P1.04-010 Neutrophil to Lymphocyte, Platelet to Lymphocyte Ratios and Systemic Inflammation in Lung Cancer Stages
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Erythrocyte sedimentation rate
Absolute neutrophil count
The Neutrophil-to-lymphocyte-ratio has recently gained increased attention as a prognostic marker for malignant disease and short term outcomes. There is little data available in patients with Crohn's disease, thus the present study was conducted to correlate preoperative Neutrophil-to-lymphocyte-ratio values with disease phenotype and postoperative course. We comprised 373 patients, who underwent intestinal resection for symptomatic Crohn's disease at an academic tertiary referral centre between 2000 and 2014. Preoperative Neutrophil-to-lymphocyte-ratio values were calculated and analyzed in regard to disease phenotype and 30-day morbidity rate. All relevant data were obtained from the institutional database and individual chart review. Male patients had significantly higher preoperative Neutrophil-to-lymphocyte-ratio values compared to female patients (5 vs. 4; p = 0.0075). A higher Neutrophil-to-lymphocyte-ratio was also found in patients with an acute indication for surgery (6.15 vs. 4.3; p = 0.0374), presenting with abscesses (5.36 vs. 4.28; p = 0.0254), inflammatory masses (5.23 vs. 4.08; p = 0.0294) or malignancy in the resected specimen (9.06 vs. 4.35, p = 0.0231). Surprisingly, patients developing postsurgical complications showed significantly lower Neutrophil-to-lymphocyte-ratio values (3.77 vs. 4.67; p = 0.0461). Elevated preoperative Neutrophil-to-lymphocyte-ratio in symptomatic Crohn's disease is not predictive for complications. However, Neutrophil-to-lymphocyte-ratio showed a significant correlation with specific disease phenotypes. Most strikingly, Neutrophil-to-lymphocyte-ratio was highly elevated in patients with a colorectal cancer in the resected specimen, which needs to be addressed in future studies.
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PURPOSE: To evaluate the neutrophil-to-lymphocyte ratio (NLR) levels to predict the severity of infl ammation in thyroid ophthalmopathy (TO).METHODS: Fifty-six patients with TO and 40 healthy subjects were included in this study.TO patients were divided into two groups according to clinical activity score (CAS).Group 1 included 24 active TO patients and Group 2 included 32 inactive TO patients.The thyroid status, white blood cell (WBC), neutrophil, and lymphocyte counts were performed.NLR was calculated by dividing the neutrophil count by the lymphocyte count.RESULTS: The mean age was 53.6 ± 5.4 in active TO group, 54.2 ± 5.6 in inactive TO group, and 52.7 ± 5.2 in the control group.The WBC, neutrophil, lymphocyte and NLR levels were higher in patients with TO than in the control group (p < 0.05).A signifi cant difference in NLR was found between the inactive and active TO groups (p < 0.05).CONCLUSION: NLR values were found to be higher in patients with TO than in controls.NLRvalues were also found higher in active TO patients than in inactive TO patients (Tab.3, Ref. 26).
Absolute neutrophil count
White blood cell
Complete blood count
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Leukocytosis, predominantly neutrophilia, has previously been described following ST elevation myocardial infarction (STEMI). The exact contribution of this phenomenon to the clinical outcome of STEMI is yet to be shown. We examined cellular inflammatory response to STEMI in the blood and its association with in-hospital mortality and/or adverse clinical events.In this cross-sectional study, 404 patients who were admitted with the diagnosis of acute STEMI at Madani Heart Hospital from March 2010 to March 2012 were studied. The complete blood cell count (CBC) was obtained from all patientswithin12-24 hours of the onset of symptoms. Total leukocytes were counted and differential count was obtained for neutrophils, lymphocytes and neutrophil/lymphocyte ratio (NLR) were evaluated. Association of cellular response with the incidence of post-MI mortality/complications was assessed by multiple logistic regression analyses.In-hospital mortality and post-STEMI complication rate were 3.7% and 43.6%, respectively. Higher age (P=0.04), female gender (0.002), lower ejection fraction (P<0.001) and absolute neutrophil count (P=0.04) were predictors of mortality. Pump failure in the form of acute pulmonary edema or cardiogenic shock occurred in 35 (8.9%) of patients. Higher leukocyte (P<0.03) and neutrophil counts (P<0.03) and higher NLR (P=0.01) were predictors of failure. The frequency of ventricular tachyarrhythmias (VT/VF) at the first day was associated with higher neutrophil count (P<0.001) and higher NLR level (P<0.001). In multivariate analysis neutrophil count was an independent predictor of mortality (OR=2.94; 1.1-8.4, P=0.04), and neutrophil count [OR=1.1, CI (1.01-1.20), P=0.02], female gender [OR=2.34, CI (1.02-4.88), P=0.04] and diabetes [OR=2.52, CI (1.21-5.2), P=0.003] were independent predictors of heart failure.A single CBC analysis may help to identify STEMI patients at risk for mortality and heart failure, and total neutrophil count is the most valuable in predicting both.
Neutrophilia
Absolute neutrophil count
Leukocytosis
Complete blood count
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Background: Neutrophil–lymphocyte ratio (NLR) is reported to be increased in various inflammatory conditions, but its significance in RA remains unclear. The aim of this study was to evaluate whether NLR can be used as a simple tool for disease activity assessment in rheumatoid arthritis (RA). Aim: The aim was to assess the NLR in RA patients and compare between active cases and those in remission. Materials and Methods: The study enrolled 150 diagnosed RA patients. Disease activity was determined with the Disease Activity Score (DAS-28), and the correlation of NLR with disease activity was analyzed. Results: NLR, C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR) were found to be significantly high in RA patients. Further, NLR correlated positively with CRP, ESR, and worsening DAS score. Conclusion: Our study concludes that NLR can become a readily available and cost-effective tool for disease assessment in RA in future.
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Chronic inflammation induces cancer and cancer induces local tissue damage with systemic inflammation. Therefore, the aim of this study is to investigate the potential relationship between the severity of inflammation and prognosis in cancer patients.This study enrolled 220 patients from January 2002 to December 2006 who underwent gastric surgery. We evaluated the relationship between preoperative inflammatory parameters (erythrocyte sedimentation rate, neutrophil-to-lymphocyte ratio) and other clinicopathological factors. Survival outcomes were compared according to the extent of inflammation.Significant elevation of erythrocyte sedimentation rate was related with old age, increased neutrophil-to-lymphocyte ratio, decreased hemoglobin, increased carcinoembryonic antigen, increased tumor size and advanced TNM stage. Neutrophil-to-lymphocyte ratio was significantly correlated with old age, increased erythrocyte sedimentation rate and advanced TNM stage. In the univariate analysis, elevated erythrocyte sedimentation rate and increased neutrophil-to-lymphocyte ratio had significantly poorer survival than those without elevation (all P<0.05). However, the multivariate analysis failed to prove erythrocyte sedimentation rate and neutrophil-to-lymphocyte ratio as independent prognostic factors.The elevation of erythrocyte sedimentation rate and neutrophil-to-lymphocyte ratio were correlated with poor prognosis in the univariate analysis and there was a strong correlation between inflammatory parameters (erythrocyte sedimentation rate and neutrophil-to-lymphocyte ratio) and tumor progression. Thus, erythrocyte sedimentation rate and neutrophil-to-lymphocyte ratio are considered useful as follow-up factors.
Erythrocyte sedimentation rate
Univariate analysis
Absolute neutrophil count
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Background:Obstructive sleep apnea syndrome (OSAS) is characterized by cyclic episodes of hypoxemia and reoxygenation. It has been suggested that OSAS is associated with chronic inflammation within the microvasculature. This low-grade inflammation may play a role in the pathophysiology of OSAS-related comorbidities. Evaluation of the inflammatory markers may predict the degree of the systemic inflammation and this may be a prognostic factor for future adverse events such as cardiovascular risks. Proinflammatory cytokines have been extensively studied in sleep-disordered breathing. Neutrophil-to-lymphocyte ratio is a recently described indicator of systemic inflammation, but it has not been studied in OSAS patients. In this study we aimed to evaluate the easily measurable parameters of systemic inflammation in these patients. We conducted this study to examine the association among OSAS and C- reactive protein, erythrocyte sedimentation rate, and neutrophil-to-lymphocyte ratio. Material andMethods:OSAS patients who underwent overnight polysomnography were studied retrospectively. They were divided into 4 groups: control, mild, moderate, and severe OSAS patients. Blood test results and inflammatory markers were compared between the groups. One-way ANOVA and Kruskall-Wallis H test were used for statistical analysis. Results:A total of 147 patients were included in the study. No differences in evaluated inflammatory markers were observed among the 4 groups. Conclusions:Evaluation of the OSAS-related systemic inflammation is not likely to be possible by CRP, ESR, or neutrophil-to-lymphocyte ratio measurements. These markers do not seem to be associated with the degree of the upper airway obstruction.
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Proinflammatory cytokine
Absolute neutrophil count
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Background: In Pakistan risk factors for coronary Artery disease are highly prevalent. The cause of 30-40% death in Pakistan is coronary artery disease. Inflammatory markers have a significant role in cardiovascular events: These markers are C - reactive protein, interlukin-6 and high erythrocyte sedimentation rate. Few parameters are proposed to pedicel the outcome in coronary artery disease that includes WBC count neutrophil count and neutrophil/lymphocyte ratio. Methodology: It was a prospective descriptive study conducted in the Cardiac unit, Ibn-e-Siena Hospital, Multan. Data of 159 patients who met the inclusion criteria was collected. Patient’s demographic details were noted. All patients having any of these, cardiogenic shock, pump failure (ejection ≤30%) and acute pulmonary edema were taken as having heart failure. Results: In this study main population was from age group 61-70 and 51-60 years age group. White blood count, absolute neutrophil count and neutrophil lymphocyte ratio was compared in patients with heart failure and without heart failure and significant difference was noted among groups. Conclusion: So white blood cell count, absolute neutrophil count and neutrophil lymphocyte ratio are good predictor of heart failure in patients with STEMI. So these parameters can be used to stratify high risk patients and can help in early identification and management of high risk patients Keywords: heart failure, neutrophil lymphocyte ratio, white cell count, ST segment elevation myocardial infarction.
Absolute neutrophil count
Erythrocyte sedimentation rate
White blood cell
Complete blood count
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Systemic inflammatory biomarkers are promising predictive and prognostic factors for solid cancers. The neutrophil-lymphocyte ratio and derived neutrophil-lymphocyte ratio are used to predict inflammation and used as biomarker in several malignancies.The purpose of this study was to demonstrate the diagnostic, predictive and prognostic role of neutrophil-lymphocyte ratio and derived neutrophil-lymphocyte ratio in patients with laryngeal neoplasms.A retrospective study was conducted on medical records involving 229 patients with benign, premalignant and malignant laryngeal neoplasms between 2002 and 2015. The diagnostic, predictive and prognostic role of neutrophil-lymphocyte ratio and derived neutrophil-lymphocyte ratio were evaluated using uni- and multivariate analysis.The neutrophil-lymphocyte ratio and derived neutrophil-lymphocyte ratio were not statistically different between patients with benign, premalignant and malignant laryngeal neoplasms. Both neutrophil-lymphocyte ratio and derived neutrophil-lymphocyte ratio were predictive factors for stage, lymph node metastasis, and distant metastasis. Patients with high neutrophil-lymphocyte ratio value (≥4) had a poor prognosis when compared with patients with low neutrophil-lymphocyte ratio value (5 year, Overall Survival: 69.0% vs. 31.1%, p<0.001; 5 year, disease free survival: 70.0% vs. 32.7%, p˂0.001; 5 year, locoregional recurrence free survival: 69.7% vs. 32.0%, p<0.001). Furthermore, neutrophil-lymphocyte ratio was an independent prognostic factor for 5 year: Overall survival (HR=2.396; 95% CI 1.408-4.077; p=0.001), Disease free survival (HR=2.246; 95% CI 1.322-3.816; p=0.006) and locoregional recurrence free survival (HR=2.210; 95% CI 1.301-3.753; p=0.003).Pretreatment neutrophil-lymphocyte ratio is a useful and reliable predictive and prognostic biomarker for patients with laryngeal carcinoma.
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We have read with a great interest the published article by Ghaffari et al. entitled with "The predictive value of total neutrophil count and neutrophil/lymphocyte ratio in predicting in-hospital mortality and complications after STEMI". Authors have suggested that complete blood count (CBC) test might help to identify ST elevation myocardial infarction (STEMI) patients and higher neutrophil count had the best predictive value for both mortality and heart failure. We believe some points should be discussed.
Absolute neutrophil count
Elevation (ballistics)
ST elevation
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