HS‐mGPS) was assessed for disease‐free survival (DFS), disease‐specific survival (DSS), and overall survival (OS) using univariate and multivariate analyses. Results: Multivariate analyses revealed that human papillomavirus (HPV) status and HS‐mGPS were significantly associated with DFS, DSS, and OS. Patients with a HS‐mGPS of 2 had a significantly higher rate of treatment‐related deaths than those with a HS‐mGPS of 0 or 1. The combination of the HS‐mGPS and PLR had more accurate predictive ability in DFS and OS compared with the HS‐mGPS alone, and the combination of the HS‐mGPS and LMR had more accurate predictive ability in DSS and OS. Conclusion: Our results indicated that the HS‐mGPS was a useful prognostic marker for patients with OPSCC, and combined markers consisting of the HS‐mGPS and PLR or LMR may provide more accurate prognostic predictions. Level of Evidence: 3. [ABSTRACT FROM AUTHOR]

Background: Inflammatory response markers are prognostic factors for several cancers, but their role in postoperative colorectal cancer (CRC) is unclear. The purpose was to evaluate the role of preoperative Neutrophil-to-Lymphocyte ratio (NLR), Platelet-to-Lymphocyte-ratio (PLR), and Lymphocyte-to-Monocyte ratio (LMR) in the prognosis of postoperative CRC patients. Methods: We retrospectively reviewed 448 CRC patients who had undergone surgical resection from December 2015 to December 2017 in our hospital. The plasma NLR, PLR, LMR, CEA, and CA19-9 were collected within 2 weeks before the operation. We recorded the clinical characteristics and survival data by reviewing medical records and phone calls. We analyzed preoperative inflammatory markers and clinical features using Pearson chi-squared tests or Fisher's tests. Uni- and multivariate Cox regression analyses were performed, and overall survival (OS) was estimated with the Kaplan-Meier method. Results: High NLR and PLR were associated with worse overall survival in postoperative CRC (HR = 2.140, 95%CI = (1.488-3.078), P < 0.001; HR =1.820, 95%CI = (1.271-2.605), P = 0.001). High LMR was associated with improved overall survival in postoperative CRC (HR = 0.341, 95%CI = (0.188-0.618), P < 0.001). In the multivariate regression analysis, the increase of NLR resulted in an increase in the risk of death (HR = 1.678, 95%CI = (1.114-2.527), P = 0.013), and for the LMR, a reduction of the risk of death (HR = 0.480, 95%CI = (0.256 - 0.902), P = 0.023). Moreover, TNM stage, CA-199, CEA, nerve or vascular invasion (NVI) and adjuvant chemotherapy after surgery also were associated with worse overall survival in postoperative CRC. Conclusion: Current evidence indicates that preoperative inflammatory markers NLR, LMR, and PLR are associated with overall survival in postoperative patients with colorectal cancer. NLR is an independent risk factor, and LMR is an independent protective factor in CRC patients after surgery. [ABSTRACT FROM AUTHOR]

Introduction. Difficulties in advanced pancreatic ductal adenocarcinoma (PDAC) treatment require a constant search for novel prognostic factors. The aim of this study is to determine the role of various morphological parameters in predicting the prognosis of advanced PDAC during systemic therapy with a FOLFIRINOX regimen. Material and methods. The data of 52 patients, treated with FOLFIRINOX chemotherapy due to metastatic PDAC were analyzed retrospectively in this study. Results. The median time of overall survival (OS) in the group of patients with neutrophil-to-lymphocyte ratio (NLR) ≥3 was 5.8 months, compared to 14.5 months in patients with NLR < 3. Median progression-free survival (PFS) in patients with NLR ≥ 3 was 4.1 months, compared to 8.5 months in patients with NLR < 3. There were no statistically significant differences among patients concerning the lymphocyte-to-monocyte ratio (LMR) and platelets-to-lymphocyte ratio (PLR). Conclusions. Higher NLR is a negative prognostic factor in metastatic PDAC. [ABSTRACT FROM AUTHOR]

Purpose: Several biomarkers, such as baseline neutrophil-to-lymphocyte ratio (NLR), have been more investigated in patients with brain metastases (BM), while their role in patients with leptomeningeal metastases (LM) has not been clarified. Considering the difference between the clinical behaviour of BM and LM, there is the need for addressing the role of these biomarkers in LM. Methods: The present study retrospectively analyzed 95 consecutive patients with LM from lung cancer who were diagnosed at the National Cancer Center, Cancer Hospital of Chinese Academy of Medical Sciences between January 2016 and December 2019. Baseline NLR, platelet-to-lymphocyte ratio (PLR), systemic immunoinflammation index (SII), and lymphocyte‐to-monocyte ratio at diagnosis of LM were calculated based on complete blood count and correlated, along with other characteristics, with overall survival (OS) using univariate and multivariate analyses. The best cutoff values for systemic immunoinflammation biomarkers were derived using the surv_cutpoint function in R software, which optimized the significance of the split between Kaplan–Meier survival curves. Results: Median OS of patients with LM was 12 months (95% CI 9– 17 months). On univariate analysis, NLR, PLR, SII, LMR, sex, smoking history, ECOG performance status (PS) scores, histological subtypes and targeted therapy were all significantly associated with OS. Only NLR (P=0.034, 95% CI 1.060– 4.578) and ECOG PS scores (P=0.019, 95% CI 0.137– 0.839) maintained a significant association with OS on multivariate analysis. Furthermore, patients with baseline NLR > 3.57 had significantly worse OS than patients with NLR ≤ 3.57 (median OS 7 vs 17 months), as did patients with ECOG PS scores > 2 vs ≤ 2 (median OS 4 vs 15 months). Conclusion: Both baseline NLR and PS scores at the time of LM diagnosis are helpful and available prognostic biomarkers for patients with LM from lung cancer. [ABSTRACT FROM AUTHOR]

Introduction: Cytokines are the small cell signalling proteins like granulocytes, lymphocytes, monocytes, etc. which may indirectly play a role in the pathophysiology of schizophrenia via inflammation. Neutrophil-to-Lymphocyte Ratio (NLR), Lymphocyte-to-Monocyte Ratio (LMR) and Platelet-to-Lymphocyte Ratio (PLR) are consistently used as a biomarkers for the innate immunity. Metabolic syndrome has been established as a serious public health concern over the last decade with increased morbidity associated with it. However, data regarding changes in LMR and PLR in metabolic syndrome is sparse. Therefore, the relationship between metabolic syndrome and raised inflammatory markers is not established. Aim: To find out the relationship between inflammatory markers and metabolic syndrome in patients of schizophrenia and normal population. Materials and Methods: A case-control study was conducted in the Department of Psychiatry, Sanjay Gandhi Memorial Hospital, Rewa, Madhya Pradesh, India, between February 2019 and January 2020. The study consisted of 84 schizophrenic patients from Inpatient and Outpatient Departments and 100 healthy controls from the general population, and data were collected using semi-structured proforma. Participants were evaluated for Complete Blood Count (CBC), parameters of metabolic syndrome (systolic and diastolic blood pressure; high density lipoprotein; triglycerides; fasting blood glucose; waist circumference) and severity of symptoms using Brief Psychiatric Rating Scale (BPRS). Data was analysed using IBM Statistical Package for the Social Sciences (SPSS) version 22.0 by Student's t-test, one way Analysis of Variance (ANOVA), repeated measure ANOVA, Spearman's rho correlation and linear regression analysis. Results: The mean age of cases and controls was 31.4±11.9 years and 35.4±14.1 years, respectively. There were 54 (64.3%) males and 30 (35.7%) females in cases and 62 (62%) males and 38 (38%) females in controls. There was a significant difference between cases and controls for LMR, and NLR at baseline and four months (p-value <0.01). There a was significant difference between two antipsychotics group for NLR and PLR at baseline, two months, and four months (p-value <0.01) with moderate to large effect size. There was a significant correlation between metabolic syndrome and LMR, NLR and PLR for cases as well as controls (p-value <0.05). Conclusion: The study established the alteration of NLR, LMR and PLR in patients of schizophrenia, and also established a relationship between MetS and inflammatory markers which suggested some common pathway between inflammation, metabolic syndrome and schizophrenia. [ABSTRACT FROM AUTHOR]

Background and Objectives: The inflammatory cells released after intracranial hemorrhage, such as monocytes, macrophages, and neutrophils, activate the inflammatory system. These parameters can be used to evaluate the clinical course of diseases. This study aims to evaluate these parameters as possible predictors for evaluating the development of brain death. Materials and Methods: Patients with a Glasgow coma scale score below 7 were assigned to Group BD (patients with brain death) and Group ICH (intracranial hemorrhage). The neutrophil, lymphocyte, platelet, monocyte counts, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), and platelet-to-neutrophil ratio (PNR) were measured at admission. Results: A high WBC count, neutrophil count, NLR, and PLR and a low lymphocyte count, LMR, and PNR were found to be significant for determining brain death. The area under the curve (AUC) values of NLR, PNR, PLR, and LMR to discriminate brain death were 0.63, 0.61, 0.56, and 0.61, respectively. Conclusion: NLR, PNR, PLR, and LMR are easily accessible and reliable parameters that can be used to predict the development of brain death and can be estimated by a simple complete blood count test. [ABSTRACT FROM AUTHOR]

Abstract Purpose This study aimed to evaluate the utility of inflammation-based prognostic scores (IBPS) and systemic immune-inflammation index (SII) in the treatment of oral cancer patients. Methods For the 183 patients enrolled in this study, IBPS and SII were calculated from peripheral blood samples obtained before and after treatment and at the time of relapse. We examined overall survival (OS) and disease-free survival (DFS) using previously reported cut-off values for IBPS. Cut-off values of neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), platelet-to-lymphocyte ratio (PLR), and prognostic nutritional index (PNI) were analyzed as NLR 1.79, PLR 114.97, LMR 5, and PNI 52.44. The cut-off value for SII was set at 569. OS and DFS were analyzed by Kaplan–Meier methods using the cutoff of each IBPS and SII. Univariate analysis and multivariate analysis using Cox proportional hazards were performed for OS and DFS. Results Kaplan–Meier methods showed the high-PNI group showed good prognosis including OS and DFS, while the high-SII group displayed poor DFS. Univariate analysis showed that pre-treatment high PNI and low SII were significantly associated with better prognosis. Multivariate analysis identified pre-treatment PNI as independently associated with OS. For DFS, univariate analysis using Cox proportional hazards modeling showed that pre-treatment high NLR and high SII were significantly associated with worse prognosis, while high PNI was significantly associated with better prognosis. Multivariate analysis identified pre-treatment PNI and SII as independently associated with DFS. Parameters of PNI and SII components were compared between pre-treatment, post-treatment and at relapse in the high- and low-PNI groups. PNI was predominantly decreased in both high- and low-PNI groups at post-treatment and at relapse compared to pre-treatment. This trend was also observed for albumin. Conclusions Higher pre-treatment PNI was associated with better OS, while lower pre-treatment PNI and higher treatment SII were associated with poorer DFS in oral cancer patients. Our data indicated that PNI and SII might offer useful biomarkers for gauging prognosis and the efficacy of conventional therapies.

Introduction: Cytokines are the small cell signalling proteins like granulocytes, lymphocytes, monocytes, etc. which may indirectly play a role in the pathophysiology of schizophrenia via inflammation. Neutrophil-to-Lymphocyte Ratio (NLR), Lymphocyte-to-Monocyte Ratio (LMR) and Platelet-to-Lymphocyte Ratio (PLR) are consistently used as a biomarkers for the innate immunity. Metabolic syndrome has been established as a serious public health concern over the last decade with increased morbidity associated with it. However, data regarding changes in LMR and PLR in metabolic syndrome is sparse. Therefore, the relationship between metabolic syndrome and raised inflammatory markers is not established. Aim: To find out the relationship between inflammatory markers and metabolic syndrome in patients of schizophrenia and normal population. Materials and Methods: A case-control study was conducted in the Department of Psychiatry, Sanjay Gandhi Memorial Hospital, Rewa, Madhya Pradesh, India, between February 2019 and January 2020. The study consisted of 84 schizophrenic patients from Inpatient and Outpatient Departments and 100 healthy controls from the general population, and data were collected using semi-structured proforma. Participants were evaluated for Complete Blood Count (CBC), parameters of metabolic syndrome (systolic and diastolic blood pressure; high density lipoprotein; triglycerides; fasting blood glucose; waist circumference) and severity of symptoms using Brief Psychiatric Rating Scale (BPRS). Data was analysed using IBM Statistical Package for the Social Sciences (SPSS) version 22.0 by Student’s t-test, one way Analysis of Variance (ANOVA), repeated measure ANOVA, Spearman’s rho correlation and linear regression analysis. Results: The mean age of cases and controls was 31.4±11.9 years and 35.4±14.1 years, respectively. There were 54 (64.3%) males and 30 (35.7%) females in cases and 62 (62%) males and 38 (38%) females in controls. There was a significant difference between cases and controls for LMR, and NLR at baseline and four months (p-value

Introduction: Systemic inflammation response index (SIRI), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) have been proposed as peripheral blood biomarkers. We compared these blood biomarkers to identify the best predictor in patients with hypopharyngeal squamous cell carcinoma (HPSCC).Methods: We conducted a retrospective study on 304 patients with HPSCC. SIRI was divided into three groups using X-tile version 3.6.1. The optimal cut-off points for NLR, LMR, and PLR were selected through RStudio. We compared the prognostic capacity of SIRI with that of NLR, LMR, and PLR using receiver operating characteristic curves.Results: Smoking, cancer in the postcricoid region, lymph node metastasis (N+), extracapsular invasion, SIRI in the highest tertile (>2.80), and LMR in the lowest tertile (<5.0) may cause poor 5-year overall survival (OS) in patients with HPSCC. Local and distant recurrences may occur earlier in those with lymph node metastasis and a tumor invading beyond the mucosa layer.Conclusions: SIRI was a better predictor of OS than LMR, PLR, and NLR in HPSCC patients. SIRI in the highest tertile (>2.80) and LMR in the lowest tertile (<5.0) may cause poor 5-year OS. [ABSTRACT FROM AUTHOR]

Abstract Backgrounds Early and accurate diagnosis of pediatric pneumonia in primary health care can reduce the chance of long-term respiratory diseases, related hospitalizations and mortality while lowering medical costs. The aim of this study was to assess the value of blood biomarkers, clinical symptoms and their combination in assisting discrimination of pneumonia from upper respiratory tract infection (URTI) in children. Methods Both univariate and multivariate logistic regressions were used to build the pneumonia screening model based on a retrospective cohort, comprised of 5211 children (age ≤ 18 years). The electronic health records of the patients, who had inpatient admission or outpatient visits between February 15, 2012 to September 30, 2018, were extracted from the hospital information system of Zhejiang Provincial People’s Hospital, Hangzhou, Zhejiang Province, China. The children who were diagnosed with pneumonia and URTI were enrolled and their clinical features and levels of blood biomarkers were compared. Using the area under the ROC curve, both two screening models were evaluated under 80% (training) versus 20% (test) cross-validation data split for their accuracy. Results In the retrospective cohort, 2548 of 5211 children were diagnosed with the defined pneumonia. The univariate screening model reached predicted AUCs of 0.76 for lymphocyte/monocyte ratio (LMR) and 0.71 for neutrophil/lymphocyte ratio (NLR) when identified overall pneumonia from URTI, attaining the best performance among the biomarker candidates. In subgroup analysis, LMR and NLR attained AUCs of 0.80 and 0.86 to differentiate viral pneumonia from URTI, and AUCs of 0.77 and 0.71 to discriminate bacterial pneumonia from URTI respectively. After integrating LMR and NLR with three clinical symptoms of fever, cough and rhinorrhea, the multivariate screening model obtained increased predictive values, reaching validated AUCs of 0.84, 0.95 and 0.86 for distinguishing pneumonia, viral pneumonia and bacterial pneumonia from URTI respectively. Conclusions Our study demonstrated that combining LMR and NLR with critical clinical characteristics reached promising accuracy in differentiating pneumonia from URTI, thus could be considered as a useful screening tool to assist the diagnosis of pneumonia, in particular, in community healthcare centers. Further researches could be conducted to evaluate the model’s clinical utility and cost-effectiveness in primary care scenarios to facilitate pneumonia diagnosis, especially in rural settings.

Yibiao Chen,1,2 Jianda Sun,1,2 Dan Hu,1,2 Jian Zhang,1,2 Yuyun Xu,1,2 Huiting Feng,1,2 Zhijie Chen,1,2 Yi Luo,1,2 Yunlong Lou,2,3 Heming Wu2,4 1Department of Radiation Oncology, Meizhou People’s Hospital (Huangtang Hospital), Meizhou Academy of Medical Sciences, Meizhou, People’s Republic of China; 2Guangdong Provincial Key Laboratory of Precision Medicine and Clinical Translational Research of Hakka Population, Meizhou People’s Hospital (Huangtang Hospital), Meizhou Academy of Medical Sciences, Meizhou, People’s Republic of China; 3Department of Nuclear Medicine, Meizhou People’s Hospital (Huangtang Hospital), Meizhou Academy of Medical Sciences, Meizhou, People’s Republic of China; 4Center for Precision Medicine, Meizhou People’s Hospital (Huangtang Hospital), Meizhou Academy of Medical Sciences, Meizhou, People’s Republic of ChinaCorrespondence: Yunlong Lou; Heming WuMeizhou People’s Hospital (Huangtang Hospital), No. 63 Huangtang Road, Meijiang District, Meizhou, 514031, People’s Republic of ChinaTel +86 753-2131-591Email louyunlong@mzrmyy.com; wuheming1986@126.comObjective: The present study aimed to investigate the predictive value of some indexes, such as neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), systemic inflammatory response index (SIRI), and systemic immune-inflammatory index (SII) in the survival of nasopharyngeal carcinoma (NPC) and provide reference for the treatment.Methods: A retrospective analysis was performed on 216 patients from 2016 to 2018. The cutoff values of these indexes were determined by the receiver operating characteristic (ROC) curve. The prognostic value of the indexes was evaluated according to the rate of overall survival (OS), regional recurrence-free survival (RRFS), locoregional recurrence-free survival (LRRFS), and distant metastasis-free survival (DMFS).Results: The survival analysis showed that NLR ≤ 2.695 (P = 0.017) and PLR ≤ 140.065 (P = 0.041) were associated with poor OS; however, the LMR and SIRI showed no significant statistical significance. NLR ≤ 2.045 (P = 0.018) and PLR ≤ 125.605 (P = 0.003) were associated with poor RRFS, LMR ≤ 2.535 (P = 0.027) and PLR ≤ 140.065 (P = 0.009) were associated with poor DMFS, NLR ≤ 2.125 (P = 0.018) and PLR ≤ 132.645 (P = 0.026) were associated with poor LRRFS, respectively. Logistic regression analysis showed that low LMR (≤ 2.535) was significantly inferior in OS (HR 23.085, 95% CI 3.425– 155.622, P = 0.001) and DMFS (HR 22.839, 95% CI 4.096– 127.343, P < 0.001). Moreover, low PLR (≤ 140.065) remained significantly related to worse OS (HR 11.908, 95% CI 1.295– 109.517, P = 0.029) and DMFS (HR 9.556, 95% CI 1.448– 63.088, P = 0.019).Conclusion: The index LMR and PLR can be used for predicting survival in NPC patients.Keywords: nasopharyngeal carcinoma, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, lymphocyte-to-monocyte ratio, systemic inflammatory response index, systemic immune-inflammatory index

BackgroundNaples prognostic score (NPS), a novel scoring system based on nutritional and inflammatory status, is associated with prognosis in several cancers. This study aimed to evaluate the prognostic significance of preoperative NPS in patients undergoing nephrectomy.Patients and MethodsThis study retrospectively analyzed patients with renal cell carcinoma (RCC) who underwent radical or partial nephrectomy between 2010 and 2013. The clinicopathological characteristics of patients stratified by preoperative NPS were compared. Survival analysis was performed using the Kaplan–Meier method and log-rank test. Univariate and multivariate Cox proportional hazards models were used to identify independent prognostic factors. Receiver operating characteristic curves were used to evaluate prediction efficiency.ResultsA total of 638 patients with operable RCC were included. The high-NPS group (NPS group 2) was significantly associated with older age (P

Purpose: To evaluate the utility of various pre-treatment prognostic scoring systems for overall survival (OS) in laryngeal cancer, including neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), modified Glasgow Prognostic Score (mGPS) and systemic immune-inflammatory index (SIII). Methods: We undertook a retrospective 5-year study of 220 patients with laryngeal squamous cell carcinoma undergoing active treatment. Results: On multivariate analysis, low NLR (≤ 2.415, p = 0.001, OR 3.851), low PLR (≤ 269.855, p = 0.002, OR 5.520), high LMR (> 2.225, p < 0.001, OR 0.458) and low SIII (≤ 1144.465, p = 0.003, OR 3.673) were significantly associated with improved OS, accounting for confounding factors of tumour subsite, T-stage and performance status. C-reactive protein (CRP) alone (p = 0.264) and mGPS (p = 0.350) were not significantly associated with OS. Conclusions: NLR, PLR, LMR and SIII represent inexpensive, easily obtainable adjuvant decision-making tools which could help tailor individualised treatment regimes. Further investigation into the utility of combination scores and the role of different laryngeal subsites may be of interest. [ABSTRACT FROM AUTHOR]

Aim: COVID-19 is a cause of high-mortality pandemic with the RNA virus in its etiology and has an effect all over the world. In the present study, the relationship between in-hospital prognosis and mortality was investigated by comparing neutrophil-to-lymphocyte ratio (NLR), platelet -to-lymphocyte ratio (PLR) values with C-reactive protein (CRP) and with a detailed analysis of complete blood count and biochemical parameters in mild and severe COVID-19 cases. Method: A total of 271 patients who were diagnosed with pneumonia because of COVID-19 and 278 healthy control groups were included in the study. In our study, COVID-19 cases were divided into 2 groups as mild and severe, and the data were compared with healthy people without COVID-19. Lung tomography results of the cases that were diagnosed with COVID-19 were examined. Those with positive RT-PCR (Real-Time Polymerized Chain Reaction) test results were recorded from the system. Biochemical tests and complete blood count parameters of the patients, NLR/lymphocyte-to-monocyte ratio (LMR)/PLR N/L, and CRP levels were compared with the control group. The results were evaluated and analyzed in statistical terms. Results: When all the data were analyzed, NLR/PLR and CRP levels were found to be higher at statistically significant levels in the severe patient group than in the control group, and LMR was lower (p<0.01). In ROC analysis, NLR/PLR and CRP had a high AUC (area under the curve) (0.844/0.719/0.501) and LMR had a low AUC (0.225). Conclusion: NLR and PLR might be useful in demonstrating the prognosis in severe COVID-19 cases. [ABSTRACT FROM AUTHOR]

Objectives: Our study was aimed to investigate the clinical characteristics of the patients with COVID-19 pneumonia and research new diagnostic methods for the disease. Methods: In this retrospective study, medical records of 46 novel coronavirus-infected pneumonia (NCIP) patients and 30 healthy individuals in the two multiple hospitals from January 2020 to March 2020 were studied. Clinical characteristics, chest computed tomographic (CT) scans, medicine treatment and laboratory information were collected and retrospectively analyzed. Neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR) and platelet-to-lymphocyte ratio (PLR) were evaluated. Results: The main symptoms of the patients with NCIP were fever (100%), cough (82.6%), anorexia (37%), expectoration (34.8%) and fatigue (21.7%), dyspnea (15.2%). Ground glass opacity (GGO) with patch shadow was the main observation of the CT imaging (43.4%), followed by GGO (21.7%), patch shadow (19.5%), GGO with consolidation (8.7%) and GGO with reticular pattern (2.1%). The median white blood cell (WBC) count, lymphocyte count, platelet, and lymphocyte-monocyte ratio (LMR) in NCIP group were all significantly lower than in control group (p<0.001, for all comparisons), while the median neutrophil-monocyte ratio (NLR) and platelets-monocyte ratio (PLR) were both significantly higher (p<0.001, for both comparisons). Median WBC count, lymphocyte count, and platelet count on discharge were significantly higher than on admission (p<0.05). Median PLR was significantly lower two weeks after discharge (p<0.001), while NLR remained the same. The area under the curve (AUC) value of WBC, lymphocyte and platelet counts, NLR, LMR and PLR were 0.766, 0.931, 0.655, 0.780, 0.847 and 0.845, respectively. Early stages of the disease were associated with quick changes in WBC, lymphocyte, and platelet levels. However, NLR did not recover even two weeks after the discharge. Conclusion: Changes in WBC, lymphocyte, and platelet counts, as well as NLR, LMR and PLR are strongly associated with COVID-19 pneumonia. Monitoring blood markers may assist in evaluating the progression of the disease [ABSTRACT FROM AUTHOR]

Simple Summary: This retrospective study using the prospectively collected registry data of newly diagnosed, previously untreated hepatocellular carcinoma (HCC) evaluates the significance of systemic inflammatory markers (SIMs) to intrahepatic recurrence (IHR) after curative treatment. Out of 4076 patients who met the inclusion criteria, 52.6% experienced IHR. SIMs, including pre-treatment platelet-to-lymphocyte ratio (PLR), post-treatment changes of neutrophil-to-lymphocyte ratio PLR, and lymphocyte-to-monocyte ratio were significantly associated with the prognosis of early-stage HCC patients who received initial curative treatment. The prognostic significances of SIMs were consistent for IHR-free survival, early and late IHR, and overall survival. Systemic inflammatory markers (SIMs) are known to be associated with carcinogenesis and prognosis of hepatocellular carcinoma (HCC). We evaluated the significance of SIMs in intrahepatic recurrence (IHR) of early-stage HCC after curative treatment. This study was performed using prospectively collected registry data of newly diagnosed, previously untreated HCC between 2005 and 2017 at a single institution. Inclusion criteria were patients with Barcelona Clinic Liver Cancer stage 0 or A, who underwent curative treatment. Pre-treatment and post-treatment values of platelet, neutrophil, lymphocyte, monocyte, neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), and lymphocyte/monocyte ratio (LMR) were analyzed with previously well-known risk factors of HCC to identify factors associated with IHR-free survival (IHRFS), early IHR, and late IHR. Of 4076 patients, 2142 patients (52.6%) experienced IHR, with early IHR in 1018 patients (25.0%) and late IHR in 1124 patients (27.6%). Pre-treatment platelet count and PLR and post-treatment worsening of NLR, PLR, and LMR were independently associated with IHRFS. Pre-treatment platelet count and post-treatment worsening of NLR, PLR, and LMR were significantly related to both early and late IHR. Pre-treatment values and post-treatment changes in SIMs were significant factors of IHR in early-stage HCC, independent of previously well-known risk factors of HCC. [ABSTRACT FROM AUTHOR]

Abstract Background The aim of this study was to assess the effect of the lymphocyte-to-monocyte ratio (LMR), neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio on overall survival and disease-free survival in patients with lung cancer treated with radical surgery. Methods We performed a retrospective review of patients with lung cancer who prospectively underwent radical resection between 2004 and 2012. Blood samples were taken as part of the preoperative workup. The inflammatory markers studied were absolute values of lymphocytes, monocytes, neutrophils and platelets, with subsequent calculation of ratios. Median follow-up was 52 months. Results Two hundred and sixty-eight patients underwent surgery, of whom 218 (81.3%) were men. Mean age was 62.9 ± 8.7 years. A lymphocyte-to-monocyte ratio ≥ 2.5 was independently associated with longer disease-free survival (hazard ratio [HR] 0.476 (0.307–0.738), p = 0.001) and longer overall survival (HR, 0.546; 95% CI: 0.352–0.846; p = 0.007), in models adjusted for age, sex, stage, and type of resection. No other systemic inflammatory marker showed a significant association. Conclusion Preoperative LMR is an independent prognostic factor of overall survival and recurrence-free survival in patients with surgically-resected early stage lung cancer.

Abstract Background We sought to compare the prognostic significance of different preoperative complete blood count cell ratios in patients with oral cavity squamous cell carcinoma (OSCC) treated with surgery and postoperative radiotherapy (PORT). Methods We retrospectively reviewed the clinical records of 890 patients with OSCC who were treated with surgery and PORT. The following preoperative complete blood count cell ratios were collected: neutrophil‐to‐lymphocyte ratio (NLR), platelet‐to‐lymphocyte ratio (PLR), and lymphocyte‐to‐monocyte ratio (LMR). Overall survival (OS), local control, regional control, and distant control (DC) served as the main outcomes of interest. Results The results of multivariate analysis in the entire study cohort revealed that a low NLR was the only independently favorable marker of both OS (adjusted hazard ratio [HR]: 0.794, 95% confidence interval (CI): 0.656–0.961, bootstrap p = 0.028) and DC (adjusted HR: 0.659, 95% CI: 0.478–0.909, bootstrap p = 0.015). Both LMR and PLR were not retained in the model as independent predictors. Subgroup analyses in high‐risk patients (i.e., those bearing T4 disease, N3 disease, or poor differentiation) revealed that a high NLR was a significant adverse risk factor for both OS and DC (all p

Objective: The purpose of this study was to investigate the prognostic impact of neutrophil to lymphocyte ratio (NLR), derived neutrophil to lymphocyte ratio (dNLR), platelet to lymphocyte ratio (PLR), and lymphocyte to monocyte ratio (LMR) on breast cancer given overall survival. Patients and Methods: We retrospectively evaluated patients diagnosed with primary breast cancer from 2004 to 2020. The association between NLR, dNLR, LMR, and PLR and overall survival (OS) was analyzed. Results: The one-year, three-year, five-year, and ten-year OS were 96%, 83%, 78%, 71%, and 63%, respectively. The parameters associated with patients with breast cancer included lymph node involvement, distant metastasis, and staging. We evaluated the baseline characteristics of the patients, according to the PLR, NLR, dNLR, and LMR, and found no significant differences. Conclusions: Serum inflammatory indicators such as neutrophil, lymphocyte, as well as NLR dNLR, LMR, and PLR, were shown to have no significant influence on prognosis in patients with breast cancer. Prospective research with a larger population of patients will provide more reliable results.

Purpose: Inflammatory indexes, including neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammation index (SII) and lymphocyte-to-monocyte ratio (LMR), have been confirmed as prognostic factors in multiple manigances. However, the prognostic value of these parameters in bevacizumab-treated non-small-cell lung cancer (NSCLC) is still not clear. Methods: We retrospectively studied 119 patients with advanced NSCLC who received bevacizumab treatment. The associations of pretreatment NLR, PLR, SII and LMR with progression-free survival (PFS) and overall survival (OS) were analyzed. Results & Conclusion: The median PFS and OS of patients with high baseline NLR, PLR and SII and low LMR were significantly decreased than those of patients with low baseline NLR, PLR and SII and high LMR. Multivariable analysis indicated that high baseline SII was independently related with inferior prognosis, and baseline LMR was an independent predictor for OS.

Purpose: This study aimed to evaluate the utility of inflammation-based prognostic scores (IBPS) and systemic immune-inflammation index (SII) in the treatment of oral cancer patients.Methods: For the 183 patients enrolled in this study, IBPS and SII were calculated from peripheral blood samples obtained before and after treatment and at the time of relapse. We examined overall survival (OS) and disease-free survival (DFS) using previously reported cut-off values for IBPS. Cut-off values of neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), platelet-to-lymphocyte ratio (PLR), and prognostic nutritional index (PNI) were analyzed as NLR 1.79, PLR 114.97, LMR 5, and PNI 52.44. The cut-off value for SII was set at 569. OS and DFS were analyzed by Kaplan-Meier methods using the cutoff of each IBPS and SII. Univariate analysis and multivariate analysis using Cox proportional hazards were performed for OS and DFS.Results: Kaplan-Meier methods showed the high-PNI group showed good prognosis including OS and DFS, while the high-SII group displayed poor DFS. Univariate analysis showed that pre-treatment high PNI and low SII were significantly associated with better prognosis. Multivariate analysis identified pre-treatment PNI as independently associated with OS. For DFS, univariate analysis using Cox proportional hazards modeling showed that pre-treatment high NLR and high SII were significantly associated with worse prognosis, while high PNI was significantly associated with better prognosis. Multivariate analysis identified pre-treatment PNI and SII as independently associated with DFS. Parameters of PNI and SII components were compared between pre-treatment, post-treatment and at relapse in the high- and low-PNI groups. PNI was predominantly decreased in both high- and low-PNI groups at post-treatment and at relapse compared to pre-treatment. This trend was also observed for albumin.Conclusions: Higher pre-treatment PNI was associated with better OS, while lower pre-treatment PNI and higher treatment SII were associated with poorer DFS in oral cancer patients. Our data indicated that PNI and SII might offer useful biomarkers for gauging prognosis and the efficacy of conventional therapies. [ABSTRACT FROM AUTHOR]

Background: Head and neck squamous cell carcinomas are associated with systemic inflammation (SI). We evaluated whether DNA methylation‐derived SI (mdSI) indices are associated with oropharyngeal cancer risk and survival. Methods: Ninety‐four oropharyngeal squamous cell carcinoma (OPSCC) cases and 57 controls with DNA methylation data were included. Logistic regression analysis and survival analysis were performed to test the association of mdSI indices with OPSCC risk and survival. Results: Higher methylation‐derived neutrophil‐to‐lymphocyte ratio (mdNLR) was associated with increased risk of OPSCC (OR = 1.21, 95%CI: 1.11–1.40) while no association was found with methylation‐derived lymphocyte‐to‐monocyte ratio (mdLMR). For 5‐year overall survival, higher mdLMR was significantly associated with decreased risk of death (HR = 0.25, 95%CI: 0.10–0.64) while the converse was observed for mdNLR (HR = 2.48, 95%CI: 1.04–5.92). Conclusion: We observed an association between mdSI indices and OPSCC risk and 5‐year overall survival. It is possible to use mdLMR as an independent prognostic factor for OPSCC. [ABSTRACT FROM AUTHOR]