The evaluation of pretreatment neutrophil–lymphocyte ratio and derived neutrophil–lymphocyte ratio in patients with laryngeal neoplasms
Görkem EskiizmirUzdan UzEce OnurBeyhan Cengiz ÖzyurtGizem Karaca CikrikciNevin ŞahinArzu OranOnur Çelįk
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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.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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The identification of prognostic and predictive biomarkers in oncological pathology is a desideratum of translational research in cancer. The neutrophil-lymphocyte ratio (NLR) and the platelet-lymphocyte ratio (PLR) were considered suggestive to characterize both cell-mediated immune status and inflammation in cancer, thus being potential biomarkers. Due to the high rate of therapeutic failure even in the case of a treatment with curative potential, head and neck cancers are a priority in the research of potential biomarkers that allow a stratification of risk groups in order to adapt the therapy. The aim of the study is the dynamic evaluation of NLR and nadir PLR and during chemotherapy cycles for patients with multimodal, nonsurgically treated head and neck cancers. The mean NLR and PLR values vary during treatment, but the mean nadir value is not significantly different from the mean NLR and PLR values before the last cycle of chemotherapy. If there is solid evidence regarding the role of NLR nadir as a biomarker, the evaluation of NLR and PLR dynamics requires further research to confirm the possibility of being validated as a prognostic or predictive biomarker of response to chemotherapy and radiotherapy in head and neck squamous cell carcinoma.
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Neutrophil-to-lymphocyte ratio (NLR) refers to the ratio of neutrophil to lymphocyte in peripheral blood.NLR is a new inflammation index which has attracted more and more attention in recent years.It reflects the dynamic balance between neutrophil and lymphocyte in peripheral blood and has been applied to the diagnosis, severity and prognosis of many diseases.This article reviews the research progress of NLR in common pulmonary diseases in order to improve clinicians′understanding of NLR.
Key words:
Lung diseases; Neutrophil-to-lymphocyte ratio
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Purpose: Our aim was to study the value of neutrophil lymphocyte Ratio (NLR) and platelet lymphocyte ratio(PLR) to predict cancer related survival among patients with colorectal cancer (CRC) after exclusion of: a) patients who died in the first 6-month of the follow-up period and b) those patients that presented with bowel obstruction. Methods: We have used our database of 1534 patients diagnosed with CRC between 2005 and 2009. Patients were included if they had documented complete blood count (CBC) before any modality of treatment (surgery or chemotherapy). Patients with bowel obstruction on presentation and those died within 6-month of the date of diagnosis were excluded. Two independent physicians have reviewed the charts for the demographic, presentation, laboratory, pathological, management and outcome variables. The primary variables were WBC parameters (total WBC, neutrophil, lymphocyte, monocyte and NLR). Patients were divided into three equal tertiles according to their pretreatment NLR [1st NLR tertile (NLR <2.8) = 73 patients, 2nd NLR tertile (NLR 2.8-5.0) = 76 patients and the 3rd NLR tertile (NLR >5.0) = 75 patients]. Similarly, patients were divided to PLR tertiles [1st PLR tertile (PLR <150) = 77 patients, 2nd LPLR tertile (PLR 150-250) = 78 patients and the 3rd PLR tertile (PLR >250) = 69 patients]. Results: We had 367 patients with pre-treatment blood differential count with 224 patients presented as non-obstructed and survived 6-month after the reported baseline differential blood count. The 1st NLR tertile had a significant lower 4-year mortality compared to the 3rd NLR tertile (15/73=20.5% vs. 30/75=40%, p=0.012 according to Fisher's exact two-tailed test). The 1st PLR tertile had a lower 4-year mortality compared to the 3rd PLR tertile (19/77=24.6% vs. 24/69=34.8%, p=0.2) that was not statistically significant (Figure 1).Figure: [546] The 4-year cancer-related mortality according to pretreatment neutrophil lymphocyte ratio (NLR) and platelet lymphocyte ratio (PLR) tertiles in the colorectal cancer patients.Conclusion: NLR is a predictor of long-term cancer specific survival among colorectal cancer patients. This finding was noted in patients who survived beyond 6-months of the reported NLR in non-obstructed colorectal cancer patients. This suggests that inflammation plays a major role in cancer progression rather than just a mere marker of acute inflammatory status.
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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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