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Objectives Methods Results Conclusions To evaluate the predictivity of haematologic parameters and HALP score on testicular viability in adults with testicular torsion.We retrospectively analyzed the clinical data of 139 men ≥18 years of age who underwent testicular detorsion with fixation (n = 90) or orchiectomy (n = 49) due to testicular torsion in five different tertiary centers between May 2019 and August 2023. Demographic, pre‐, peri‐ and postoperative data were analyzed.The hemoglobin, albumin, lymphocyte, and platelet (HALP) score in the orchiectomy group was significantly lower compared to the detorsion group (adjusted p = 0.032). Platelet to lymphocyte ratio and duration of torsion were significantly higher in the orchiectomy group (adjusted p = 0.048, adjusted p = 0.000, respectively). Neutrophil‐lymphocyte ratio did not reach statistical significance between the groups (adjusted p = 0.074) Furthermore, the orchiectomy group had statistically significantly more heterogeneous echotexture on scrotal ultrasonography (adjusted p = 0.000). On binary logistic regression analysis; platelet‐lymphocyte ratio and HALP score were not found as significant predictors for surgical outcome (p = 0.296, p = 0.078, respectively). Multivariate logistic regression analysis revealed that only heterogeneous echotexture on scrotal Doppler ultrasonography and duration of torsion were independent risk factors for testicular necrosis development (p = 0.004, p < 0.001, respectively).This study demonstrates that heterogeneous echotexture on ultrasound and longer duration of torsion seem to be independent risk factors for testicular necrosis after testicular torsion in adults. However, neither haematologic parameters nor HALP score provided valuable information for testicular viability before scrotal exploration in our series. [ABSTRACT FROM AUTHOR]

Background Aluminum phosphides (AlP) is a solid fumigant pesticide known for its high toxicity and mortality. Diagnosis of AlP is based on the history and clinical examination. The literature on the early prediction of adverse outcomes following AlP exposure is limited. Therefore, the current study aimed to investigate the role of neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte Ratio (PLR) as early accessible predictors of mortality in AlP-exposed patients. Method We conducted a retrospective cross-sectional study on 420 adult patients with acute AlP poisoning. Results This study reported mean NLR and PLR of 4.07 ± 3.82 and 182.97 ± 147.29, respectively. Patients with high NLR and PLR showed more severe presentation, indicated by the significantly lower Glasgow scales and higher poison severity score grades. Besides, the need for mechanical ventilation, vasopressor therapy, and ICU admission was significantly higher among patients with high NLR and PLR (P  = 0.000). We observed a significantly higher proportion of mortality among patients with high NLR (69.5%) and PLR (87.4%) (P  = 0.000). The NLR > 3.42, PLR > 172.5, and their combinations were significant predictors of mortality, showing area under curves above 0.94. Utilizing a combination of NLR and PLR yielded a modestly improved performance as a mortality predictor with a slight increase in the Youden index (0.81). The high NLR and high PLR groups had mean survival times of 28.851 and 16.256 h respectively. Conclusion These findings suggest that high NLR and PLR are associated with a worse prognosis and a higher mortality risk among patients with acute AlP poisoning. [ABSTRACT FROM AUTHOR]

Abstract Background This study investigates the role of Delta Neutrophil Index (DNI), an inflammation marker, in late-onset fetal growth restriction (LO-FGR) and its prediction of composite adverse neonatal outcomes. Methods A retrospective study was conducted on 684 pregnant women (456 with normal fetal development and 228 with LO-FGR) who delivered at Health Sciences University Etlik Zubeyde Hanim Women’s Health Training and Research Hospital between January 1, 2015, and June 30, 2018. Composite adverse neonatal outcomes were defined as at least one of the following: 5th minute APGAR score -2.9, yielding a sensitivity of 78.41%, a specificity of 52.97%, a positive likelihood ratio (+ LR) of 1.68, and a negative likelihood ratio (-LR) of 0.37 (p -2.2, a sensitivity of 69.90%, a specificity of 55.36%, a + LR of 1.56, and a -LR of 0.51 (p

Purpose: Patients presenting with ureteral stones and concurrent urinary tract infections require prompt kidney drainage as per standard care guidelines. However, even in patients who are promptly drained and treated with appropriate antibiotics, the mortality rate due to urosepsis has been reported to be nearly 9%. Therefore, Predictive tools for early sepsis detection have become essential. The Neutrophil-to-Lymphocyte Ratio (NLR) and Platelet-to-Lymphocyte Ratio (PLR) are potential biomarkers for predicting infection risk in these patients. Methods: A retrospective cohort analysis involving patients diagnosed with obstructing ureteral stones who underwent urgent stent placement due to suspected urinary tract infection (UTI) in the emergency room (ER) was conducted. The baseline characteristics of patients were age, sex, comorbidities, and urological history. Laboratory data collected during hospitalization included total leukocyte and platelet counts and blood cultures. Ratios were calculated from the serum studies obtained upon admission to the ER. A logistic regression model was utilized to predict the incidence of positive qSOFA score (sepsis prediction score), the need for vasopressors, intensive care unit (ICU) admission, and sepsis, using NLR and PLR as independent variables. Results: Between January 2016 and December 2020, 143 patients with a diagnosis of obstructing ureteral stone were admitted to the ER with a suspected UTI. 11.9% showed a positive qSOFA score, 20.3% required vasopressor support for > 1 h after ureteral stent placement, 28.7% required ICU admission, and 16.8% met sepsis criteria. Sepsis was defined as patients who were qSOFA positive and vasopressors needed for more than 1 h following stent placement. Logistic regression analysis revealed that PLR and positive blood cultures correlated significantly with positive qSOFA scores. Using logistic regression analysis, PLR, NLR, and positive blood culture were each independent predictors of vasopressor requirements, ICU admission, and urosepsis. Conclusions: NLR and PLR may be valuable prognostic markers for predicting urosepsis risk in urolithiasis patients who present with obstructing stones and concern for systemic infection. Their utility may be in helping clinicians in early risk stratification, prompt intervention, and resource allocation. [ABSTRACT FROM AUTHOR]

Background and objectives: Following nephrectomy with curative intent, a subset of patients diagnosed with non-metastatic renal cell carcinoma (nmRCC) will present late recurrences, with metastatic relapses after 5 years from the surgical intervention. The aim of this study is to evaluate the prevalence of late recurrences in Romanian patients with nmRCC that have undergone surgery and to assess the clinicopathological characteristics prognostic for late-relapse RCC. Materials and methods: This is a single-center, retrospective and observational study that analyzed patients with nmRCC with clear cell histology who underwent surgical resection of the primary tumor with curative intent. The patients included in the study were treated and further surveilled according to a personalized follow-up plan between January 2011 and December 2012 in The Oncology Institute "Prof. Dr. Ion Chiricuţă", Cluj-Napoca, Romania. Study endpoints included median disease-free survival (DFS), median overall survival (OS), as well as evaluation of possible prognostic factors indicative of late relapse. Results: In the study cohort (n=51), the median DFS was 46 months and median OS was 130 months. DFS was significantly correlated with the International Metastatic Renal Cell Carcinoma Database Consortium (IMDC) score (p=0.04, HR=2.48; 95% CI [1.02, 6.01]), neutrophil to lymphocyte ratio (NLR) (a higher NLR value was associated with a poorer DFS, p=0.035), tumor size (T4 tumors vs. T1 p<0.05, HR=9,81; 95% CI [2.65, 36.27]) and Fuhrman nuclear grade (Fuhrman grade 1 vs. Fuhrman grade 3 p<0.05, HR=4,16; 95% CI = [1.13,15.22]). Fifty one percent of the patients included experienced disease relapse. From this subgroup, a significant percentage of 42% patients presented disease recurrence after 60 months from nephrectomy. OS was correlated to IMDC score (p=0.049, HR=2.36; 95% CI [1, 5.58]) and Fuhrman nuclear grade (Fuhrman grade 1 vs. Fuhrman grade 3 p<0.05, HR=3,97; 95% CI [1.08, 14.54]). Conclusions: The results of this study support the previously presented biological behavior of RCC, demonstrating that late recurrences in RCC are not uncommon occurrences and patients with localized RCC should be followed up for a longer interval after the surgery for the primary tumor. In addition, the study strengthens the data supporting certain biomarkers as valuable prognostic factors determining survival outcomes of patients with RCC. [ABSTRACT FROM AUTHOR]

Background: This study investigates the role of Delta Neutrophil Index (DNI), an inflammation marker, in late-onset fetal growth restriction (LO-FGR) and its prediction of composite adverse neonatal outcomes. Methods: A retrospective study was conducted on 684 pregnant women (456 with normal fetal development and 228 with LO-FGR) who delivered at Health Sciences University Etlik Zubeyde Hanim Women's Health Training and Research Hospital between January 1, 2015, and June 30, 2018. Composite adverse neonatal outcomes were defined as at least one of the following: 5th minute APGAR score < 7, respiratory distress syndrome (RDS), or neonatal intensive care unit (NICU) admission. Results: The FGR group had significantly higher levels of neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), monocyte to lymphocyte ratio (MLR), and DNI compared to controls (p < 0.05, for all). For FGR diagnosis, the DNI demonstrated the highest area under the curve (AUC = 0.677, 95% CI: 0.642–0.711) with a cut-off value of > -2.9, yielding a sensitivity of 78.41%, a specificity of 52.97%, a positive likelihood ratio (+ LR) of 1.68, and a negative likelihood ratio (-LR) of 0.37 (p < 0.001). For predicting composite adverse neonatal outcomes in the FGR group, DNI again demonstrated superior performance with an AUC of 0.635 (95% CI: 0.598–0.670), a cut-off value of > -2.2, a sensitivity of 69.90%, a specificity of 55.36%, a + LR of 1.56, and a -LR of 0.51 (p < 0.001). NLR, PLR, and MLR had AUCs below 0.55, indicating poor discriminative ability, with none reaching statistical significance. Conclusion: This study highlights the potential role of DNI as a promising biomarker for detecting inflammatory processes associated with LO-FGR and its complications. [ABSTRACT FROM AUTHOR]

Background: Repeated polyserositis, another name for familial Mediterranean fever (FMF), is an autoimmune disorder with an autosomal recessive nature primarily characterized by short-lived repeated periods of peritonitis, pleuritis, and arthritis, generally accompanied by fever. Methods: Our participants were divided into two groups. Group I (patients): 100 individuals who were diagnosed as patients with FMF and were monitored. Group II (control): matched- healthy individuals (100 controls). They were compared and followed up as regards demographic, clinical, and laboratory data: routine investigations, neutrophil/lymphocyte ratio (NLR), platelet lymphocyte ratio (PLR), and mean platelet volume (MPV), red cell distribution width (RDW), C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR). Results: Group I: MPV mean was 12.03 ± 2.89, whereas group II MPV mean was 7.74 ± 0.57. MPV was significantly statistically greater in group I than in group II. RDW mean in group I was 17.07 ± 1.39 and in group II was 12.92 ± 0.63. RDW was also significantly statistically greater in group I compared with group II. Group I's NLR mean was 3.05 ± 0.71, whereas group II's NLR mean was 1.75 ± 0.2. PLR mean in group I was 164.8 ± 122.8 and in group II was 111.26 ± 29.16. Conclusion: A statistically significant association was shown between the diagnosis of adult FMF and NLR, PLR, MPV, and RDW. [ABSTRACT FROM AUTHOR]

Inflammation is a complex physiological process that plays a pivotal role in many if not all pathological conditions, including infectious as well as inflammatory diseases, like periodontitis and autoimmune disorders. Inflammatory response to periodontal biofilms and tissue destruction in periodontitis is associated with the release of inflammatory mediators. Chronic inflammation can promote the development of cancer. Persistence of inflammatory mediators plays a crucial role in this process. Quantification and monitoring of the severity of inflammation in relation to cancer is essential. Periodontitis is mainly quantified based on the severity and extent of attachment loss and/or pocket probing depth, in addition with bleeding on probing. In recent years, studies started to investigate inflammation indices in association with periodontal diseases. To date, only few reviews have been published focusing on the relationship between blood cell count, inflammation indices, and periodontitis. This review presents a comprehensive overview of different systemic inflammation indices, their methods of measurement, and the clinical applications in relation to periodontitis and cancer. This review outlines the physiological basis of inflammation and the underlying cellular and molecular mechanisms of the parameters described. Key inflammation indices are commonly utilized in periodontology such as the neutrophil to lymphocyte ratio. Inflammation indices like the platelet to lymphocyte ratio, platelet distribution width, plateletcrit, red blood cell distribution width, lymphocyte to monocyte ratio, delta neutrophil index, and the systemic immune inflammation index are also used in hospital settings and will be discussed. The clinical roles and limitations, relationship to systemic diseases as well as their association to periodontitis and treatment response are described. [ABSTRACT FROM AUTHOR]

Background: Recent evidence links the prognosis of traumatic brain injury (TBI) to various factors, including baseline clinical characteristics, TBI specifics, and neuroimaging outcomes. This study focuses on identifying risk factors for short-term survival in severe traumatic brain injury (sTBI) cases and developing a prognostic model. Methods: Analyzing 430 acute sTBI patients from January 2018 to December 2023 at the 904th Hospital's Neurosurgery Department, this retrospective case–control study separated patients into survival outcomes: 288 deceased and 142 survivors. It evaluated baseline, clinical, hematological, and radiological data to identify risk and protective factors through univariate and Lasso regression. A multivariate model was then formulated to pinpoint independent prognostic factors, assessing their relationships via Spearman's correlation. The model's accuracy was gauged using the Receiver Operating Characteristic (ROC) curve, with additional statistical analyses for quantitative factors and model effectiveness. Internal validation employed ROC, calibration curves, Decision Curve Analysis (DCA), and Clinical Impact Curves (CIC) to assess model discrimination, utility, and accuracy. The International Mission for Prognosis and Analysis of Clinical Trials in TBI (IMPACT) and Corticosteroid Randomization After Significant Head injury (CRASH) models were also compared through multivariate regression. Results: Factors like unilateral and bilateral pupillary non-reactivity at admission, the derived neutrophil to lymphocyte ratio (dNLR), platelet to lymphocyte ratio (PLR), D-dimer to fibrinogen ratio (DFR), infratentorial hematoma, and Helsinki CT score were identified as independent risk factors (OR > 1), whereas serum albumin emerged as a protective factor (OR < 1). The model showed superior predictive performance with an AUC of 0.955 and surpassed both IMPACT and CRASH models in predictive accuracy. Internal validation confirmed the model's high discriminative capability, clinical relevance, and effectiveness. Conclusions: Short-term survival in sTBI is significantly influenced by factors such as pupillary response, dNLR, PLR, DFR, serum albumin levels, infratentorial hematoma occurrence, and Helsinki CT scores at admission. The developed nomogram accurately predicts sTBI outcomes, offering significant clinical utility. [ABSTRACT FROM AUTHOR]

Purpose: 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. [ABSTRACT FROM AUTHOR]

Introduction: Diagnosing acute appendicitis in paediatric patients remains a challenge. Various diagnostic tools have been proposed to be used in predicting acute appendicitis including scoring, radiology, and laboratory tests. Objective: We plan to study Neutrophil to Lymphocyte Ratio (NLR) and Platelet to Lymphocyte Ratio (PLR) as laboratory markers in predicting acute appendicitis. Method: Paediatric patients diagnosed with appendicitis were studied retrospectively. Control group was taken from hypospadia and undescendent testis patients whose blood tests were taken before surgery. A total of 124 patients were included, consisting of 69 patients in appendicitis group and 55 patients in control group. Result: There is significant comparison in NLR (p=0.000) and PLR (p=0.000) between appendicitis and control group. Area Under the Curve for NLR as a diagnostic tool was found to be 0.954. Cut-off point was found at 2.83 with 85% sensitivity and 96% specificity. Area Under the Curve for PLR as a diagnostic tool was found to be 0.858. Cut-off point was found at 123.9 with 87% sensitivity and 73% specificity. Conclusion: We suggest that NLR and PLR are reliable laboratory tests in predicting appendicitis. Further studies in bigger populations are required. [ABSTRACT FROM AUTHOR]

Introduction: Biomarkers that help to evaluate the immune system and could be useful in multiple sclerosis (MS) are the neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), and systemic immune‐inflammatory index (SII). The objective of this work is to evaluate the significance of the SII index, PLR, and NLR before and after transplantation in individuals with MS who underwent autologous hematopoietic stem cell transplant (aHSCT) at a single institution. Methods: Patients with MS who received an aHSCT between 2017 and 2022 were included in the study. NLR, PLR, and SII index were calculated prior to the transplant and 100 days after, and evaluation of the expanded disability status scale (EDSS) was done before the transplant and 12 months after. The cohort was divided into two groups: aHSCT responders (R) and nonresponders (NR). Results: Fifty‐eight individuals were examined: 37 patients in the responders group R group and 21 in NR group. There was no statistically significant difference in the SII, NLR, and PLR prior to the transplant, however at 100 days post‐HSCT, NLR in the R group was 1.8 versus 3.1 in the NR group (p = 0.003), PLR was 194 versus 295, respectively (p = 0.024), meanwhile SII index was 489.5 versus 729.3 (p < 0.001). Conclusion: High NLR and SII index values after the aHSCT were associated with a worsening in the EDSS score. However, since this is the first ever study that compared NLR and SII index with the aHSCT response in persons with MS, further studies must be performed to corroborate this information. [ABSTRACT FROM AUTHOR]

Abstract Background Hemogram indices are simple, economic indicators of the systemic inflammation characteristic of autoimmune diseases including vasculitides. The clinical utility of hemogram indices in hepatitis C virus-related vasculitis (HCV-V) has not been established. This study aimed to evaluate neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), neutrophil/hemoglobin ratio (NHR), platelet/hemoglobin ratio (PHR), and systemic immune-inflammation index (SII) as potential biomarkers of HCV-V, and their relationship with disease activity. This cross-sectional case–control study was conducted in the departments of Rheumatology and Rehabilitation and Hepatogastroenterology, at Cairo University Hospital. Patients with HCV-V, patients with HCV infection free from extrahepatic manifestations (HCV sine vasculitis), and healthy control subjects were recruited. HCV-V activity was assessed using the Birmingham Vasculitis Activity Score (BVAS). Results Twenty-four HCV-V patients, 21 HCV sine vasculitis patients, and 40 healthy controls were recruited. Age and sex distribution was similar across groups. In HCV-V patients, NLR, PLR, NHR, and SII were higher than healthy controls, with NLR (area under curve (AUC) 0.94, p = 0.002), PLR (AUC 0.72, p = 0.007), NHR (AUC 0.89, p

Background: Hemodialysis (HD) is the treatment of end-stage renal disease (ESRD), which leads to increased inflammation and mortality. This study aimed to investigate the relationship of neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) with high sensitivity C-reactive protein (hs-CRP) levels to predict inflammatory conditions in HD patients. Materials and Methods: A total of 100 eligible maintenance HD patients referred to 22 Bahman and 17 Shahrivar hospitals in Mashhad were enrolled in this cross-sectional study. We collected demographic and clinical data, as well as values of inflammatory markers such as NLR, PLR, and hs-CRP, from the patient’s medical records. Results: Forty-six of the patients were female. The mean age of the patients was 37.96±10.29 years, and the mean duration of HD was 54.32±50 months. The mean hs-CRP levels, NLR, and PLR were 6.08±5.70 mg/L, 2.79±1.18, and 125.80±57.14, respectively. The results showed a statistically significant and direct relationship between PLR and hs-CRP levels (P=0.01). There was no correlation between NLR and hs-CRP levels (P=0.8). Additionally, PLR was inversely correlated with hs-CRP in hypertensive patients (r=-0.283, P=0.04), female patients (r=0.3, P=0.04), and patients with HD duration of less than five years (r=0.3, P=0.001). Conclusion: Based on these findings, the PLR is a useful inflammatory marker in HD patients with ESRD that correlates with hs-CRP levels. We recommend further investigations to establish its accuracy in clinical care.

Background: Hemogram indices are simple, economic indicators of the systemic inflammation characteristic of autoimmune diseases including vasculitides. The clinical utility of hemogram indices in hepatitis C virus-related vasculitis (HCV-V) has not been established. This study aimed to evaluate neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), neutrophil/hemoglobin ratio (NHR), platelet/hemoglobin ratio (PHR), and systemic immune-inflammation index (SII) as potential biomarkers of HCV-V, and their relationship with disease activity. This cross-sectional case–control study was conducted in the departments of Rheumatology and Rehabilitation and Hepatogastroenterology, at Cairo University Hospital. Patients with HCV-V, patients with HCV infection free from extrahepatic manifestations (HCV sine vasculitis), and healthy control subjects were recruited. HCV-V activity was assessed using the Birmingham Vasculitis Activity Score (BVAS). Results: Twenty-four HCV-V patients, 21 HCV sine vasculitis patients, and 40 healthy controls were recruited. Age and sex distribution was similar across groups. In HCV-V patients, NLR, PLR, NHR, and SII were higher than healthy controls, with NLR (area under curve (AUC) 0.94, p = 0.002), PLR (AUC 0.72, p = 0.007), NHR (AUC 0.89, p < 0.001) and SII (AUC 0.92, p < 0.001) discriminating both groups. PHR correlated with BVAS (r = 0.53, p = 0.007) while NHR correlated with ESR (r = 0.55, p = 0.007). NLR, NHR, and SII were higher in HCV-V than HCV sine vasculitis patients, with NHR (AUC 0.74, p = 0.022) and SII (AUC 0.75, p = 0.038) discriminating in both groups. Conclusion: Hemogram indices are useful biomarkers of HCV-V. Longitudinal studies are recommended to explore the predictive power of HCV-infected patients developing vasculitis and their potential relationship with therapeutic response and disease relapse. [ABSTRACT FROM AUTHOR]

Objective To establish the derived indicators from blood cell analysis of the elderly in Anning region of Yunnan province, lymphocyte to monocyte ratio (LMR), neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR) reference interval, Observed differences from multicenter surveys, To determine the necessity to establish this reference interval. Methods The analysis results of people above 60 years old for physical examinations in the information system of Anning First People’s Hospital from June 2022 to September 2022 were collected retrospectively. The biological reference interval for healthy elderly people in Anning City was established according to the indirect method in the international CLSI EP28-A3c guidelines. Results A total of 8 877 cases were included. Red blood cell count (RBC), hemoglobin (HGB), hematocrit (HCT), mean red blood cell hemoglobin concentration (MCHC), platelet count (PLT), and lymphocyte percentage (LYM%) decreased with age, and the difference between men and women was statistically significant ( P < 0.05) . Only the broadband coefficient of variation of red blood cell volume distribution (RDWCV) increased with age. White blood cell count (WBC), absolute value of neutrophils (NEU#), absolute value of eosinophils (EOS#), percentage of neutrophils (NEU%), percentage of eosinophils (EOS%), mean red cell volume (MCV), standard deviation of red blood cell volume distribution width (RDWSD), platelet volume distribution width (PDW) were statistically significant only between men and women (P < 0.05), while the remaining items were not significant by age and sex (P > 0.05). NLR increased with age, and men were significantly higher than women of the same age. Both LMR and PLR were higher in females than in males. Conclusion The results of WBC, RBC, HGB, PLT and HCT in the self-built reference interval were quite different from the reference interval of the multi-center survey. [ABSTRACT FROM AUTHOR]

Introduction: Neutrophil/lymphocyte ratio (NLR) and platelet/ lymphocyte ratio (PLR) are readily available and inexpensive biomarkers that have received great attention for diagnosing type 2 diabetes(T2DM) complications. The objective of the present cross-sectional study was to compare diagnostic values of these biomarkers with C-reactive protein(CRP) in detecting diabetic foot ulcer (DFU) and osteomyelitis (OS) and discriminating between the degree of DFU according to Wagner's classification. Methods: A total of 217 individuals (42 healthy controls, 40 T2DM patients without DFU, and 135 patients with DFU) were enrolled. The DFU patients were classified according to Wagner's classification into grade 1, grade 2, and grade 3. Blood samples were obtained and various biochemical and hematological parameters including creatine, CRP, HbA1c, NLR, and PLR were measured. Results: The levels of CRP, PLR, and NLR were significantly higher in the patients with DFU and OS compared to healthy controls and T2DM patients without DFU. The median values of CRP were correlated with the severity of DFU and increased with DFU grades. The highest values of CRP, NLR, and PLR were observed in the DFU patients with OS which were significantly higher than those of DFU patients with grades 1 and 2 as well as T2DM patients without DFU. The PLR and NLR had no significant performance in diagnosing DFU patients with grades 1 and 2 from the patients without DFU. Conclusion: NLR and PLR could be useful for diagnosing OS but cannot be used for detecting lower grades of DFU. CRP showed higher performance in detecting OS compared to PLR and NLR. [ABSTRACT FROM AUTHOR]

Background and objectivesFollowing nephrectomy with curative intent, a subset of patients diagnosed with non-metastatic renal cell carcinoma (nmRCC) will present late recurrences, with metastatic relapses after 5 years from the surgical intervention. The aim of this study is to evaluate the prevalence of late recurrences in Romanian patients with nmRCC that have undergone surgery and to assess the clinicopathological characteristics prognostic for late-relapse RCC.Materials and methodsThis is a single-center, retrospective and observational study that analyzed patients with nmRCC with clear cell histology who underwent surgical resection of the primary tumor with curative intent. The patients included in the study were treated and further surveilled according to a personalized follow-up plan between January 2011 and December 2012 in The Oncology Institute "Prof. Dr. Ion Chiricuţă", Cluj-Napoca, Romania. Study endpoints included median disease-free survival (DFS), median overall survival (OS), as well as evaluation of possible prognostic factors indicative of late relapse.ResultsIn the study cohort (n=51), the median DFS was 46 months and median OS was 130 months. DFS was significantly correlated with the International Metastatic Renal Cell Carcinoma Database Consortium (IMDC) score (p=0.04, HR=2.48; 95% CI [1.02, 6.01]), neutrophil to lymphocyte ratio (NLR) (a higher NLR value was associated with a poorer DFS, p=0.035), tumor size (T4 tumors vs. T1 p

Previous studies have suggested that alopecia areata (AA) is an organ-specific disease characterized by loss of immune privilege of hair follicles. However, an increasing body of research indicates that it not only affects the skin but may also be accompanied by systemic inflammatory reactions. Therefore, searching for simple and easily available biomarkers to describe the underlying systemic inflammation in AA patients is of great clinical significance. Complete blood collection-based systemic inflammation biomarkers have been shown to be associated with the severity and prognosis of various skin and autoimmune diseases. They involve multiple cell lineages and can reveal different pathways of immune-inflammatory responses. The aim of this study was to investigate the level of complete blood collection-based systemic inflammation biomarkers in patients with AA, and to analyse their relationship with the disease severity. A total of 302 AA patients and 296 healthy controls were included in this study and the neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), systemic immune inflammation index (SII), and white blood cell/lymphocyte ratio (WLR) were calculated. The differences in these indicators between the 2 groups were compared, and the relationship between NLR, PLR, SII, WLR, and the risk of severe AA were analysed. AA patients had higher NLR, SII, and WLR compared with healthy controls (p = 0.004, 0.002, and 0.002 respectively). PLR and SII were higher in the severe AA group compared with the mild-to-moderate AA patients (p = 0.005 and 0.011 respectively). The risk of severe AA increased with the increasing of PLR, SII, NLR, and WLR (p for trend was 0.001, 0.006, 0.022, and 0.021, respectively). The levels of systemic inflammation biomark-ers in AA patients are higher than in healthy people. NLR, PLR, SII, and WLR are risk factors for severe AA, suggesting a close association between systemic inflammation and disease occurrence in AA patients.

BackgroundWe conducted a large-scale epidemiological analysis to investigate the associations between systemic inflammation markers and heart failure (HF). Our aim is to identify potential biomarkers for early detection of HF.MethodsA cross-sectional study was conducted using data from the National Health and Nutrition Examination Survey. We investigated the associations between five systemic inflammation markers (neutrophil to lymphocyte ratio [NLR], platelet to lymphocyte ratio [PLR], systemic immune inflammation index [SII], system inflammation response index [SIRI], and aggregate index of systemic inflammation [AISI]) and the risk of HF.ResultsThe prevalence rates of HF exhibited a gradual increase across increasing logNLR, logPLR, logSII, logSIRI, and logAISI tertiles. Compared to those in the highest tertiles of logNLR, logSII, logSIRI, and logAISI had a 1.579-fold, 1.341-fold, 1.956-fold, and 1.499-fold increased risk of HF compared to those in the lowest tertile respectively. Conversely, there was no significant correlation between logPLR and HF risk among subjects in the highest tertile. The restricted cubic splines (RCS) analysis revealed a non-linear relationship between the elevation of systemic inflammation markers and HF prevalence. Specifically, a per standard deviation increase in any of these variables is associated with a respective 45%, 29%, 28%, 44% and 29% increase in HF prevalence. The receiver operating characteristic (ROC) analysis demonstrated favorable sensitivity and specificity of these systemic inflammation markers in detecting the presence of HF.ConclusionOur cross-sectional study demonstrates significant positive correlations between the NLR, PLR, SII, SIRI, and AISI with the incidence of HF.

Abstract Background Increasing evidence has showed that inflammatory biomarkers, including neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR) and fibrinogen can be used as predictors in the prognosis of esophageal squamous cell carcinoma (ESCC). The aim of this study was to explore prognostic value of these biomarkers and evaluate the clinicopathological and prognostic significance of combined score based on plasma fibrinogen and platelet-lymphocyte ratio (F-PLR score). Methods A total of 506 patients with ESCC were enrolled in this study. Harrell’s concordance index (c-index) was used to determine the optimal cut-off values of these markers and evaluate their prognostic significance. The relationship between factors with survival rates (including overall survival [OS] and disease-free survival [DFS]) was explored by Kaplan-Meier curve, univariate analysis and multivariate cox hazard analysis. Results Our result indicated that high F-PLR score was significantly associated with longer tumor length and deeper depth of tumor invasion (p

Objective: To determine whether postmenopausal status is associated with elevated plasma inflammatory markers ferritin, neutrophil to lymphocyte ratio NLR, platelet to lymphocyte ratio PLR) compared to premenopausal status in women with type 2 diabetes mellitus and to establish a correlation between inflammatory markers and glycemic status in pre-and post-menopausal diabetic women. Methods: A total of 80 participants aged 25-75 were recruited, from January 2024 to April 2024 and were divided into pre-and postmenopausal groups (Group I and II respectively) based on history using convenient sampling. Clinical assessments included general physical exams and BMI calculations. The biochemical analysis involved measuring Glycosylated haemoglobin (HbA1c), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and ferritin levels. The study examined the inflammatory profiles linked to menopausal status in diabetic patients. Results: HBA1c levels were significantly higher (P < 0.05)in Group I than in Group 2 (median 9.35 [interquartile range: 8.0 – 10.4] versus 7.10 [interquartile range: 6.42 – 8.37] Also serum ferritin levels in Group I were significantly higher (P < 0.05) as compared to Group II (median 173 [interquartile range: 100-190] versus 35.14 [interquartile range: 8.12 – 52.75]. PLR showed significant differences (P < 0.05) between the two groups, the ratio being higher in Group II as compared to Group I (median 108 [interquartile range: 85.38-132.77] versus 74.10 [interquartile range: 69.88-85.12]There was significant negative association between HbA1C and ferritin in both premenopausal and postmenopausal diabetic patients. However, there is no significant correlation between HbA1C and NLR or PLR in either group. Conclusion: The interaction between menopause and T2DM affected the platelet-to-lymphocyte ratio but not the neutrophil)to-lymphocyte ratio. Also, ferritin levels are decreased in postmenopausal diabetic women. Further, glycemic status is not the only risk factor for predicting inflammation in diabetics, other risk factors have to be catered to evaluate the inflammation status of diabetic pre and postmenopausal females. [ABSTRACT FROM AUTHOR]

Objective To explore the correlation between neutrophil-to-lymphocyte ratio (NLR) and Behcet’s disease (BD) activity. Methods A total of 103 BD patients were divided into the low activity group (0-4, 61 cases) and the high activity group (5-11, 42 cases) according to electronic medical record-based disease activity index (EMRAI) score. The white blood cell (WBC), neutrophil (NEU), lymphocyte (LY), platelet (PLT), red blood cell (RBC), hemoglobin (Hb), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), IgG, IgA, IgM, complement C3 and C4 were detected. NLR and platelet-to-lymphocyte ratio (PLR) were calculated. The correlation between NLR, PLR and ESR, CRP, EMRAI were analyzed. Logistic regression was used to analyze the influencing factors of BD disease activity. Receiver operating characteristic (ROC) curve was drawn to evaluate the effectiveness of NLR in judging BD disease activity. Results WBC, NEU, PLT, ESR, CRP, NLR, PLR, complement C3 and C4 in patients were higher in the high activity group than those in the low activity group (P＜0.05), and there were no significant differences in other indexes (P＞0.05). NLR was positively correlated with ESR, CRP and EMRAI in the whole group, while PLR was positively correlated with ESR, CRP and EMRAI in the whole group (P＜0.05). Logistic regression analysis showed that high NLR was a risk factor for BD disease activity (OR=1.511, 95%CI: 1.080-2.113, P＜0.05). ROC curve analysis showed that the area under the curve (AUC) of NLR in evaluating BD disease activity was 0.706 (95%CI: 0.603-0.809). Conclusion NLR is effective in judging the disease activity of BD patients, and can be used as a biological index to evaluate the disease activity of BD. [ABSTRACT FROM AUTHOR]

Background: Neuromyelitis optica spectrum disorder (NMOSD) is a complex neuroinflammatory disease characterized by severe disability. In this study, we investigated the relationship between cerebrospinal fluid (CSF)/serum albumin quotient (Qalb) and platelet to lymphocyte ratio (PLR) in assessing disease severity. Method: A retrospective analysis of 72 NMOSD patients and 72 healthy controls was conducted, and patients were divided into two groups based on their Expanded Disability Status Scale (EDSS) scores. Results: NMOSD patients had significantly higher levels of serum PLR, neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), and C-reactive protein (CRP) compared to healthy controls (all P<0.01). Patients in the EDSS≥4 group exhibited significantly elevated levels of Qalb, QIgG, QIgA, QIgM, and PLR (P=0.000, P<0.0001, P=0.0019, P=0.0001, respectively). Spearman's correlation test revealed significant positive associations between Qalb, QIgG, QIgA, QIgM, PLR, and EDSS score. Specifically, Qalb (r=0.571; P<0.001), QIgG (r=0.551; P<0.001), QIgA (r=0.519; P<0.001), and QIgM (r=0.541; P<0.001) demonstrated significant positive correlations with EDSS score, while PLR exhibited a moderate positive correlation (r=0.545; P<0.001) with EDSS score and a mild positive association (r=0.387; P<0.001) with Qalb. The increase of Qalb was positively correlated with the increased EDSS score (r=0.528, P=0.001), as well as the increase of QIgG (r=0.509, P=0.001), and the increase of QIgA (r=0.4989, P=0.03). ROC analysis indicated that Qalb, QIgG, QIgA, QIgM, and PLR levels could effectively serve as indicators of NMOSD severity (all P<0.0001). Multivariate analysis confirmed the independent significance of Qalb and PLR in assessing disease severity (P=0.000). Conclusion: These findings provide valuable insights into the risk and pathogenesis of NMOSD and highlight the potential of Qalb and PLR as independent markers for disease severity assessment in NMOSD patients. [ABSTRACT FROM AUTHOR]

BackgroundInflammation is considered to play an important role in chronic obstructive pulmonary disease (COPD) and acute myocardial infarction (AMI), but the relationship between inflammation and poor prognosis in these patients has not yet been studied.MethodsWe enrolled AMI patients combined with COPD and divided them into three groups according to the tertiles of neutrophil-to-lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR) and monocyte to lymphocyte ratio (MLR) respectively. Logistic regression analyses were used to identify risk factors for in-hospital all-cause death in these patients. Covariates were adjusted stepwise to determine the association between inflammatory markers and poor prognosis. Also, the receiver operating characteristic (ROC) curve was used to evaluate the greatest predictive indicator for all-cause death.ResultsA total of 281 AMI patients combined with COPD were enrolled, of which 31 experienced in-hospital mortality. The risk of all-cause death was significantly higher among those with higher NLR. The highest tertile of NLR was significantly associated with an increased risk of all-cause death (all P

Abstract Background Chronic kidney disease (CKD) is a progressive failure of renal function with ongoing systemic inflammation. Inflammatory markers such as neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), and proteinuria were documented as independent predictors of CKD progression. Although proteinuria estimated by the protein to creatinine ratio (UPCR) is generally employed to screen the disease progression of CKD, the correlation of NLR and PLR with different stages of CKD is yet to be studied. Consequently, this study strived to find the stage-wise correlation between NLR and PLR with proteinuria in CKD patients. Methods Eighty-five CKD patients with proteinuria who visited the Nephrology Clinic at Teaching Hospital Jaffna, Sri Lanka, were randomly selected and categorized as stages II to IV based on the estimated glomerular filtration rate (e-GFR). Blood samples were collected and subjected to investigate patients’ NLR and PLR. Furthermore, urine protein and creatinine were measured and UPCR was calculated. Participants’ demographic, clinical, and laboratory data were obtained from patients’ clinical registry. Spearman’s rank correlation and receiver operative characteristic (ROC) curve analysis was done, and the p value

Objective To investigate the relationship of neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) with early renal damage in pre-eclampsia (PE) patients. Methods A total of 98 PE patients (PE group) and 113 patients with gestational hypertension (GH, GH group) admitted to our hospital from January 2020 to February 2022 were recruited, and another 68 healthy pregnant women who underwent regular pregnancy examination in our hospital were enrolled as control group. Serum NLR, PLR, and renal function indicators [urea nitrogen (BUN), serum creatinine (Scr), cystatin C (Cys-C) and estimate glomerular filtration rate (eGFR)] were recorded in the 3 groups. According to whether renal injury occurred, the patients of the PE group were divided into non-renal injury subgroup (56 cases) and renal injury group (42 cases). The relationships of NLR and PLR with renal function indicators were analyzed, and the results were further analyzed for the risk factors. The predictive values of NLR and PLR for early renal injury in PE patients were analyzed. Results The levels of NLR, BUN, Scr, Cys-C and 24-h urine protein were significantly higher in the GH group and the PE group than the control group(P < 0.05), and those in the PE group were obviously higher than those in the GH group (P < 0.05). The levels of PLR and eGFR were statistically lower in the GH group and PE group than those in the the control group, and that in the PE group was decreased than that in the GH group (P < 0.05). Pearson correlation analysis showed that NLR was positively correlated with BUN, Scr, Cys-C and 24-h urine protein, and negatively with eGFR, while PLR was negatively correlated with above renal function indicators, and positively with eGFR. Multivariate analysis indicated that severe PE, NLR, PLR, 24-h urine protein and eGFR were the main risk factors for early renal injury in PE patients (P < 0.05). Receiver operating characteristic (ROC) curve analysis showed that the cut-off values of NLR and PLR for predicting early renal injury in PE patients were 2.71 and 103.26, the area under the curve value was 0.896 and 0.809, the sensitivity was 93.28 % and 90.81 %, and the specificity was 80.17% and 80.01%, respectively. Conclusion Elevated levels of NLR and PLR are associated with early renal damage in PE patients, and they are risk factors and have high predictive values for early kidney damage in PE patients.

Wenbin Lu,&ast; Shengwei Lin,&ast; Cheng Wang, Peipei Jin, Jinjun Bian Faculty of Anesthesiology, Changhai Hospital, Naval Medical University/Second Military Medical University, PLA, Shanghai, 200433, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Peipei Jin; Jinjun Bian, Faculty of Anesthesiology, Changhai Hospital, Naval Medical University, 168, Changhai Road, Shanghai, 200433, People’s Republic of China, Tel/Fax +86-021-31161886 ; +86-021-31161841, Email kingpei89@163.com; jinjunbicu@163.comPurpose: To explore the relationship between the systemic inflammation response index (SIRI) and postoperative delirium (POD) in older patients with hip arthroplasty surgery.Patients and Methods: Older patients who underwent elective hip arthroplasty surgery were included in this retrospective study. SIRI, neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) were collected from blood routine examination at admission. Binary logistic regression analysis was performed to evaluate the association between SIRI levels and POD was analyzed.Results: Ultimately, 116 older patients who met the inclusion criteria were assessed. Thirty-four (29%) of 116 patients diagnosed with POD were defined as the POD group, and the rest consisted of the Non-POD group. Compared with non-POD patients, POD patients showed significantly higher levels of SIRI (P < 0.001) and NLR (P = 0.002) at admission. There was no significance in the levels of PLR between two groups. SIRI was independently associated with the occurrence of POD in multivariate logistic regression analysis [odds ratio (OR) = 3.34, 95% confidence interval (95% CI) = 1.26– 8.85, P = 0.016]. Receiver operating characteristic curve analysis indicated that SIRI with an optimal cutoff value of 0.987 predicted the POD with a sensitivity of 88.2% and specificity of 74.4%, and the area under the curve was 0.82 (95% CI, 0.74– 0.90, P < 0.01).Conclusion: Preoperative SIRI and NLR levels in the blood are associated with the occurrence of POD. Moreover, preoperative SIRI level is a useful candidate biomarker to identify delirium after elective hip arthroplasty surgery in older patients.Keywords: geriatric, hip arthroplasty, neutrophil to lymphocyte ratio, postoperative delirium, platelet to lymphocyte ratio, systemic inflammation response index

Background Important predictive value of platelet-lymphocyte ratio (PLR) for adverse outcomes of cardiovascular disease has been proved in previous studies, however, the predictive value of PLR for short-term prognosis in elderly patients with acute myocardial infarction (AMI) remains to be explored. Objective To determine the predictive ability of PLR for mortality risk during hospitalization in elderly patients with AMI. Methods The medical history data of 1 423 elderly patients with AMI treated in the Department of Cardiology of the Second Hospital of Dalian Medical University from December 2015 to December 2021 was retrospectively collected, mainly including gender, age, BMI, blood pressure classification, glycated hemoglobin, platelet count, neutrophil count, lymphocyte count, estimated glomerular filtration rate, lipid related indices, the combination of heart failure and diabetes, the use of statins and antiplatelet agents during hospitalization, with the final outcome defined as all-cause death during hospitalization. The included patients were divided into the non-death group (n=1 315) and death group (n=108) according to the occurrence of death. ROC curve was used to determine the predictive ability of PLR for in-hospital mortality risk in elderly patients with AMI, and the clinical application value of PLR and its combined indicators by decision curve analysis (DCA) . Results There were significant differences in age, BMI, PLR, white blood cell count, neutrophil count, lymphocyte count, red blood cell count, hemoglobin, fasting blood glucose level, AST, TG, CTNI, eGFR grade, proportion of heart failure, proportion of antiplatelet drugs, and proportion of lipid-lowering drugs between the death group and the non-death group (P

Background: Preterm birth is one of the main causes of neonatal morbidity and mortality in pregnancies worldwide. This investigation is undertaken to determine the usefulness of neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR), which are complete blood count (CBC) parameters, in predicting preterm birth among women with threatened preterm labour (TPL). Methods: A retrospective observational study was conducted between 2019 and 2023, and medical charts of 250 pregnant patients internalized for TPL were investigated. A hundred and forty of them gave birth prematurely, and remaining 110 women who responded to bed rest and medical treatment constituted the control group. NLR, PLR and other inflammatory markers such as systemic immune-inflammation index (SII = neutrophil × platelet/lymphocyte count) were recorded, and their probable correlations with preterm delivery were evaluated. Logistic regression and area under curve (AUC) analysis were used to assess the predictive value of these markers. Results: There were no significant differences between those who delivered at term and patients with preterm labour who delivered

Background: Cancer prognoses have been indicated to be associated with Onodera’s prognostic nutritional index (OPNI), the neutrophil-to-lymphocyte ratio (NLR), the platelet-to-lymphocyte ratio (PLR), and the systemic immune-inflammatory index (SII). We investigated the prognostic value of the OPNI, NLR, PLR, and SII for serous ovary cancer (SOC). Methods: We retrospectively analyzed the cases of 133 patients with SOC treated at our institution from 2014 to 2021. The survival of the patients was assessed utilizing the Kaplan-Meier method to analyze overall survival (OS). Additionally, a multivariate analysis employing the Cox proportional hazard regression model was conducted to identify the independent prognostic factors for SOC. The positive event for the ROC diagnosis is mortality during follow-up. Results: The results revealed the following optimal cut-off points: OPNI, 45.5; NLR, 2.3; PLR, 224.4; and SII, 747.5. A comparative analysis demonstrated significant differences between high- and low-OPNI score groups in the treatment method, tumor stage, lymph node metastasis, albumin, NLR, PLR, and SII; other indicators are not irrelevant. We also observed that the OPNI, NLR, PLR, and SII were related to OS: the OPNI score was positively correlated with OS whereas the NLR, PLR, and SII values were negatively correlated with OS. These results identified the OPNI as the best prognostic indicator for SOC. Conclusions: Our findings demonstrate that the OPNI, NLR, PLR, and SII could be used as predictive and prognostic parameters for SOC.

Ya Xin Zhang,1– 3,&ast; Zhi Yuan Shen,1– 3,&ast; Yi Cun Jia,1– 3 Xin Guo,1– 3 Xiao Su Guo,1– 3 Yuan Xing,1– 3 Shu Juan Tian1– 3 1Department of Neurology, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei, People’s Republic of China; 2Department of Neurology, Hebei Hospital, Xuanwu Hospital, Capital Medical University, Shijiazhuang, Hebei, People’s Republic of China; 3Neuromedical Technology Innovation Center of Hebei Province, Shijiazhuang, Hebei, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Shu Juan Tian; Yuan Xing, Department of Neurology, The First hospital of Hebei Medical University, Shijiazhuang, Hebei, 050030, People’s Republic of China, Email jtian72@126.com; leaf_trunks@163.comBackground 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.Keywords: acute ischemic stroke, short-term functional outcome, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, lymphocyte-to-monocyte ratio, systemic inflammatory response index

Abstract Objective This study aimed to evaluate the clinical effectiveness of chemotherapy following immune checkpoint inhibitors (ICI). The association between inflammatory and nutritional factors and prognosis has also been investigated. Methods We retrospectively reviewed the medical records of recurrent or metastatic head and neck squamous cell carcinoma (RMHNSCC) patients who received chemotherapy following ICI therapy. The response rate and survival after chemotherapy, and nutritional and inflammatory factors, were examined. Results The ICI before chemotherapy was nivolumab in 36 patients (70.6%) and pembrolizumab in 15 patients (29.4%). The chemotherapy regimens consisted of PTX in 32 patients (62.7%), PTX + Cmab in 9 (17.6%), and S1 in 10 (19.6%). The median overall survival (OS) was 20 months (95% CI 12–25), the estimated 12-month OS rate was 63.3%, the median progression-free survival (PFS) was 5 months (CI 4–6), and the 12-month PFS estimate was 8.9%. Univariate analysis significantly correlated Neutrophil-to-Lymphocyte Ratio (NLR), platelet-to-lymphocyte ratio (PLR), controlling nutritional status score (CONUT), and prognostic nutrition index (PNI) with OS and PFS. Additionally, these factors were significantly correlated with OS and PFS in the log-rank tests. Conclusions Chemotherapy following ICI is highly effective. There were no significant differences in the chemotherapy regimens. Inflammatory and nutritional factors may associate with patient prognosis after chemotherapy.

Objective To investigate the diagnostic and prognostic value of neutrophil/lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR) in children with mycoplasma pneumonia (MP) infection. Methods The retrospective analysis was adopted. One hundred children patients with MP-IgM positive from January to June 2023 served as the case group, and other 100 healthy children during the same period were extracted as the control group; the results of the first re-examination in the case group served as the standard, the children patients in the case group were divided into the unrecovered group (MP-IgM positive) and the recovered group (MP-IgM negative); the levels of NLR and PLR were compared among the groups, and the logistic regression model was established, then the receiver operating characteristic (ROC) curve was used to analyze the diagnostic value of the two. Results The levels of NLR and PLR in the case group were significantly higher than those in the control group (P<0.05); the areas under the curve (AUC) of single detection and combined detection of NLR and PLR in the diagnosis of the children patients with MP infection were 0.749, 0.701 and 0.758 respectively. AUC of the combined detection was maximal, the corresponding sensitivity was 83.00% and the specificity was 61.00% (P<0.001). The levels of NLR and PLR in the unrecovered group were also significantly increased compared with those in the recovered group (P<0.05). Conclusion NLR and PLR are closely correlated to MP infection, and their combined detection has the higher sensitivity for MP infection and the both also have a certain prompt effect on the prognosis in the children patients. [ABSTRACT FROM AUTHOR]

Objective: We aim to study association between neutrophile to lymphocyte (NLR) and platelet to lymphocyte (PLR) ratios and disease activity, and their value to predict bDMARD response. Methods: A set of spondylarthritis (SpA) patients under bDMARD registered in the Reuma.pt registry was studied. Sociodemographic, clinical and laboratorial variables were assessed on bDMARD initiation, 6, 12, 18 and 24 months (M) thereafter. Univariable and multivariable generalized estimation equations models assessed associations with disease activity. The NLR and PLR predictive value was assessed using univariable and multivariable logistic regression models. Results: A total of 170 patients were included. Most were male (54.7%), with a predominantly axial phenotype (84.7%). Significant associations were observed between NLR [b=1.55, 95% confidence interval (CI) = (1.38; 1.74)] and PLR [(b=1.16, 95% CI = (1.09; 1.24)] with ASDAS-CRP (p<0.001). Both baseline ratios predicted Δ ASDASCRP ≥ 1.1 at 6 months [OR = 2.20, 95% CI = (1.21, 4.00) for NLR; OR = 1.02, 95% CI = (1.01, 1.04) for PLR, p<0.01)]. PLR was a significant predictor of Δ ASDAS-CRP ≥ 1.1 in all timepoints [OR (12 M) = 1.02, 95% CI = (1.00, 1.03), p<0.05; OR (18M) = 1.02, 95% CI = (1.01, 1.03), p<0.001; OR (24M) = 1.01, 95% CI = (1.01, 1.02), p<0.01]. Conclusion: NLR and PLR were associated with disease activity during the follow up of these patients. They seem to be significant predictors of therapeutic response to bDMARD in naïve SpA patients. [ABSTRACT FROM AUTHOR]

Hepatocellular carcinoma (HCC) is associated with higher mortality as a result of poor prognosis and unavailability of effective treatment options. This study retrospectively analyzed the clinical value of platelet-to-lymphocyte ratio (PLR) to aid in differentiating early hepatocellular carcinoma from liver cirrhosis patients. Three hundred and nine (309) patients including 155 patients with hepatocellular carcinoma (HCC) and 154 patients with liver cirrhosis were enrolled in this study. General clinical characteristics and blood parameters of each patient were collected, calculated, and retrospectively analyzed. Mann–Whitney U test was calculated to compare the two groups. Receiver operating characteristics (ROC) curve was performed to investigate the diagnostic potential of PLR in the prediction of HCC at a cut-off with high accuracy (area under the curve [AUC]) > 0.80. Hemoglobin (HB) concentration, red blood cell (RBC) count, neutrophil (NEU) count, platelet count, platelet-to-lymphocyte ratio (PLR), and neutrophil-to-lymphocyte ratio (NLR) were significantly higher in the HCC patients than in the liver cirrhosis patients (p < 0.05). ROC curve analysis showed that the AUC, optimal cut-off value, sensitivity, and specificity of PLR to predict HCC patients were 0.912, 98.7, 81.2%, and 80.6% respectively. The results suggest that PLR is a potential biomarker that can be used to predict early HCC. [ABSTRACT FROM AUTHOR]

To evaluate platelet indices, platelet to lymphocyte ratio and neutrophil to lymphocyte ratio as prognostic and risk factors in patients with coronary artery disease Introduction: cardiovascular diseases have 12 million deaths annually which is one of the commonest causes of death globally. Platelet parameters like Mean platelet volume (MPV), platelet distribution width (PDW) and WBC parameters like Neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio(PLR) have recently been emerging as a new prognostic marker in number of coronary artery disease (CAD) with limited studies to explore their utility. Aims and objectives: this study aimed to evaluate MPV, P-LCR, PDW, PLR, NLR and GRACE risk score in CAD patients. Material and methods: this descriptive cross-sectional study was done in 330 cases of CAD and 200 healthy controls were studied.MPV, platelet-large cell ratio (P-LCR), PLR, NLR and PDW of patients were analyzed. Results: In our study, 245 were males and 85 were females. Mean PDW, MPV, Mean PLCR, Mean NLR was significantly higher in CAD cases as compared to controls (p value < 0.05). Mean PLR was not significantly different in CAD cases and controls. MPV was more associated risk predictor of CAD (8.98 times) followed by NLR (2.79 times), PDW (1.53 times) and PLCR (1.02 times). Discussion and conclusion: platelet indices, NLR and PLR are simple cost effective parameters and in future these might be useful adjuvant tests in conjunction with conventional biochemical cardiac markers in early prediction of risk of CAD in patients admitted to hospital and can guide clinicians in assessing the prognosis on short and long term follow up of these patients in terms of morbidity and mortality. [ABSTRACT FROM AUTHOR]

Background: Surgical site infections (SSIs) can pose significant risks to patients undergoing surgical procedures. This study aimed to investigate the risk factors and diagnostic value of neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) for SSIs in patients undergoing laparoscopic radical nephrectomy for renal cell carcinoma. Methods: A retrospective analysis of 866 patients at our hospital was conducted between June 2016 and June 2022. The study divided patients into two groups: those with SSIs and those without. General data and operative room‐related information were collected. Inclusion and exclusion criteria were clearly defined. Peripheral blood indicators were analysed, and observation indicators were meticulously selected, including surgery time, usage of a laminar flow operating room and intraoperative hypothermia. Statistical analysis was performed using SPSS 25.0 software, including univariate, multivariate analysis and receiver operating characteristic (ROC) curve analysis. Results: Thirty‐six out of 866 patients developed SSIs. Statistically significant differences were found for surgery time, usage of non‐laminar flow operating rooms and intraoperative hypothermia (p < 0.05). ROC curve analysis showed an AUC of 0.765 (95% CI: 0.636–0.868) for serum NLR and PLR, with optimal cut‐off values at NLR 4.8 and PLR 196, indicating moderate to strong discriminative ability for SSIs. Conclusions: The study identified non‐laminar flow operating rooms, extended surgery time, and intraoperative hypothermia as significant risk factors for SSIs. Serum NLR and PLR were found valuable as biomarkers for SSIs diagnosis, holding potential for preoperative risk assessment and improved patient safety in renal cell carcinoma care. [ABSTRACT FROM AUTHOR]

To analyze the influencing factors of readmission within 1 year after discharge of patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD), and to explore the predictive value of serum albumin to globulin ratio (AGR) combined with platelet to lymphocyte ratio (PLR) for readmission within 1 year after discharge of patients with AECOPD at the same time. 261 patients with AECOPD who were admitted to Guangdong Provincial People's Hospital from May 2018 to October 2021 were selected, and they were divided into readmission group(n=96) and non readmission group(n=165) based on whether they were readmission within 1 year after discharge. The AGR and PLR were compared between the two groups, and the influencing factors of readmission within 1 year after discharge of patients with AECOPD were analyzed by univariate and multivariate Logistic regression analysis. The predictive value of AGR and PLR for readmission within 1 year after discharge of patients with AECOPD was analyzed by the receiver operating characteristic (ROC) curve. The AGR of the readmission group was lower than that of the non readmission group, while the PLR was higher than that of the non readmission group (P<0.05). The readmission within 1 year after discharge of patients with AECOPD was related to ADL scores, daily average time of moderate to low intensity physical activity, home oxygen therapy, number of acute exacerbations in the first year before admission, FEV1% Pred, time of use antibiotic (P<0.05). Multivariate Logistic regression analysis showed that daily average time of moderate to low intensity physical activity less than 2 h, number of acute exacerbations in the first year before admission greater than or equal 2 times, FEV1%Pred less than 50, low AGR, and high PLR were risk factors for readmission within 1 year after discharge of patients with AECOPD (P<0.05). ROC curve analysis showed that the area under the curve (AUC) predicted by the combination of AGR and PLR for readmission within 1 year after discharge of patients with AECOPD was greater than that predicted by AGR and PLR alone. The predictive value of AGR combine with PLR for readmission within 1 year after discharge of patients with AECOPD are higer. daily average time of moderate to low intensity physical activity less than 2 h, number of acute exacerbations in the first year before admission greater than or equal 2 times, FEV1%Pred less than 50, low AGR, and high PLR were risk factors for readmission within 1 year after discharge of patients with AECOPD. [ABSTRACT FROM AUTHOR]

Objective: Neutrophil, lymphocyte, monocyte, thrombocyte counts and as novel inflammatory factors, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR) and red cell distribution width (RDW) play an important role in the occurrence and development of diseases. In this study, it was aimed to investigate the relationship between preoperative NLR, PLR, LMR and RDW values of patients hospitalized in the intensive care unit (ICU) after oncological surgery, and the length of intensive care and mortality rates. In addition, it was aimed to compare the demographic, clinical characteristics and laboratory parameters of the patients between both groups. Methods: Patients hospitalized in the ICU after oncological surgery were included in the study. The patients were divided into two groups as patients undergoing gastrointestinal malignancy (colorectal, stomach and hepatocellular) surgery (group 1) and patients who had undergoing urologic malignancy (kidney, bladder and prostate) surgery (group 2). Information regarding demographics (age and gender), comorbidities, neutrophil-lymphocyte-platelet counts, NLR-PLR-LMR-RDW values, length of ICU stay, acute physiology and chronic health evaluation II (APACHE-II) score, Glasgow coma scale and mortality rates were recorded. Results: Two hundred sixty-eight patients were analyzed including 144 patients (99 women, 45 men) undergoing gastrointestinal malignancy surgery (group 1), 124 patients (28 women, 96 men) undergoing urologic malignancy surgery (group 2). We found differences in lymphocyte count, LMR, and PLR values between the two groups. We found that NLR, PLR, LMR, and RDW values, as well as the counts of neutrophils, lymphocytes, and platelets, can predict mortality at specific cut-off points. Furthermore, we also identified an association between NLR, PLR, RDW values, and the APACHE-II score with the length of ICU stay. There was a difference in lymphocyte count, LMR and PLR values between the two groups. Conclusion: By utilizing cost-effective and practically applicable laboratory parameters, we can anticipate the mortality rates of patients following after cancer surgery. Patients predicted to have a high mortality rate can be followed more closely and comprehensively. [ABSTRACT FROM AUTHOR]

Aim: The aim of the study is to investigate the relationship of subclinical inflammatory factors Platelet crit (PCT), Neutrophil-lymphocyte ratio (NLR), Monocyte-lymphocyte ratio (MLR), Platelet-lymphocyte ratio (PLR) obtained from complete blood count (CBC) with Abortion Immunes (AI) and obstetric results. In recent years, studies reveal that subclinical inflammatory markers can be used as an indicator of the inflammatory process in many diseases. Few studies have evaluated indicators of inflammation and postpartum outcomes in abortion imminent patients. Materials and Methods: The study was conducted between January 2020 and January 2021. A total of 429 pregnant women, 203 of whom were pregnant with AI and 226 who were healthy, were included in the study. Results: PCT, NLR, and MLR values were significantly higher and PLR values were low in the AI group (p<0.05). PCT > 0.22, NLR > 2.29, and MLR > 0.20 were significantly associated with an increased risk of AI (p<0.05). PLR value above 135.5 was associated with the normal group. There was a significant difference between the group whose pregnancy was terminated by abortion and the group who gave birth in terms of PCT, NLR, MLR, and PLR values. PCT, NLR, and MLR values were high in the abortion group, and PLR values were low (p<0.05). Premature birth was developed in 11.3% (n=15) of AI patients. There was a significant difference between the preterm and term pregnancy in terms of PCT, NLR, MLR, and PLR levels (p<0.005). PCT, NLR, and MLR values were high and PLR levels were low in pregnant women who gave birth prematurely. Conclusion: We think that close follow-up of abortion imminent patients with high levels of these inflammatory factors is appropriate. [ABSTRACT FROM AUTHOR]

Objective: Immune checkpoint inhibitors are rapidly being used in solid and hematologic malignancies, including gynecologic cancers. The high mortality and relapsing rates of advanced gynecologic malignancies remain a challenging issue. This study aimed to identify the predicting factors associated with survival prognosis and disease control in patients with refractory/relapsing (R/R) gynecologic malignancies receiving anti PD-1 therapy. Materials and methods: We retrospectively reviewed the medical records of 49 patients diagnosed with R/R gynecologic malignancies between July 2012 and June 2019 in Chang Gung Memorial Hospital, Taiwan. Among the 49 patients, 6 were excluded due to incomplete medical records or not receiving anti PD-1 therapy. The remaining 43 patients were further divided into responsive and non-responsive groups according to disease control for predicting prognostic factor analysis. Results: For the 43 cases, the median age at diagnosis and disease follow-up length were 54 years and 29 months, respectively. Among them, 23 (53%) were categorized into the responsive group, and the remaining 20 (47%) were categorized into the non-responsive group. The mortality rates were 17% and 25% in the responsive and non-responsive groups, respectively. The responsive group had significantly higher absolute lymphocyte count (ALC), higher absolute neutrophil count (ANC) and low platelet to lymphocyte ratio (PLR) than the non-responsive group. A superior long-term survival trend was also observed in the responsive group, but the difference was not statistically significant. Conclusions: This study reinforced the hypothesis that high ALC, high ANC and low PLR are associated with superior disease control in patients with R/R gynecologic malignancies receiving anti PD-1 therapy.

INTRODUCTION: The Neutrophil to Lymphocyte Ratio (NLR) and Platelet to Lymphocyte Ratio (PLR) have recently been reported as potentially useful indicators of inflammation. In this study, the authors investigated their predictive role for postoperative complications of Coronary Artery Bypass Graft (CABG).METHOD: This study was conducted on the medical records of patients who had undergone isolated CABG in 2019-2020 in Isfahan, Iran. The baseline clinical characteristics were obtained from medical records. The diagnosis of postoperative Acute Kidney Injury (AKI) was defined based on the Kidney Disease Improving Global Outcomes guideline. The postoperative bleeding amount was measured from the total chest tube output during the Intensive Care Unit (ICU) admission after surgery. NLR and PLR were measured by dividing the neutrophil and platelet counts by the lymphocyte count, respectively. All data were analyzed using the Statistical Package for Social Sciences (SPSS) version 24.RESULTS: Of 356 patients, data of 280 patients, including 219 males and 61 females, were recruited. The mean age among all patients was 63.78±9.07 years. There were no significant differences between the bleeding group and non-bleeding group regarding NLR (2.33(1.89-2.73) vs. 2.20(1.63-3)) and PLR (119.26(94.41-146.39) vs. 110.26(82.13-136.34)) (p=0.742, p=0.228 respectively). NLR and PLR were significantly higher in AKI-positive patients (P< 0.001 and P=0.002, respectively). Only NLR showed the potential ability to predict postoperative AKI in the crude model (P

Introduction: At the crossroads of heart failure (HF) and systemic inflammation, platelets and lymphocytes are both influenced as well as actively participating in the bidirectional relationship. The platelet to lymphocyte ratio (PLR) could therefore be a marker of severity. This review aimed to assess the role of PLR in HF.