Background:Neutrophil-lymphocyte ratio(NLR)and platelet-lymphocyte ration(PLR)have been shown to contribute to tumour progression and response to therapy.Methods:We retrospectively counted NLR and PLR in 719 patients ...Background:Neutrophil-lymphocyte ratio(NLR)and platelet-lymphocyte ration(PLR)have been shown to contribute to tumour progression and response to therapy.Methods:We retrospectively counted NLR and PLR in 719 patients with advanced malignancies receiving chemo-and/or immuno-therapy.Results:Both the pretreatment NLR and PLR were significantly elevated in patients with progressive disease than in those without progressive disease.Compared to low groups,the high NLR and PLR groups showed significantly worse event free survival.Conclusion:We propose that NLR and PLR are not only effective blood markers for predicting therapeutic responses to chemo-and/or immuno-therapy,but also useful in detecting survival in diverse malignancies.展开更多
AIMTo identify simple and sensitive markers for postoperative complications after gastrectomy, the predictive values were compared among candidate preoperative factors.METHODSThree-hundred and twelve patients with pre...AIMTo identify simple and sensitive markers for postoperative complications after gastrectomy, the predictive values were compared among candidate preoperative factors.METHODSThree-hundred and twelve patients with previously untreated clinical T2-4 gastric cancer who underwent a D2 standard gastrectomy (distal gastrectomy or total gastrectomy) were included in the analysis. Correlations between 21 parameters that can be determined by preoperative routine blood tests and clinically relevant postoperative complications (grade II or higher according to the Clavien-Dindo classification) were evaluated. The optimal cutoff values and clinical significance of the selected markers were further evaluated by subgroup analyses according to age, body mass index, operative procedure and clinical disease stage.RESULTSSixty-six patients (21.1%) experienced grade II or higher postoperative complications. The platelet-lymphocyte ratio (PLR, total lymphocyte count/platelet count × 100) exhibited the highest area under the curve value (0.639) for predicting postoperative complications among the 21 parameters, and the optimal cutoff value was determined to be 0.71 (sensitivity = 70%, specificity = 56%). In the univariate analysis, the odds ratio of a low PLR for the occurrence of postoperative complications was 2.94 (95%CI: 1.66-5.35, P < 0.001), and a multivariate binomial logistic analysis involving other potential risk factors identified a low PLR as an independent risk factor for postoperative complications (OR = 3.32, 95%CI: 1.82-6.25, P < 0.001). In subgroups classified according to age, body mass index, operative procedure and clinical disease stage, the low PLR group exhibited an increased incidence of postoperative complications.CONCLUSIONThe preoperative PLR is a simple and useful predictor of complications after curative gastrectomy in patients with clinical T2-4 gastric cancer.展开更多
BACKGROUND A well-recognized class effect of immune checkpoint inhibitors(ICI)is immune-related adverse events(IrAEs)ranging from low grade toxicities to life-threatening end organ damage requiring permanent discontin...BACKGROUND A well-recognized class effect of immune checkpoint inhibitors(ICI)is immune-related adverse events(IrAEs)ranging from low grade toxicities to life-threatening end organ damage requiring permanent discontinuation of ICI.Deaths are reported in<5%of patients treated with ICI.There are,however,no reliable markers to predict the onset and severity of IrAEs.We tested the association between neutrophil-lymphocyte ratio(NLR)and platelet-lymphocyte ratio(PLR)at baseline with development of clinically significant IrAEs(grade≥2)in hepatocellular carcinoma(HCC)patients treated with ICI.AIM To test the association between NLR and PLR at baseline with development of clinically significant IrAEs(grade≥2)in HCC patients treated with ICI.METHODS Data was extracted from an international database from a consortium of 11 tertiary-care referral centers.NLR=absolute neutrophil count/absolute lymphocyte count(ALC)and PLR=platelet count/ALC.Cutoff of 5 was used for NLR and 300 for PLR based on literature.We also tested the association between RESULTS Data was collected from 361 patients treated between 2016-2020 across the United States(67%),Asia(14%)and Europe(19%).Most patients received Nivolumab(n=255,71%).One hundred sixty-seven(46%)patients developed at least one IrAE,highest grade 1 in 80(48%),grade≥2 in 87(52%)patients.In a univariable regression model PLR>300 was significantly associated with a lower incidence of grade≥2 IrAEs(OR=0.40;P=0.044).Similarly,a trend was observed between NLR>5 and lower incidence of grade≥2 IrAEs(OR=0.58;P=0.097).Multivariate analyses confirmed PLR>300 as an independent predictive marker of grade≥2 IrAEs(OR=0.26;P=0.011),in addition to treatment with programmed cell death ligand 1(PD-1)/cytotoxic T lymphocyte-associated protein-4(OR=2.57;P=0.037)and PD-1/tyrosine kinase inhibitor(OR=3.39;P=0.01)combinations.Antibiotic use was not associated with IrAE incidence(OR=1.02;P=0.954).Patients treated with steroids had a>2-fold higher incidence of grade≥2 IrAEs(OR=2.74;P<0.001),although 74%were prescribed steroids for the treatment of IrAEs.CONCLUSION Given that high baseline NLR and PLR are associated with a decreased incidence of IrAEs,lower baseline NLR and PLR may be predictive biomarkers for the appearance of IrAEs in HCC treated with ICI.This finding is in keeping with several studies in solid tumors that have shown that baseline NLR and PLR appear predictive of IrAEs.展开更多
The short-term impacts of urban air pollution on the platelet-lymphocyte ratio (PLR) and neutrophil-lymphocyte ratio (NLR) remain obscure.In this study,we included 3487 urban adults from the Wuhan-Zhuhai cohort.Indivi...The short-term impacts of urban air pollution on the platelet-lymphocyte ratio (PLR) and neutrophil-lymphocyte ratio (NLR) remain obscure.In this study,we included 3487 urban adults from the Wuhan-Zhuhai cohort.Individual inhalation exposure to air pollutants was estimated by combining participants’daily breath volume and ambient concentrations of six air pollutants (includingfine particulate matter (PM_(2.5)),inhalable particulate matter(PM_(10)),nitrogen dioxide (NO_(2)),sulfur dioxide (SO_(2)),carbon monoxide (CO) and ozone (O_(3))).The cumulative impacts were assessed by applying lag structures of up to 7 days before the survey date.Associations of air pollutants with PLR and NLR were assessed using a linear mixed model and Bayesian kernel machine regression (BKMR) model.We found that PLR was negatively related to PM_(2.5)(lag02-lag06),PM_(10)(lag02-lag07),NO_(2)(lag02-lag07),and SO_(2)(lag03-lag05) and NLR was negatively related to PM_(10)(lag05 and lag07).In the BKMR model,a negative joint association between the six-air-pollutant mixture and PLR and NLR was observed,whereas PM_(10)and NO_(2)appeared to be more important than the other pollutants in the mixture.The negative impact of air pollutants was stronger in males,participants with lower body mass index (<24 kg/m^(2)),those cooking meals at home,drinkers,and nonexercisers.In conclusion,short-term exposure to air pollutants is significantly related to PLR and NLR in peripheral blood.PLR and NLR may provide new insight into the molecular mechanism underlying the adverse health impact of air pollutants.展开更多
Inflammation has been shown to be a factor in tumorigenesis. The circulating platelet to lymphocyte ratio (PLR) is a representative index of systemic inflammation. In this study, we analyzed the association between pr...Inflammation has been shown to be a factor in tumorigenesis. The circulating platelet to lymphocyte ratio (PLR) is a representative index of systemic inflammation. In this study, we analyzed the association between preoperative PLR levels and clinicopathological variables in two hundred sixty-four Japanese patients with localized breast carcinoma. We also evaluated the prognostic significance of preoperative PLR levels using the Cox proportional hazard model. Seventy-five patients (28.4%) had elevated PLR values, whereas 189 (71.6%) had depressed PLR values. The PLR correlated significantly with venous invasion (P < 0.05). Disease-free survival rates were significantly worse among patients with elevated PLR values than among those with lower PLR value (5-year survival, 81.6% vs. 90.7%, respectively;P < 0.05). In multivariate analysis, elevated PLR, nuclear grade, and lymph node involvement were significant prognostic factors for disease-free survival in patients with breast carcinoma (P < 0.05). Preoperative PLR levels may be an independent prognostic factor in patients with breast carcinoma.展开更多
<strong>Introduction: </strong>Breast cancer had become top leading cause of death in Taiwan and endangered women’s health worldwide. Therefore, we try to invest the peripheral inflammatory cell counts an...<strong>Introduction: </strong>Breast cancer had become top leading cause of death in Taiwan and endangered women’s health worldwide. Therefore, we try to invest the peripheral inflammatory cell counts and neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) from our routine practice for the predictor of prognosis of breast cancer after resection. <strong>Patients and</strong> <strong>Methods: </strong>There were 574 breast cancer patients accepted surgical resection and registered in Cancer Registry Center of our hospital. Patient’s basic profiles, peripheral neutophil, lymphocyte and platelet count were measured for study. The scales of NLR and PLR were derived from the lower and higher normal range in cell count from neutrophil, lymphocyte and platelet respectively. Therefore, the scales for NLR and PLR were ≤1.62, 1.63 - 2.57, ≥2.58 and ≤224, 225 - 253, ≥254 respectively for analysis. <strong>Results: </strong>Poor 5-yr survival rate was found if higher cell counts of neutrophil and platelet (p ≤ 0.05). Three scales of NLR were ≤1.62, 1.63 - 2.57, ≥2.58, and their 5-year survival rates were 94%, 91% and 84% respectively (p = 0.019). In the subgroup of HER-2 (negative), and 3-Negative breast patients had a higher NLR of poor prognosis. But higher PLR was found less in 3-Negative and non in 3-Positive patients (p = 0.039). The PLR was ≤224, 225 - 253, ≥254 and their 5-year survival rates were 92%, 87%, and 64% respectively (p = 0.001);Multivariate Cox regression model for predictor of breast cancer patients who have 3.39 (PLR ≥ 254) and 2.45 (NLR ≥ 2.58 ) times risk (p = 0.02 and p = 0.002) of poor prognosis respectively. <strong>Conclusion: </strong>Peripheral inflammatory cell counts are easily to take in our clinical practice and have a potential role as predictors of prognosis. We have to pay attention to the trends of peripheral inflammatory cell count and their ratio in our clinical practice where possible.展开更多
AIM: To assess the prognostic significance of immunological and nutritional-based indices, including the prognostic nutritional index(PNI), neutrophillymphocyte ratio(NLR), and platelet-lymphocyte ratio in gastric can...AIM: To assess the prognostic significance of immunological and nutritional-based indices, including the prognostic nutritional index(PNI), neutrophillymphocyte ratio(NLR), and platelet-lymphocyte ratio in gastric cancer.METHODS: We retrospectively reviewed 632 gastric cancer patients who underwent gastrectomy between1998 and 2008. Areas under the receiver operating characteristic curve were calculated to compare the predictive ability of the indices, together with estimating the sensitivity, specificity and agreement rate.Univariate and multivariate analyses were performed to identify risk factors for overall survival(OS). Propensity score analysis was performed to adjust variables to control for selection bias.RESULTS: Each index could predict OS in gastric cancer patients in univariate analysis, but only PNI had independent prognostic significance in multivariate analysis before and after adjustment with propensity scoring(hazard ratio, 1.668; 95% confidence interval:1.368-2.035). In subgroup analysis, a low PNI predicted a significantly shorter OS in patients with stage Ⅱ-Ⅲ disease(P = 0.019, P < 0.001), T3-T4 tumors(P <0.001), or lymph node metastasis(P < 0.001). Canton score, a combination of PNI, NLR, and platelet, was a better indicator for OS than PNI, with the largest area under the curve for 12-, 36-, 60-mo OS and overall OS(P = 0.022, P = 0.030, P < 0.001, and P = 0.024,respectively). The maximum sensitivity, specificity, and agreement rate of Canton score for predicting prognosis were 84.6%, 34.9%, and 70.1%, respectively.CONCLUSION: PNI is an independent prognostic factor for OS in gastric cancer. Canton score can be a novel preoperative prognostic index in gastric cancer.展开更多
AIM: To explore the correlation between several blood cell-associated inflammatory indices including mean platelet volume(MPV), platelet distribution width(PDW), neutrophil to lymphocyte ratio(NLR) and platelet-lympho...AIM: To explore the correlation between several blood cell-associated inflammatory indices including mean platelet volume(MPV), platelet distribution width(PDW), neutrophil to lymphocyte ratio(NLR) and platelet-lymphocyte ratio(PLR), and the presence and severity of diabetic retinopathy(DR). METHODS: We searched for eligible studies from PubMed, EMBASE, Web of Science and CNKI up to December 13, 2017. Standardized mean difference(SMD) calculated with confidence interval(CI) of 95% was used to estimate the values of those indices. RESULTS: A total of 31 studies were included in the present Meta-analysis. As compared with type 2 diabetes mellitus(T2 DM) patients without DR, the values of MPV, PDW, NLR, and PLR were higher in patients with DR(SMD=0.67; 95%CI: 0.36 to 0.98; SMD=0.51; 95%CI: 0.27 to 0.75; SMD=0.77; 95%CI: 0.49 to 1.05 and SMD=1.18; 95%CI: 0.07 to 2.28). Additionally, it was also observed that MPV was closely correlated with the severity of DR. CONCLUSION: MPV, PDW, NLR, and PLR could be recommended as diagnostic biomarkers for DR, and MPV could be applied to assess the severity of DR.展开更多
BACKGROUND Gastric leiomyomas and gastric stromal tumors are the most common types of gastric tumors encountered.In recent years,the incidence of the two types of tumors has been increasing,but the differential diagno...BACKGROUND Gastric leiomyomas and gastric stromal tumors are the most common types of gastric tumors encountered.In recent years,the incidence of the two types of tumors has been increasing,but the differential diagnosis is still a challenge in clinical work.However,as there are many reports on stromal tumors and inflammation-related indicators are gradually being paid attention to as important factors in predicting tumor prognosis,the two main purposes of this study were to explore the inflammation-related differences between the two types of tumors and to develop a nomogram as a predictive model.AIM To explore the differences in platelet-lymphocyte ratio(PLR),neutrophillymphocyte ratio(NLR),lymphocyte mononuclear cell ratio(LMR),and SII between the two types of tumors,and simultaneously create the nomogram model.METHODS This study enrolled 88 patients in the gastric stromal tumor group and 56 patients in the gastric leiomyoma group,and the relevant data of the two groups were entered into the system for an integrated analysis.The primary objective of this study was to identify the differences in the inflammation index between the two types of tumors.RESULTS There were statistically significant differences between the two groups in sex,age,and tumor location.In comparison,gastric leiomyomas seem to be more common in women,young patients,and gastric cardia,which is in line with our previous research;the groups showed the following statistical differences:PLR(158.2%vs 134.3%,P=0.028),NLR(2.35 vs 1.68,P=0.000),LMR(5.75 vs 10.8,P=0.004),and SII(546.2 vs 384.3,P=0.003).The results of the multivariate logistic regression analysis showed that sex,age,tumor location,and LMR were independent risk factors for the identification of the two types of tumors.After considering the risk factors selected by the above analysis into the predictive model,a predictive model for distinguishing gastrointestinal stromal tumors from gastric leiomyomas was established as the nomogram.CONCLUSION Gastric leiomyomas and gastric stromal tumors are not only different in factors such as age of the patient,but also in inflammatory indicators such as LMR and PLR.We have established a predictive model related to the laboratory indicators and are looking forward to further research conducted in this clinical area.展开更多
Objective:Albumin-globulin ratio(AGR),prognostic nutritional index(PNI),and platelet to-lymphocyte ratio(PLR)have been validated as prognostic factors for gastric cancer(GC).However,significant gender differences exis...Objective:Albumin-globulin ratio(AGR),prognostic nutritional index(PNI),and platelet to-lymphocyte ratio(PLR)have been validated as prognostic factors for gastric cancer(GC).However,significant gender differences exist in albumin levels and inflammatory cell counts,and further research is required to understand how these differences influence GC prognosis.This study aims to investigate the prognostic impact of nutritional and inflammatory indicators on GC patients undergoing radical surgery,as well as the influence of gender on these indicators’prognostic value.Methods:The study included 596 patients with advanced GC hospitalized in the Department of Gastrointestinal Surgery,General Surgery,Xiangya Hospital of Central South University from January 2012 to December 2016.Receiver operating characteristic(ROC)analysis was performed to determine cutoff values for nutritional and inflammatory factors.Univariate analysis was used to identify factors significantly affecting survival in GC patients,while multivariate and Kaplan-Meier analyses determined independent prognostic factors for GC.Results:Multivariate analysis revealed that postsurgical tumor node metastasis(pTNM)stage[stage II:hazard ratio(HR)=3.284,P=0.012;stage III:HR:8.062,P<0.001],low preoperative AGR(HR=1.499,P=0.012),and postoperative PNI(HR=1.503,P=0.008)were risk factors for overall survival in male patients after radical GC surgery.For female patients,pN2-3(HR=3.185,P<0.001),total gastrectomy(HR=2.286,P=0.004),low preoperative PLR(HR=1.702,P=0.027),and postoperative PNI(HR=1.943,P=0.011)were identified as risk factors for overall survival.Conclusion:Postoperative PNI is an independent risk factor for all advanced GC patients.Preoperative PLR is an independent prognostic factor only for female patients,while preoperative AGR is an independent prognostic factor only for male patients.Further research is warranted to investigate the gender-specific differences in GC prognosis.展开更多
Objective:To evaluate the prognostic value of platelet-to-lymphocyte ratio(PLR)in upper tract urothelial carcinoma(UTUC)patients treated with radical nephroureterectomy.Methods:This study was pre-registered in PROSPER...Objective:To evaluate the prognostic value of platelet-to-lymphocyte ratio(PLR)in upper tract urothelial carcinoma(UTUC)patients treated with radical nephroureterectomy.Methods:This study was pre-registered in PROSPERO(No.CRD42020186645).Two reviewers independently performed a comprehensive literature search on PubMed,Web of Science,EMBASE,Cochrane Library databases,China Biology Medicine disc(CBM),Wanfang database,and China National Knowledge Infrastructure(CNKI)from inception to May 2021 for prospective or retrospective cohort studies evaluating the prognostic value of PLR.Literature was analyzed with inclusion and exclusion criteria.Data and other useful clinicopathological features were extracted and analyzed with fixed or random-effect models when applicable.Heterogeneity was assessed on the basis of Cochran’s Q test and I2 statistic.Publication bias was assessed with funnel plots and precisely assessed by Egger's tests.Results:A total of ten studies involving 3287 UTUC patients were included.Meta-analysis showed that elevated preoperative PLR was associated with worse overall survival(HR=1.51,95%CI 1.17-1.94,P=0.001),cancer specific survival(HR=1.52,95%CI 1.21-1.90,P<0.001),disease free survival(HR=1.32,95%CI 1.12-1.56,P=0.001),and progression free survival(HR=1.88,95%CI 1.41-2.52,P<0.001).Furthermore,the sensitivity analyses validated the stability and reliability of the results.Conclusion:The present meta-analysis demonstrates a significant association between elevated preoperative PLR and poor prognosis of UTUC patients treated with radical nephroureterectomy.Hence,PLR could be helpful as a potential prognostic biomarker to guide clinical decision-making and select individualized treatment strategies for UTUC patients.However,more prospective and large-scale trials are needed to provide more evidence.展开更多
This commentary evaluates the study by Liu et al.This study investigates the predictive utility of the neutrophil-lymphocyte ratio,platelet-lymphocyte ratio,systemic immune-inflammation index,and carcinoembryonic anti...This commentary evaluates the study by Liu et al.This study investigates the predictive utility of the neutrophil-lymphocyte ratio,platelet-lymphocyte ratio,systemic immune-inflammation index,and carcinoembryonic antigen levels for post-operative intra-abdominal infection following colorectal cancer(CRC)surge-ry.The study highlights the critical need for analyzing diverse patient demogra-phics and delves into the potential impact of various confounding factors on the predictive accuracy of these markers.Additionally,the commentary advocates for the initiation of prospective studies aimed at validating and enhancing the clinical utility of these biomarkers in the context of CRC treatment.The commentary aims to underscore the importance of broadening the research framework to include a wider patient demographic and more comprehensive factor analyses,thereby enriching the predictive model's applicability and relevance in clinical settings.展开更多
The albumin-bilirubin(ALBI)score is a useful prognostic marker that predicts mortality in patients suffering from terminal diseases.Recently,it has been reported that ALBI score is a predictor of non-malignant liver d...The albumin-bilirubin(ALBI)score is a useful prognostic marker that predicts mortality in patients suffering from terminal diseases.Recently,it has been reported that ALBI score is a predictor of non-malignant liver diseases.The cutoff point of the ALBI score that distinguishes hepatocellular carcinoma from non-malignant liver disease is still not identified.Therefore,the ALBI score is a sensi-tive rather than a specific predictor of the poor outcomes of liver diseases.There are many hematological indices and ratios that are utilized as prognostic biomarkers.Among these biomarkers are the neutrophil-to-lymphocyte ratio,platelet-to-lymphocyte ratio(PLR),and platelet-hemoglobin ratio(PHR),which are useful discriminating prognostic biomarkers for liver diseases,e.g.,hepato-cellular carcinoma,hepatitis,liver fibrosis,etc.There is evidence that PLR and PHR are prognostic biomarkers that predict the poor outcomes of diseases.Therefore,concomitant measurements of ALBI score and PHR or ALBI score and PLR will improve the predictive value that can differentiate hepatocellular carcinoma from non-malignant diseases.展开更多
Aim:To validate a novel Japanese indication criteria for liver transplantation(LT)for hepatocellular carcinoma(HCC),i.e.,the 5-5-500 criteria(nodule size≤5 cm in diameter,nodule number≤5,and alfa-fetoprotein(AFP)va...Aim:To validate a novel Japanese indication criteria for liver transplantation(LT)for hepatocellular carcinoma(HCC),i.e.,the 5-5-500 criteria(nodule size≤5 cm in diameter,nodule number≤5,and alfa-fetoprotein(AFP)value≤500 ng/mL)and the Japanese double eligibility criteria(DEC)(patients meeting the Milan or the 5-5-500 criteria)in the University of Tokyo cohort.The usefulness of biomarkers in predicting the recurrence of HCC was also verified.Methods:The overall survival and recurrence rates of patients meeting the Milan,5-5-500,and the Japanese DEC were compared among 153 patients who underwent living donor LT(LDLT)between 1996 and 2019.A receiver-operating characteristics curve analysis was conducted to evaluate the usefulness of AFP,lens culinaris agglutinin-reactive fraction of AFP,des-gamma-carboxy prothrombin,neutrophil-lymphocyte ratio,and the platelet-lymphocyte ratio to detect recurrence.Results:The 5-year recurrence rate for all patients,those meeting the Japanese DEC,5-5-500 criteria,and the Milan criteria was 10.9%,9.2%,7.4%,and 7.6%,respectively.Compared with the conventional Milan criteria,the 5-5-500 criteria and the Japanese DEC could increase the number of eligible LDLT candidates by 6.1%and 11.4%.Among five biomarkers,the area under the curve value of AFP was the highest(0.852).Conclusion:The results suggest that the 5-5-500 criteria and the Japanese DEC are the appropriate selection criteria for patients with HCC in LDLT.Among five biomarkers investigated,AFP was most reliable to predict HCC recurrence,which justified the utilization of AFP in the 5-5-500 criteria and the Japanese DEC.展开更多
Objective:Wet cupping therapy(WCT)is one of the complementary and traditional therapies that are still must be scientifically interpreted.This study aimed to assess hemogram parameters that are subclinical inflammator...Objective:Wet cupping therapy(WCT)is one of the complementary and traditional therapies that are still must be scientifically interpreted.This study aimed to assess hemogram parameters that are subclinical inflammatory markers in patients with fibromyalgia syndrome(FMS)and observe how they were affected with WCT.Methods:The present study consisted of two groups;patient group included participants who were diagnosed with FMS and who received WCT and control group included healthy participants who received WCT within the concept of preventive medicine.Results:Neutrophil-to-lymphocyte ratio(NLR)and platelet-lymphocyte ratio(PLR)values were higher in the patient group(P=0.029and P=0.003,respectively).Considering that the participants had FMS,the optimal cutoff value for PLR was≥1.62,sensitivity was 70%,specificity was 56%,positive predictive value was 61.7%,and negative predictive value was 65.3%.Receiver operating characteristic(ROC)curve revealed a significant sensitivity and specificity(ROC area=0.664),(confidence interval[CI]:0.530–0.781)(P<0.023).The optimal cutoff value for PLR was≥146,sensitivity was 60%,specificity was 83%,positive predictive value was 78%,and negative predictive value was 67%.ROC curve revealed a statistically significant sensitivity and specificity(ROC area=0.726),(CI:0.59–0.83)(P<0.001).The optimal cutoff value for platelet was≥284,000,sensitivity was 83%,specificity was 40%,positive predictive value was 58%,and negative predictive value was 70%.ROC curve revealed a significant sensitivity and specificity(ROC area=0.65),(CI:0.51–0.76)(P=0.036).Conclusion:NLR,PLR,and thrombocyte count parameters can be useful in the process of diagnosing FMS.In addition,NLR,PLR,and MPV decreased in patients who received WCT.展开更多
基金supported by the project of Young Technical Talents of Tianjin Medical University General Hospital(GG-2021-08).
文摘Background:Neutrophil-lymphocyte ratio(NLR)and platelet-lymphocyte ration(PLR)have been shown to contribute to tumour progression and response to therapy.Methods:We retrospectively counted NLR and PLR in 719 patients with advanced malignancies receiving chemo-and/or immuno-therapy.Results:Both the pretreatment NLR and PLR were significantly elevated in patients with progressive disease than in those without progressive disease.Compared to low groups,the high NLR and PLR groups showed significantly worse event free survival.Conclusion:We propose that NLR and PLR are not only effective blood markers for predicting therapeutic responses to chemo-and/or immuno-therapy,but also useful in detecting survival in diverse malignancies.
文摘AIMTo identify simple and sensitive markers for postoperative complications after gastrectomy, the predictive values were compared among candidate preoperative factors.METHODSThree-hundred and twelve patients with previously untreated clinical T2-4 gastric cancer who underwent a D2 standard gastrectomy (distal gastrectomy or total gastrectomy) were included in the analysis. Correlations between 21 parameters that can be determined by preoperative routine blood tests and clinically relevant postoperative complications (grade II or higher according to the Clavien-Dindo classification) were evaluated. The optimal cutoff values and clinical significance of the selected markers were further evaluated by subgroup analyses according to age, body mass index, operative procedure and clinical disease stage.RESULTSSixty-six patients (21.1%) experienced grade II or higher postoperative complications. The platelet-lymphocyte ratio (PLR, total lymphocyte count/platelet count × 100) exhibited the highest area under the curve value (0.639) for predicting postoperative complications among the 21 parameters, and the optimal cutoff value was determined to be 0.71 (sensitivity = 70%, specificity = 56%). In the univariate analysis, the odds ratio of a low PLR for the occurrence of postoperative complications was 2.94 (95%CI: 1.66-5.35, P < 0.001), and a multivariate binomial logistic analysis involving other potential risk factors identified a low PLR as an independent risk factor for postoperative complications (OR = 3.32, 95%CI: 1.82-6.25, P < 0.001). In subgroups classified according to age, body mass index, operative procedure and clinical disease stage, the low PLR group exhibited an increased incidence of postoperative complications.CONCLUSIONThe preoperative PLR is a simple and useful predictor of complications after curative gastrectomy in patients with clinical T2-4 gastric cancer.
文摘BACKGROUND A well-recognized class effect of immune checkpoint inhibitors(ICI)is immune-related adverse events(IrAEs)ranging from low grade toxicities to life-threatening end organ damage requiring permanent discontinuation of ICI.Deaths are reported in<5%of patients treated with ICI.There are,however,no reliable markers to predict the onset and severity of IrAEs.We tested the association between neutrophil-lymphocyte ratio(NLR)and platelet-lymphocyte ratio(PLR)at baseline with development of clinically significant IrAEs(grade≥2)in hepatocellular carcinoma(HCC)patients treated with ICI.AIM To test the association between NLR and PLR at baseline with development of clinically significant IrAEs(grade≥2)in HCC patients treated with ICI.METHODS Data was extracted from an international database from a consortium of 11 tertiary-care referral centers.NLR=absolute neutrophil count/absolute lymphocyte count(ALC)and PLR=platelet count/ALC.Cutoff of 5 was used for NLR and 300 for PLR based on literature.We also tested the association between RESULTS Data was collected from 361 patients treated between 2016-2020 across the United States(67%),Asia(14%)and Europe(19%).Most patients received Nivolumab(n=255,71%).One hundred sixty-seven(46%)patients developed at least one IrAE,highest grade 1 in 80(48%),grade≥2 in 87(52%)patients.In a univariable regression model PLR>300 was significantly associated with a lower incidence of grade≥2 IrAEs(OR=0.40;P=0.044).Similarly,a trend was observed between NLR>5 and lower incidence of grade≥2 IrAEs(OR=0.58;P=0.097).Multivariate analyses confirmed PLR>300 as an independent predictive marker of grade≥2 IrAEs(OR=0.26;P=0.011),in addition to treatment with programmed cell death ligand 1(PD-1)/cytotoxic T lymphocyte-associated protein-4(OR=2.57;P=0.037)and PD-1/tyrosine kinase inhibitor(OR=3.39;P=0.01)combinations.Antibiotic use was not associated with IrAE incidence(OR=1.02;P=0.954).Patients treated with steroids had a>2-fold higher incidence of grade≥2 IrAEs(OR=2.74;P<0.001),although 74%were prescribed steroids for the treatment of IrAEs.CONCLUSION Given that high baseline NLR and PLR are associated with a decreased incidence of IrAEs,lower baseline NLR and PLR may be predictive biomarkers for the appearance of IrAEs in HCC treated with ICI.This finding is in keeping with several studies in solid tumors that have shown that baseline NLR and PLR appear predictive of IrAEs.
基金supported by the Key Program of the National Natural Science Foundation of China (No. 91543207)the Major Research Program of the National Natural Science Foundation of China (No. 91843302)。
文摘The short-term impacts of urban air pollution on the platelet-lymphocyte ratio (PLR) and neutrophil-lymphocyte ratio (NLR) remain obscure.In this study,we included 3487 urban adults from the Wuhan-Zhuhai cohort.Individual inhalation exposure to air pollutants was estimated by combining participants’daily breath volume and ambient concentrations of six air pollutants (includingfine particulate matter (PM_(2.5)),inhalable particulate matter(PM_(10)),nitrogen dioxide (NO_(2)),sulfur dioxide (SO_(2)),carbon monoxide (CO) and ozone (O_(3))).The cumulative impacts were assessed by applying lag structures of up to 7 days before the survey date.Associations of air pollutants with PLR and NLR were assessed using a linear mixed model and Bayesian kernel machine regression (BKMR) model.We found that PLR was negatively related to PM_(2.5)(lag02-lag06),PM_(10)(lag02-lag07),NO_(2)(lag02-lag07),and SO_(2)(lag03-lag05) and NLR was negatively related to PM_(10)(lag05 and lag07).In the BKMR model,a negative joint association between the six-air-pollutant mixture and PLR and NLR was observed,whereas PM_(10)and NO_(2)appeared to be more important than the other pollutants in the mixture.The negative impact of air pollutants was stronger in males,participants with lower body mass index (<24 kg/m^(2)),those cooking meals at home,drinkers,and nonexercisers.In conclusion,short-term exposure to air pollutants is significantly related to PLR and NLR in peripheral blood.PLR and NLR may provide new insight into the molecular mechanism underlying the adverse health impact of air pollutants.
文摘Inflammation has been shown to be a factor in tumorigenesis. The circulating platelet to lymphocyte ratio (PLR) is a representative index of systemic inflammation. In this study, we analyzed the association between preoperative PLR levels and clinicopathological variables in two hundred sixty-four Japanese patients with localized breast carcinoma. We also evaluated the prognostic significance of preoperative PLR levels using the Cox proportional hazard model. Seventy-five patients (28.4%) had elevated PLR values, whereas 189 (71.6%) had depressed PLR values. The PLR correlated significantly with venous invasion (P < 0.05). Disease-free survival rates were significantly worse among patients with elevated PLR values than among those with lower PLR value (5-year survival, 81.6% vs. 90.7%, respectively;P < 0.05). In multivariate analysis, elevated PLR, nuclear grade, and lymph node involvement were significant prognostic factors for disease-free survival in patients with breast carcinoma (P < 0.05). Preoperative PLR levels may be an independent prognostic factor in patients with breast carcinoma.
文摘<strong>Introduction: </strong>Breast cancer had become top leading cause of death in Taiwan and endangered women’s health worldwide. Therefore, we try to invest the peripheral inflammatory cell counts and neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) from our routine practice for the predictor of prognosis of breast cancer after resection. <strong>Patients and</strong> <strong>Methods: </strong>There were 574 breast cancer patients accepted surgical resection and registered in Cancer Registry Center of our hospital. Patient’s basic profiles, peripheral neutophil, lymphocyte and platelet count were measured for study. The scales of NLR and PLR were derived from the lower and higher normal range in cell count from neutrophil, lymphocyte and platelet respectively. Therefore, the scales for NLR and PLR were ≤1.62, 1.63 - 2.57, ≥2.58 and ≤224, 225 - 253, ≥254 respectively for analysis. <strong>Results: </strong>Poor 5-yr survival rate was found if higher cell counts of neutrophil and platelet (p ≤ 0.05). Three scales of NLR were ≤1.62, 1.63 - 2.57, ≥2.58, and their 5-year survival rates were 94%, 91% and 84% respectively (p = 0.019). In the subgroup of HER-2 (negative), and 3-Negative breast patients had a higher NLR of poor prognosis. But higher PLR was found less in 3-Negative and non in 3-Positive patients (p = 0.039). The PLR was ≤224, 225 - 253, ≥254 and their 5-year survival rates were 92%, 87%, and 64% respectively (p = 0.001);Multivariate Cox regression model for predictor of breast cancer patients who have 3.39 (PLR ≥ 254) and 2.45 (NLR ≥ 2.58 ) times risk (p = 0.02 and p = 0.002) of poor prognosis respectively. <strong>Conclusion: </strong>Peripheral inflammatory cell counts are easily to take in our clinical practice and have a potential role as predictors of prognosis. We have to pay attention to the trends of peripheral inflammatory cell count and their ratio in our clinical practice where possible.
基金Supported by National Natural Science Foundation of China,Nos.81101865 and 81272637Doctoral Fund of the Ministry of Education of China,No.20110171120064+1 种基金Natural Science Foundation of Guangdong Province,No.S2013020012724Clinical Medicine Research Project 5010 of Sun Yat-sen University,No.2010006
文摘AIM: To assess the prognostic significance of immunological and nutritional-based indices, including the prognostic nutritional index(PNI), neutrophillymphocyte ratio(NLR), and platelet-lymphocyte ratio in gastric cancer.METHODS: We retrospectively reviewed 632 gastric cancer patients who underwent gastrectomy between1998 and 2008. Areas under the receiver operating characteristic curve were calculated to compare the predictive ability of the indices, together with estimating the sensitivity, specificity and agreement rate.Univariate and multivariate analyses were performed to identify risk factors for overall survival(OS). Propensity score analysis was performed to adjust variables to control for selection bias.RESULTS: Each index could predict OS in gastric cancer patients in univariate analysis, but only PNI had independent prognostic significance in multivariate analysis before and after adjustment with propensity scoring(hazard ratio, 1.668; 95% confidence interval:1.368-2.035). In subgroup analysis, a low PNI predicted a significantly shorter OS in patients with stage Ⅱ-Ⅲ disease(P = 0.019, P < 0.001), T3-T4 tumors(P <0.001), or lymph node metastasis(P < 0.001). Canton score, a combination of PNI, NLR, and platelet, was a better indicator for OS than PNI, with the largest area under the curve for 12-, 36-, 60-mo OS and overall OS(P = 0.022, P = 0.030, P < 0.001, and P = 0.024,respectively). The maximum sensitivity, specificity, and agreement rate of Canton score for predicting prognosis were 84.6%, 34.9%, and 70.1%, respectively.CONCLUSION: PNI is an independent prognostic factor for OS in gastric cancer. Canton score can be a novel preoperative prognostic index in gastric cancer.
文摘AIM: To explore the correlation between several blood cell-associated inflammatory indices including mean platelet volume(MPV), platelet distribution width(PDW), neutrophil to lymphocyte ratio(NLR) and platelet-lymphocyte ratio(PLR), and the presence and severity of diabetic retinopathy(DR). METHODS: We searched for eligible studies from PubMed, EMBASE, Web of Science and CNKI up to December 13, 2017. Standardized mean difference(SMD) calculated with confidence interval(CI) of 95% was used to estimate the values of those indices. RESULTS: A total of 31 studies were included in the present Meta-analysis. As compared with type 2 diabetes mellitus(T2 DM) patients without DR, the values of MPV, PDW, NLR, and PLR were higher in patients with DR(SMD=0.67; 95%CI: 0.36 to 0.98; SMD=0.51; 95%CI: 0.27 to 0.75; SMD=0.77; 95%CI: 0.49 to 1.05 and SMD=1.18; 95%CI: 0.07 to 2.28). Additionally, it was also observed that MPV was closely correlated with the severity of DR. CONCLUSION: MPV, PDW, NLR, and PLR could be recommended as diagnostic biomarkers for DR, and MPV could be applied to assess the severity of DR.
基金Supported by Beijing Municipal Science&Technology Commission,No.D17100006517003and Beijing Municipal Administration of Hospitals Incubating Program,No.PX2020001.
文摘BACKGROUND Gastric leiomyomas and gastric stromal tumors are the most common types of gastric tumors encountered.In recent years,the incidence of the two types of tumors has been increasing,but the differential diagnosis is still a challenge in clinical work.However,as there are many reports on stromal tumors and inflammation-related indicators are gradually being paid attention to as important factors in predicting tumor prognosis,the two main purposes of this study were to explore the inflammation-related differences between the two types of tumors and to develop a nomogram as a predictive model.AIM To explore the differences in platelet-lymphocyte ratio(PLR),neutrophillymphocyte ratio(NLR),lymphocyte mononuclear cell ratio(LMR),and SII between the two types of tumors,and simultaneously create the nomogram model.METHODS This study enrolled 88 patients in the gastric stromal tumor group and 56 patients in the gastric leiomyoma group,and the relevant data of the two groups were entered into the system for an integrated analysis.The primary objective of this study was to identify the differences in the inflammation index between the two types of tumors.RESULTS There were statistically significant differences between the two groups in sex,age,and tumor location.In comparison,gastric leiomyomas seem to be more common in women,young patients,and gastric cardia,which is in line with our previous research;the groups showed the following statistical differences:PLR(158.2%vs 134.3%,P=0.028),NLR(2.35 vs 1.68,P=0.000),LMR(5.75 vs 10.8,P=0.004),and SII(546.2 vs 384.3,P=0.003).The results of the multivariate logistic regression analysis showed that sex,age,tumor location,and LMR were independent risk factors for the identification of the two types of tumors.After considering the risk factors selected by the above analysis into the predictive model,a predictive model for distinguishing gastrointestinal stromal tumors from gastric leiomyomas was established as the nomogram.CONCLUSION Gastric leiomyomas and gastric stromal tumors are not only different in factors such as age of the patient,but also in inflammatory indicators such as LMR and PLR.We have established a predictive model related to the laboratory indicators and are looking forward to further research conducted in this clinical area.
基金supported by the National Natural Science Foundation of China(8197103463).
文摘Objective:Albumin-globulin ratio(AGR),prognostic nutritional index(PNI),and platelet to-lymphocyte ratio(PLR)have been validated as prognostic factors for gastric cancer(GC).However,significant gender differences exist in albumin levels and inflammatory cell counts,and further research is required to understand how these differences influence GC prognosis.This study aims to investigate the prognostic impact of nutritional and inflammatory indicators on GC patients undergoing radical surgery,as well as the influence of gender on these indicators’prognostic value.Methods:The study included 596 patients with advanced GC hospitalized in the Department of Gastrointestinal Surgery,General Surgery,Xiangya Hospital of Central South University from January 2012 to December 2016.Receiver operating characteristic(ROC)analysis was performed to determine cutoff values for nutritional and inflammatory factors.Univariate analysis was used to identify factors significantly affecting survival in GC patients,while multivariate and Kaplan-Meier analyses determined independent prognostic factors for GC.Results:Multivariate analysis revealed that postsurgical tumor node metastasis(pTNM)stage[stage II:hazard ratio(HR)=3.284,P=0.012;stage III:HR:8.062,P<0.001],low preoperative AGR(HR=1.499,P=0.012),and postoperative PNI(HR=1.503,P=0.008)were risk factors for overall survival in male patients after radical GC surgery.For female patients,pN2-3(HR=3.185,P<0.001),total gastrectomy(HR=2.286,P=0.004),low preoperative PLR(HR=1.702,P=0.027),and postoperative PNI(HR=1.943,P=0.011)were identified as risk factors for overall survival.Conclusion:Postoperative PNI is an independent risk factor for all advanced GC patients.Preoperative PLR is an independent prognostic factor only for female patients,while preoperative AGR is an independent prognostic factor only for male patients.Further research is warranted to investigate the gender-specific differences in GC prognosis.
基金National Natural Science Foundation of China(81970662)Key Research and Development of Shanxi Province(201803D31110)the Shanxi‘1331 Project’key Innovation Team Construction Plan(3c332019001)。
文摘Objective:To evaluate the prognostic value of platelet-to-lymphocyte ratio(PLR)in upper tract urothelial carcinoma(UTUC)patients treated with radical nephroureterectomy.Methods:This study was pre-registered in PROSPERO(No.CRD42020186645).Two reviewers independently performed a comprehensive literature search on PubMed,Web of Science,EMBASE,Cochrane Library databases,China Biology Medicine disc(CBM),Wanfang database,and China National Knowledge Infrastructure(CNKI)from inception to May 2021 for prospective or retrospective cohort studies evaluating the prognostic value of PLR.Literature was analyzed with inclusion and exclusion criteria.Data and other useful clinicopathological features were extracted and analyzed with fixed or random-effect models when applicable.Heterogeneity was assessed on the basis of Cochran’s Q test and I2 statistic.Publication bias was assessed with funnel plots and precisely assessed by Egger's tests.Results:A total of ten studies involving 3287 UTUC patients were included.Meta-analysis showed that elevated preoperative PLR was associated with worse overall survival(HR=1.51,95%CI 1.17-1.94,P=0.001),cancer specific survival(HR=1.52,95%CI 1.21-1.90,P<0.001),disease free survival(HR=1.32,95%CI 1.12-1.56,P=0.001),and progression free survival(HR=1.88,95%CI 1.41-2.52,P<0.001).Furthermore,the sensitivity analyses validated the stability and reliability of the results.Conclusion:The present meta-analysis demonstrates a significant association between elevated preoperative PLR and poor prognosis of UTUC patients treated with radical nephroureterectomy.Hence,PLR could be helpful as a potential prognostic biomarker to guide clinical decision-making and select individualized treatment strategies for UTUC patients.However,more prospective and large-scale trials are needed to provide more evidence.
基金Supported by Joint Project of the Natural Science Foundation of Ningde,No.2023J49.
文摘This commentary evaluates the study by Liu et al.This study investigates the predictive utility of the neutrophil-lymphocyte ratio,platelet-lymphocyte ratio,systemic immune-inflammation index,and carcinoembryonic antigen levels for post-operative intra-abdominal infection following colorectal cancer(CRC)surge-ry.The study highlights the critical need for analyzing diverse patient demogra-phics and delves into the potential impact of various confounding factors on the predictive accuracy of these markers.Additionally,the commentary advocates for the initiation of prospective studies aimed at validating and enhancing the clinical utility of these biomarkers in the context of CRC treatment.The commentary aims to underscore the importance of broadening the research framework to include a wider patient demographic and more comprehensive factor analyses,thereby enriching the predictive model's applicability and relevance in clinical settings.
文摘The albumin-bilirubin(ALBI)score is a useful prognostic marker that predicts mortality in patients suffering from terminal diseases.Recently,it has been reported that ALBI score is a predictor of non-malignant liver diseases.The cutoff point of the ALBI score that distinguishes hepatocellular carcinoma from non-malignant liver disease is still not identified.Therefore,the ALBI score is a sensi-tive rather than a specific predictor of the poor outcomes of liver diseases.There are many hematological indices and ratios that are utilized as prognostic biomarkers.Among these biomarkers are the neutrophil-to-lymphocyte ratio,platelet-to-lymphocyte ratio(PLR),and platelet-hemoglobin ratio(PHR),which are useful discriminating prognostic biomarkers for liver diseases,e.g.,hepato-cellular carcinoma,hepatitis,liver fibrosis,etc.There is evidence that PLR and PHR are prognostic biomarkers that predict the poor outcomes of diseases.Therefore,concomitant measurements of ALBI score and PHR or ALBI score and PLR will improve the predictive value that can differentiate hepatocellular carcinoma from non-malignant diseases.
文摘Aim:To validate a novel Japanese indication criteria for liver transplantation(LT)for hepatocellular carcinoma(HCC),i.e.,the 5-5-500 criteria(nodule size≤5 cm in diameter,nodule number≤5,and alfa-fetoprotein(AFP)value≤500 ng/mL)and the Japanese double eligibility criteria(DEC)(patients meeting the Milan or the 5-5-500 criteria)in the University of Tokyo cohort.The usefulness of biomarkers in predicting the recurrence of HCC was also verified.Methods:The overall survival and recurrence rates of patients meeting the Milan,5-5-500,and the Japanese DEC were compared among 153 patients who underwent living donor LT(LDLT)between 1996 and 2019.A receiver-operating characteristics curve analysis was conducted to evaluate the usefulness of AFP,lens culinaris agglutinin-reactive fraction of AFP,des-gamma-carboxy prothrombin,neutrophil-lymphocyte ratio,and the platelet-lymphocyte ratio to detect recurrence.Results:The 5-year recurrence rate for all patients,those meeting the Japanese DEC,5-5-500 criteria,and the Milan criteria was 10.9%,9.2%,7.4%,and 7.6%,respectively.Compared with the conventional Milan criteria,the 5-5-500 criteria and the Japanese DEC could increase the number of eligible LDLT candidates by 6.1%and 11.4%.Among five biomarkers,the area under the curve value of AFP was the highest(0.852).Conclusion:The results suggest that the 5-5-500 criteria and the Japanese DEC are the appropriate selection criteria for patients with HCC in LDLT.Among five biomarkers investigated,AFP was most reliable to predict HCC recurrence,which justified the utilization of AFP in the 5-5-500 criteria and the Japanese DEC.
文摘Objective:Wet cupping therapy(WCT)is one of the complementary and traditional therapies that are still must be scientifically interpreted.This study aimed to assess hemogram parameters that are subclinical inflammatory markers in patients with fibromyalgia syndrome(FMS)and observe how they were affected with WCT.Methods:The present study consisted of two groups;patient group included participants who were diagnosed with FMS and who received WCT and control group included healthy participants who received WCT within the concept of preventive medicine.Results:Neutrophil-to-lymphocyte ratio(NLR)and platelet-lymphocyte ratio(PLR)values were higher in the patient group(P=0.029and P=0.003,respectively).Considering that the participants had FMS,the optimal cutoff value for PLR was≥1.62,sensitivity was 70%,specificity was 56%,positive predictive value was 61.7%,and negative predictive value was 65.3%.Receiver operating characteristic(ROC)curve revealed a significant sensitivity and specificity(ROC area=0.664),(confidence interval[CI]:0.530–0.781)(P<0.023).The optimal cutoff value for PLR was≥146,sensitivity was 60%,specificity was 83%,positive predictive value was 78%,and negative predictive value was 67%.ROC curve revealed a statistically significant sensitivity and specificity(ROC area=0.726),(CI:0.59–0.83)(P<0.001).The optimal cutoff value for platelet was≥284,000,sensitivity was 83%,specificity was 40%,positive predictive value was 58%,and negative predictive value was 70%.ROC curve revealed a significant sensitivity and specificity(ROC area=0.65),(CI:0.51–0.76)(P=0.036).Conclusion:NLR,PLR,and thrombocyte count parameters can be useful in the process of diagnosing FMS.In addition,NLR,PLR,and MPV decreased in patients who received WCT.
