To compare central visual field progression using mean deviation and pointwise linear regression analysis

Purpose: To compare central visual field progression using mean deviation and pointwise linear regression (PLR) analysis. Methods: We analyzed the 10?2 Humphrey visual field (HVF) tests for moderate and advanced primary glaucoma who had undergone at least five reliable 10?2 visual field tests with a minimum follow?up of at least two years and best?corrected visual acuity better than 6/12. Regression slope less than ?1 dB/year at P < 0.01 at a point was defined as an individual threshold point progression. Results: Ninety?six eyes of 74 patients were included. The median follow?up duration was of 4 years (±1.97). Median 10?2 mean deviation (MD) at inclusion was ?19.01 dB (interquartile range [IQR] ?13.2, ?24.14) and ?21.90 (IQR ? 13.4, ?27.8) on 24?2 HVF. The median rate of MD change was ?0.13 dB/year (IQR ? 0.46, 0.08) for 10?2. The median rate for visual field index (VFI) change was 0.9% per year (IQR ? 1.5, 0.4). Twenty?eight percent of eyes (27 eyes) showed progression. Twelve percent (12 eyes) showed progression of two or more points in the same hemifield on pointwise linear regression (PLR) analysis, and 16% of eyes (15 eyes) showed progression of one point. The median rate of MD change was significantly more in progressing eyes based on PLR analysis than eyes with no progression (?0.5 vs. ?0.06 dB/year P < 0.001). One patient had likely and the second had possible progression on 24?2. In 24 eyes, event analysis did not show any change; the rest mean deviation was out of range. Conclusion: Central visual field PLR analysis is useful in detecting progression in advanced glaucomatous damage.

Role of neutrophil-to-lymphocyte, neutrophil-to-eosinophil and platelet-to-lymphocyte ratios in the diagnosis of bullous pemphigoid and Pemphigus disease

Context: Bullous pemphigoid (BP) and “Pemphigus diseases” (PD) can have overlapping clinical manifestations and accurate distinction is crucial for appropriate management. Aims: The study aimed at analyzing the utility of simple hematological markers of systemic inflammation like neutrophil-to-lymphocyte ratio (NLR), neutrophil-to-eosinophil ratio (NER), and platelet-to-lymphocyte ratio (PLR) in clinical decision making in the setting of clinical differentials of BP and PD in a particular case. Methods: This single-centre based retrospective observational analytical study included adult subjects newly diagnosed to have BP (n=66) or PD (n=53), confirmed with direct immune-fluorescence testing, over a period of six years. Blood counts performed using Coulter™ hematology analyser, at the time of their initial presentation, were retrieved from the hospital medical records, and the leucocyte ratios were calculated.Statistical Analysis: The data were compared between the two groups, using Mann–Whitney U test and chi-square test /Fisher's exact test. ROC curve analysis was performed to estimate cut-off values. Results: The BP group had a significantly higher NLR, total leukocyte counts (TLC), absolute eosinophil counts (AEC), and absolute lymphocyte counts (ALC), and lower NER values compared to the PD group (P < 0.05). Areas under ROC for NLR, NER, TLC, AEC, and ALC were between 0.5 and 0.7. NLR ? 7, AEC ? 2055/cumm, and TLC ? 15,000/cumm had a specificity of 90.6, 100, and 100% respectively for identifying BP patients out of the two groups, but with a low sensitivity of 22.7, 21, and 22.7%, respectively. Conclusions: NLR can be a valuable diagnostic adjunct in subtyping autoimmune bullous disorders, albeit in a small proportion of cases.

Study on the prognostic influencing factors of esophageal squamous cell carcinoma and the predictive value of inflammatory reaction indexes on its postoperative recurrence / 中华肿瘤杂志

Objective: To explore the influence factors of poor prognosis of esophageal squamous cell carcinoma (ESCC) and the predictive value of inflammatory reaction indexes including neutrophils and lymphocytes ratio (NLR), platelet and lymphocyte ratio (PLR), monocyte and lymphocyte ratio (MLR) provision and differentiation degree, infiltration depth, lymph node metastasis number on the postoperative recurrence of ESCC. Methods: A total of 130 patients with ESCC who underwent radical resection from February 2017 to February 2019 in Nanyang Central Hospital were selected and divided into good prognosis group (66 cases) and poor prognosis group (64 cases) according to the prognostic effect. The clinical data and follow-up data were collected. Multivariate logistic regression analysis was used to determine the independent influencing factors of poor prognosis. Spearman correlation analysis was used to determine the correlation between preoperative NLR, PLR and MLR with the degree of differentiation, depth of invasion and number of lymph node metastases. Receiver operating characteristic (ROC) curve analysis was used to evaluate the efficacy of NLR, PLR and MLR in predicting poor prognosis of ESCC. Results: Univariate analysis showed that the degree of differentiation, the degree of invasion and the number of lymph node metastasis were related to the prognoses of patients with ESCC (P<0.05). Multivariate logistic regression analysis showed that the degree of differentiation, depth of invasion and number of lymph node metastases were independent influencing factors for poor prognosis of patients with ESCC, moderate differentiation (OR=2.603, 95% CI: 1.009-6.715) or low differentiation (OR=9.909, 95% CI: 3.097-31.706), infiltrating into fibrous membrane (OR=14.331, 95% CI: 1.333-154.104) or surrounding tissue (OR=23.368, 95% CI: 1.466-372.578), the number of lymph node metastases ≥ 3 (OR=9.225, 95% CI: 1.693-50.263) indicated poor prognosis. Spearman correlation analysis showed that NLR was negatively correlated with the degree of differentiation and the number of lymph node metastases (r=-0.281, P=0.001; r=-0.257, P=0.003), PLR was negatively correlated with the degree of differentiation, depth of invasion and number of lymph node metastasis (r=-0.250, P=0.004; r=0.197, P=0.025; r=-0.194, P=0.027), MLR was positively correlated with the degree of differentiation and the number of lymph node metastasis (r=0.248, P=0.004; r=0.196, P=0.025). ROC curve analysis showed that the areas under the curve of NLR, PLR and MLR in predicting poor prognosis of ESCC were 0.971, 0.925 and 0.834, respectively. The best cut-off value of NLR was 2.87. The sensitivity and specificity of NLR in predicting poor prognosis of ESCC were 90.6% and 87.9%, respectively. The optimal cut-off value of PLR was 141.75. The sensitivity and specificity for predicting poor prognosis of ESCC were 92.2% and 87.9%, respectively. The best cut-off value of MLR was 0.40. The sensitivity and specificity of MLR in predicting poor prognosis of esophageal squamous cell carcinoma were 54.7% and 100.0%, respectively. Conclusions: The degree of differentiation, the degree of invasion and the number of lymph node metastases are closely related to the poor prognosis of patients with esophageal squamous cell carcinoma. NLR, PLR and MLR can provide important information for predicting the poor prognosis of esophageal squamous cell carcinoma.

Neutrophil to lymphocyte ratio, platelet to lymphocyte ratioand one year survival of lung cancer in Sanglahhospital

Background:Lung cancer is ranked third as the most common cancer in Indonesia. The one-year survival rate of advanced-stage non-smallcell lung carcinoma (NSCLC) patient is quite low, that is 24.6%. Effective and inexpensive prognostic markers need to be further studied due to an increasing incidence of cancer. Inflammation plays an important role in tumorigenesis and research showed an association of NLR and PLR values with poor prognosis in patients with various solid tumors, but current cutoff values still vary. This study wanted to determine the value of NLR, PLR and their relationship with the survival rate of advancedstage NSCLC patients at Sanglah hospital.Methods:A retrospective cohort study using the medical record of 96 advanced-stage NSCLC patients who underwent treatment since January 2018 in Sanglah hospital, was closely monitored for a year since diagnosed. Analysis was performed with ROC, Kaplan Meier analysis, log rank test, and time independent cox regression model.Results:The one-yearsurvival rate of advancedstage NSCLC patient is 14.6%, with median survival 3.26 months. Cut off NLR> 3.37, median survival 2.66,p=0.00. Cut off PLR>178.55, median survival 3.26, p=0.35. Multivariate analysis showed that NLR, HR=2.75 and performance status, HR=1.78 were associated with survival.Conclusions:NLR with cut off>3.37 is associated with one-year survival rate of advanced-stage NSCLC patient. PLR did not have any significant association with one-year survival rate of advanced-stage NSCLC patient.

Evaluation of simple cost-effective immuno-haematological markers to predict outcome in hospitalized COVID-19 patients during second wave

Background:COVID-19 pandemic has strained the health infrastructure globally, hence the importance of cost-effective biomarkers. We aimed to identify simple haematological prognostic markers in hospitalized COVID-19 patients to differentiate between milder and severe cases, thus predicting outcome.Methods:A retrospective study of COVID-19 patients admitted at MallaReddy institute of medical sciences was conducted from April to June 2021. Total leukocyte count (TLC), neutrophil-to-lymphocyte ratio (NLR), derived NLR ratio (dNLR) and platelet-to-lymphocyte ratio (PLR) were calculated and correlated with outcome. These parameters were compared with other inflammatory markers using ROC(receiver operator curve)analysis.Results:303 patients of 397 fulfilled the inclusion criteria (male-198, female-105). There was a significant higher mean of NLR in patients with death (14.46�84) compared to patients recovered (8.43�33), similarly the dNLR was higher in death (8.06�34) compared to recovered (4.97�49). A significant positive strength of association between the NLR and dNLR with the ESR, CRP, CORADS score and CT severity score in the patients. The ROC analysis showed the NLR (AUC=0.777) and dNLR (0.799) a better marker to predict the outcome.Conclusions:In COVID-19, immuno-haematological markers like NLR, dNLR, PLR found to be a simple and cost-effective tool to prognosticate the clinical outcome among hospitalized patients and were in concordance with the other inflammatory markers. Hence, these markers serve as better indicators in risk stratification and better management.

Predictive effect of inflammatory biomarkers on prognosis of liver transplantation for hepatocellular carcinoma / 器官移植

Tumor recurrence is the main issue that affects the long-term survival of recipients after liver transplantation for hepatocellular carcinoma. Accurate preoperative evaluation and proper selection of transplant recipients are the key factors affecting the long-term prognosis of recipients undergoing liver transplantation for hepatocellular carcinoma. Neutrophil, lymphocyte, C-reactive protein, platelet and fibrinogen (FIB) are major biomarkers that indicate inflammatory response of the host. Multiple studies have found that these biomarkers may not only represent the inflammatory response, but also could be integrated to predict tumor recurrence and long-term survival rate of the recipients following liver transplantation for hepatocellular carcinoma. These biomarkers mainly consist of neutrophil-to-lymphocyte ratio (NLR), Glasgow prognostic score (GPS), FIB, platelet-to-lymphocyte ratio (PLR) and prognostic nutritional index (PNI), etc. In this article, research progresses on predictive effect of inflammatory biomarkers on prognosis of liver transplantation for hepatocellular carcinoma were reviewed.

Value of neutrophil / lymphocyte ratio and platelet / lymphocyte ratio in the diagnosis and prediction of disease severity in juvenile atopic dermatitis / 中国输血杂志

【Objective】 To study the value of neutrophil/lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR) in the diagnosis and prediction of disease severity in adolescent atopic dermatitis (AD). 【Methods】 A total of 100 AD patients and 50 healthy individuals were selected from Dermatology Department of our hospital.The age, gender, blood routine results of all subjects were collected, and NLR and PLR were calculated.The diagnostic value of NLR and PLR for AD and severe AD was discussed by receiver operating curve (ROC), the relationship between NLR, PLR and the risk of AD was analyzed. 【Results】 The AUC of NLR and PLR in the diagnosis of AD was 0.780 and 0.769, with the best cutoff value at 2.95 and 98.50 respectively, and no significant difference in the predictive value between NLR and PLR was noticed (P>0.05). The proportion of NLR≥2.95, PLR≥98.50, red blood cell distribution width (RDW), mean platelet volume (MPV), white blood cell count (WBC) and eosinophils (E) in AD group were significantly higher than those in control group (all P<0.05). Before and after adjusting for confounding factors, the odds ratio (OR) of patients with NLR≥2.95 and PLR≥98.50 were 12.250 vs 6.048 and 5.525 vs 4.352, respectively.NLR, PLR and E in mild AD group were lower than those in severe AD group, and NLR and E in moderate AD group were lower than those in severe AD group, the differences were statistically significant (all P<0.05). The AUC of NLR and PLR in diagnosis of severe AD was respectively 0.712 and 0.675, the difference was statistically significant (P<0.05). NLR, PLR, RDW and E were positively correlated with SCORAD score, and the r values were 0.254, 0.198, 0.202 and 0.219 respectively. 【Conclusion】 The increase of NLR and PLR were the risk factors of AD, and had certain diagnostic value for AD and severe AD.

The effect and correlation of smoking with platelet indices, neutrophil lymphocyte ratio and platelet lymphocyte ratio

ABSTRACT Introduction: Smoking is associated with the occurrence and progression of cardiovascular diseases, inflammatory disorders and malignancies. Objective: To study the platelet indices, neutrophil lymphocyte ratio (NLR) and platelet lymphocyte ratio (PLR) in smokers and their correlation with smoking pack-years. Method: A total of 110 smokers and 110 non-smokers were included. The smokers were grouped into three groups: mild (<5 pack-years), moderate (5-10 pack-years) and heavy (>10 pack-years). The platelet count, plateletcrit (PCT), mean platelet volume (MPV) and platelet distribution width (PDW) were noted. The NLR and PLR were calculated and the statistical analysis was made using the Student's T-test, Analysis of Variance (ANOVA) and Spearman's correlation coefficient. Results: The platelet count, PCT and PDW were significantly higher with mean values: 218.56 ± 121.31 vs 203.23 ± 80.35 (p-value = 0.038), 0.27 ± 0.10 vs 0.26 ± 0.10 (p-value = 0.041) and 12.54 ± 1.45 vs 11.99 ± 1.70 (p-value = 0.001) in smokers and non-smokers, respectively. The PLR differed significantly with mean values: 119.40 ± 84.81 in smokers and 181.99 ± 313.09 in non-smokers, with a p-value of 0.045. A significant positive correlation was found between pack-years of smoking and platelet count and PLR with the Pearson correlation coefficient of 0.250 and 0.198 and p-values, 0.008 and 0.037, respectively. The Platelet Count, PCT, MPV and PDW varied significantly between mild, moderate and heavy smoker groups, with p-values of 0.045, 0.010, 0.015 and 0.017, respectively. Conclusion: The platelet indices and inflammatory markers NLR and PLR are derived from routine blood investigations, which are easily available and inexpensive. The monitoring of platelet indices, along with the PLR, can be used as early predictors of morbidity in smokers.

Association Between Platelet Lymphocyte Ratio and Prognosis of Non-small Cell Lung Cancer Patients Treated with PD-1/PD-L1 Inhibitor: A Meta-analysis / 肿瘤防治研究

Objective To investigate the prognostic value of the platelet-lymphocyte ratio (PLR) in non-small cell lung cancer patients treated with PD-1/PD-L1 inhibitors. Methods PubMed, EMBASE, Web of Science, Medline, Cochrane Library, China National Knowledge Infrastructure, Chinese Biomedical Literature Database, VIP, WanFang and other databases were searched online for eligible studies about evaluating the relation between PLR and the prognosis of NSCLC patients treated with PD-1/PD-L1 inhibitors from the establishment of database to April 2020. The relevant data of literatures that met the inclusion criteria were extracted. Pooled estimates of HR and 95%CI were calculated using Stata 15.0. Results We included six studies involving 551 patients. Elevated PLR was associated with worse OS and PFS of NSCLC patients treated with PD-1/PD-L1 inhibitors. The subgroup analysis of OS showed the prognostic value of high PLR in Caucasian race, cutoff value ≤169.05, PLR cutoff value determination according to previous literature and multi-center retrospective study (P < 0.05). Subgroup analysis of PFS showed the prognostic value of high PLR in East Asian race, cutoff value ≤169.05, PLR cutoff value determination according to previous literature and single-center retrospective study (P < 0.05). Conclusion Among NSCLC patients treated with PD-1/PD-L1 inhibitors, elevated blood PLR is associated with shorter OS and PFS, indicating that it may be a potential biomarker for PD-1/PD-L1 treatment on NSCLC patients.

Relation Between NLR, LMR, PLR and Prognosis of Osteosarcoma / 肿瘤防治研究

Objective To explore prognostic value of pre-treatment NLR, PLR and LMR in patients with osteosarcoma. Methods We retrospectively analyzed the clinical and survival data of 70 patients with osteosarcoma who received the same treatment regimen and calculated the NLR, PLR and LMR at initial diagnosis of osteosarcoma. ROC analysis was used to analyze the AUC and confirm the optimal cut-off value. Kaplan-Meier analysis was performed for survival curves. Cox regression models were employed to determine the independent prognostic factors. Results NLR=3.025, LMR=4.82 and PLR=111.5. The 3- and 5-year survival rates of patients with high NLR were 42.0% and 28.0%, while those in the low NLR group were 73.9% and 60.2% (P=0.002). The 3- and 5-year survival rates of patients in the high LMR group were 71.1% and 55.3% (P < 0.001), while those in the low LMR group were 33.3% and 10.4%. The 3- and 5-year survival rates of patients with high PLR were 30.8% and 23.8%, while those in the low PLR group were 63.6% and 56.6% (P=0.001). Univariate analysis showed that NLR, PLR, LMR and lung metastasis were significantly correlated with patients' death (P < 0.05). Multivariate Cox regression analysis showed that NLR and LMR were independent prognostic factors affecting the overall survival of osteosarcoma patients. Conclusion NLR and LMR levels are the prognostic indicators of patients with osteosarcoma. Patients with NLR > 3.025 and LMR < 4.82 have a short survival period, which may need more aggressive chemotherapy and close follow-up to improve clinical treatment results.

Role of Puerariae Lobatae Radix in Gegen Decoction for treatment of primary dysmenorrhea / 中国中药杂志

This study aimed to explore the characteristic role of Puerariae Lobatae Radix(PLR) in Gegen Decoction for the treatment of primary dysmenorrhea(PD). Estrogen(E_2) was combined with oxytocin to establish a mouse model of PD. The mice were randomly divided into a normal group, a model group, a Gegen Decoction group, a PLR-free Gegen Decoction group, a PLR group, and a positive drug group(ibuprofen). Writhing response times and writhing incubation of mice in each group were tested by behavio-ral assessment, and the serum levels of prostaglandin F_(2α)(PGF_(2α)), prostaglandin E_2(PGE_2), E_2, and progesterone(PROG) were detected by ELISA kits. Western blot method was adopted to detect cyclooxygenase-2(COX-2) and estrogen receptor alpha(ER_α) expression levels in uterine tissues. Doppler ultrasound was employed to detect changes in uterine artery blood flow in mice, including peak systolic blood flow velocity(maximum velocity), end-diastolic velocity(minimum velocity), peak systolic blood flow velocity/end-diastolic velocity(S/D), pulsatility index(PI), and resistive index(RI). Histopathological changes in the uterus were detected by HE staining. Based on the oxytocin-induced isolated uterine contraction model, the effects of Gegen Decoction, PLR-free Gegen Decoction, and PLR on the amplitude, frequency, and activity of isolated uterine contraction were compared to investigate the role of PLR in Gegen Decoction for the treatment of PD. The results showed that compared with the Gegen Decoction group, the PLR-free Gegen Decoction improved the indicators of PD except for E_2 content, ER_α expression, and uterine artery blood flow. PLR could significantly down-regulate the serum content of E_2 and the protein expression of uterine ER_α, and improve the uterine artery blood flow. The data suggested that PLR, as the sovereign drug of Gegen Decoction, might function in Gegen Decoction for the treatment of PD by mediating E_(2 )and improving the uterine artery blood flow.

Predictive value of peripheral blood NLR and PLR in perioperative period on the prognosis of patients with intrahepatic cholangiocarcinoma / 中国肿瘤生物治疗杂志

@#[摘 要] 目的：探讨肝内胆管癌（intrahepatic cholangiocarcinoma，ICCA）围手术期外周血中性粒细胞与淋巴细胞比率（neutrophil-to-lymphocyte ratio，NLR）和血小板与淋巴细胞比率（platelet-to-lymphocyte ratio，PLR）对患者预后的预测价值。方法：收集2015年1月至2018年1月在上海市松江区中心医院接受肝切除术治疗的ICCA患者97例作为ICCA组，选择同期在本院做健康体检的志愿者100例作为正常对照组。检测两组受试者术前1 d、术后3 d和7 d外周血的NLR、PLR，采用单因素、多因素分析ICCA患者术后随访期死亡的危险因素，采用Kaplan-Meier生存曲线分析术后3 d的NLR和PLR对ICCA患者术后生存时间的影响，采用受试者工作特征曲线（receiver operating characteristic curve，ROC）分析术后3 d的NLR和PLR水平对患者术后随访期死亡的预测价值。结果：ICCA组患者术前1 d、术后3和7 d外周血的NLR、PLR均高于正常对照组（均P<0.05），术前1 d和7 d外周血NLR、PLR差异无统计学意义（P>0.05），术后3 d外周血NLR、PLR水平最高（P<0.05）。多发肿瘤、合并淋巴结转移、TNM分期Ⅲ~Ⅳ、CA199水平增高、术后3 d的NLR和PLR较高分别是ICCA患者随访期死亡的独立危险因素（均P<0.05）。ROC曲线显示，术后3 d的NLR和PLR高低对ICCA患者术后生存时间具有预测价值。Kaplan-Meier生存曲线显示，低NLR[（50.32±3.69） vs （30.12±2.36）个月]和低PLR[（53.6±3.75） vs （37.6±2.96）个月]患者生存时间均长于高NLR和PLR的ICCA患者（均P<0.05）。结论：ICCA术后3 d的NLR和PLR异常增高是患者肝切除术后死亡的独立危险因素，其对患者生存时间具有早期预测价值。

Neutrophil/lymphocyte and platelet/lymphocyte ratios as potential markers of disease activity in patients with Ankylosing spondylitis: a case-control study

Abstract Background: The neutrophil/ lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR) have the potential to be inflammatory markers that reflect the activity of many inflammatory diseases. The aim of this study was to evaluate the NLR and PLR as potential markers of disease activity in patients with ankylosing spondylitis. Methods: The study involved 132 patients with ankylosing spondylitis and 81 healthy controls matched in terms of age and gender. Their sociodemographic data, disease activity scores using the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), erythrocyte sedimentation rate (ESR), and white blood cell, neutrophil, lymphocyte and platelet counts were recorded. The patients with ankylosing spondylitis were further divided according to their BASDAI scores into patients with inactive disease (BASDAI < 4) and patients with active disease (BASDAI ≥4). The correlations between the NLR, PLR and disease activity were analysed. Results: There was a statistically significant difference in the NLR and PLR between the active and inactive ankylosing spondylitis patients (2.31 ± 1.23 vs. 1.77 ± 0.73, p = 0.002), (142.04 ± 70.98 vs. 119.24 ± 32.49, p < 0.001, respectively). However, there was no significant difference in both the NLR and PLR between the healthy control group and ankylosing spondylitis patients (p > 0.05). In addition, the PLR was significantly higher in both the active and inactive groups compared to those in the healthy control group (142.04 ± 70.98 vs. 99.32 ± 33.97, p = 0.014), (119.24 ± 32.49 vs. 99.32 ± 33.97, p = 0.019). The BASDAI scores were positively correlated with the PLR (r = 0.219, p = 0.012) and the NLR, but they were not statistically significant with the later (r = 0.170, p = 0.051). Based on the ROC curve, the best NLR cut-off value for predicting severe disease activity in ankylosing spondylitis patients was 1.66, with a sensitivity of 61.8% and a specificity of 50.6%, whereas the best PLR cut-off value was 95.9, with a sensitivity of 70.9% and a specificity of 55.5%. Conclusion: The PLR may be used as a useful marker in the assessment and monitoring of disease activity in AS together with acute phase reactants such as the ESR.

The predictive value of preoperative fibrinogen level in peripheral blood combined with platelet-to-lymphocyte ratio in the prognosis of colorectal cancer / 医学研究生学报

ObjectiveThe local recurrence or distant metastasis of colorectal cancer (CRC) after surgical resection still directly affects the prognosis of CRC patients.This study aims to investigate the clinical significance of preoperative peripheral blood fibrinogen (Fbg) level combined with platelet-to-lymphocyte ratio (PLR) in the prognosis of CRC.MethodsThe clinicopathological characteristics of 108 CRC patients who were diagnosed by pathology and underwent surgical resection in Wujin hospital affiliated to Jiangsu University from January 2013 to December 2015 were analyzed. Fbg and PLR thresholds were determined by ROC curve, and the patients were grouped according to Fbg combined with PLR (F-PLR) to analyze the relationship between different F-PLR scores and the clinicopathological characteristics and prognosis of CRC patients.ResultsPLR showed statistically significant difference in the left and right half of the tumor (P0.05). Multivariate analysis using COX regression showed that F-PLR score, TNM stage and lymph node metastasis were independent risk factors for the prognosis of CRC patients (P<0.05).ConclusionThe F-PLR score (Fbg and PLR combined) can be used as a predictor of treatment effect and prognosis of CRC patients to guide clinical treatment decisions and prognoses.

Correlation analysis of platelet-lymphocyte ratio with system involvement and disease activity in rheumatoid arthritis / 医学研究生学报

ObjectiveIt is very important to monitor the disease activity and complications of patients in the treatment of rheumatoid arthritis (RA). In this paper, we evaluated the level of platelet-lymphocyte ratio (PLR) of peripheral blood in patients with rheumatoid arthritis and discussed the relationship between PLR and the system involvement, laboratory indexes, and disease activity in patients with rheumatoid arthritis.MethodsFrom September 2013 to May 2017, 123 patients with rheumatoid arthritis who were first diagnosed in the General Hospital of Eastern Theater Command were analyzed retrospectively. 123 healthy persons(healthy control group) and 123 patients with other autoimmune diseases(disease control group) were matched according to the sex and age in a ratio of 1:1. According to the disease activity score 28 joints C-reactive protein (DAS28-CRP), RA patients were divided into the high activity group and the low activity group, and the PLR levels of high-activity and low-activity patients, healthy control group and disease control group were compared, respectively. To evaluate the relationship between system involvement and PLR level in RA patients; to analyze the correlation between PLR and DAS28-CRP and traditional inflammatory indexes by Spearman; to evaluate the application effect of receiver operating characteristic curve(ROC) in the diagnosis of RA and the differentiation of disease activity of RA patients.ResultsThe PLR level of RA patients was significantly higher than that of healthy people [133.63 (103.17, 140.99)] and disease control group [159.83(104.22, 203.55)], and the difference was statistically significant(P0.05]. There was a significant positive correlation between PLR and DAS28 CRP, C-reactive protein (CRP), ESR (r=0.433, 0.501, 0.592, P all <0.01）. The AUC of PLR in diagnosing RA and evaluating RA was 0.68 and 0.73 respectively. When cut off value was 134.47 and 147.61 respectively, sensitivity was 74.8% and 77.5%, specificity was 56.5% and 63.2%.ConclusionThe level of PLR of peripheral blood in patients with RA is increased, especially in patients with circulatory system involvement, infectious diseases or RF positive, and related to disease activity. PLR is expected to be an effective supplement for RA disease diagnosis and disease activity assessment and has potential application value.

Relationship between platelet-lymphocyte ratio and tumour infiltrating lymphocyte on metastatic in breast cancer patient

Background: Platelet-lymphocyte ratio (PLR) is known associated with the prognosis of distant metastatic breast cancer. Tumor-infiltrating lymphocyte (TIL) in breast cancer also associated with the prognosis of distant metastatic breast cancer. In this study, we will examine the relationship between PLR and TIL, in association with the metastatic incidence in breast cancer.Methods: This research is a retrospective, analytic, cross-sectional study. Data was taken from medical records of breast cancer patients at Sanglah general hospital. Samples were taken by nested sampling by selecting all breast cancer patients from the period of January 1st, 2017, to December 31st, 2018, which had complete medical record data, with total sample 211. The PLR and TIL were calculated and analyzed in relation to metastasis incidence of breast cancer.Results: The sample characteristics were sorted by age, education, occupation, the area of origin, menstrual status, breast cancer staging, breast cancer subtype, TIL levels, lymphovascular invasion (LVI) status, metastatic status, and breast cancer grading. The data were analyzed to know the association of PLR, TIL, confounding factors in relation to metastatic incidences. In the sample group with PLR ≥ 156 10µ /µL, there were 22.9% cases of metastases (p = 0.002). The sample group at low TIL had metastatic event 12.5% with (p=0.442).Conclusions: PLR was associated with higher metastasis in breast cancer patients and low TIL had no association with breast cancer metastasis.

Prognostic value of rise in neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) in predicting the mortality in paediatric intensive care

Background: When the body is stressed in diverse pathological conditions, it responds by mounting an inflammatory response. Predictive biomarkers reflecting the response may serve as guide to management. Neutrophil to Lymphocyte Ratio and Platelet to Lymphocyte Ratio has been frequently used in adult patients as an indicator for mortality. However, no study has looked into their use within pediatric population. The objective of the study is to assess the prognostic value of rise in NLR and PLR in pediatric intensive care as markers of mortality.Methods: A retrospective study based on 3 year data from HIMS and G-HEALTH data systems of AJ Institute of Medical Science, of all patients admitted to PICU after excluding those in whom all the study parameters were not retrievable, were postoperative patients and/or stay was less than 5 days. NLR and PLR ratios were determined and compared to PELOD 2 using SPSS version 17.0.Results: The demographic data was matched. PELOD 2 (>20) predicted mortality in 72.2% of the patients, while NLR increase predicted in 61.1% and PLR increase in 77.8%. A decreasing trend in NLR and PLR were both closely related to better survival. Among the 3, Rise in PLR had higher sensitivity, specificity, PPV, NPV, and overall accuracy of 72.73% (p <0.001) to predict mortality.Conclusions: The study gives an insight into the fact that simple and inexpensive markers such as rise in NLR and PLR helps in predicting the mortality in the pediatric intensive care which is comparable to PELOD 2 score.

Impact of the Pretreatment or Posttreatment NLR and PLR on the Response of First Line Chemotherapy and the Outcomes in Patients with Advanced Non-small Cell Lung Cancer / 中国肺癌杂志

BACKGROUND@#Neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR), indexes of systemic inflammation, have been associated with worse survival for many types of cancer. The aim of this study is to investigate the impact of NLR and PLR on overall survival (OS) and to explore the value of changes in the NLR and PLR with treatment as a response indicator in non-small cell lung cancer (NSCLC).@*METHODS@#A total of 68 NSCLC patients in Peking University Third Hospital were eligible for retrospective analysis between April 2008 and April 2015. The pretreatment and posttreatment NLR and PLR in all patients were calculated based on complete blood counts. Potential prognostic factors such as age, gender, performance status, histology, stage, response to chemotherapy, NLR and PLR were analyzed. NLR and PLR were assessed at baseline and during chemotherapy treatment. OS was calculated by the Kaplan-Meier method. Univariate and multivariate Cox regression analyses were performed to determine the associations of the PLR, NLR and clinical features with OS.@*RESULTS@#Among the 68 cases, the values of the posttreatment NLR after two cycles of chemotherapy (NLR2) and the pretreatment NLR (NLR0) were (2.69±2.06) and (3.94±2.12), respectively. NLR2 was significantly lower than NLR0 (P=0.000). There was no difference between the pretreatment PLR (PLR0) and the posttreatment PLR after two cycles of chemotherapy (PLR2) (P0.05). According to univariate analysis, the OS was significantly associated with NLR0, PLR0, NLR2, the response of 2 and 4 cycles of first line chemotherapy, status and regimens of second line treatment (P0.05). The multivariate analysis showed that NLR0 (P=0.004), the response with 4 cycles of first line chemotherapy (P=0.022) and status of second line treatment (P=0.007) were independent prognostic indicators in the 68 patients.@*CONCLUSIONS@#The study showed that NLR0 was well connected with outcomes and NLR2 was well connected with the response to first line chemotherapy in patients with advanced non-small cell lung cancer. Therefore, NLR may be a biomarker for predicting the outcomes and response of first line chemotherapy and a potential target for management of non-small cell lung cancer.

Higher preoperative platelet-to-lymphocyte ratio is a poor prognostic marker for the early stage malignant melanoma patients / 中国肿瘤生物治疗杂志

@#[Abstract] Objective: To explore the relationship between the preoperative blood indicators (platelets, monocytes, neutrophils-to-lymphocyte ratio) and clinicopathological characters and the prognosis of the early stage malignant melanoma（MM）patients. Methods: Clinicopathological data of 120 cases of stage I-III MM patients, who received initial treatment and radical operation in the Cancer Hospital of Tianjin Medical University from January 2007 to May 2012, were obtained for this study. The correlations between parameters of PLR (platelet-to-lymphocyte ratio), LMR (lymphocyte-to-monocyte ratio), NLR (neutrophil-to-lymphocyte ratio), hemoglobin, neutrophils, lymphocytes, monocytes, eosinophils, basophils, platelets, lactate dehydrogenase, age, stage as well as ulcer and the prognosis of the patients were evaluated. Results: Patients whose tumor with ulceration have higher NLR and basophilic granulocyte (all P< 0.05）. Univariate analysis showed that NLR, PLR, LMR, neutrophil, lymphocyte, monocyte, lactic dehydrogenase, age, stage and ulceration were the risk factors of poor 5-year overall survival (P<0.05). The multivariate analysis identified PLR（HR=4.206， 95%CI:1.65410.696， P<0.01），stage（HR=7.670， 95%CI:3.977-14.795， P<0.01）and ulceration（HR=1.931， 95%CI:1.029-3.623， P<0.05）as independent risk factors for the prognosis of the MM patients. Conclusion: Higher preoperative PLR can be used as a predictive factor for poor prognosis of the early stage MM patients.

The value of preoperative NLR and PLR combined with the consensus in surgical decision making for branch duct intraductal papillary mucinous neoplasm of the pancreas / 中华普通外科杂志

Objective To analyze the difference among the 3 guidehnes used to make surgical decision for branch duct intraductal papillary mucinous neoplasm (BD-IPMN),then the guidelines were combined with neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) respectively for further analysis.Methods Clinical data of 51 appropriate BD-IPMN patients who underwent surgical resection from January 2008 to December 2015 was retrospectively analyzed.Results The significant difference was exist in the consensus for followup criterion (P ＜ 0.05).The preoperative NLR and PLR were helpful for the differential diagnosis between malignant and benign BD-IPMN,because the receiver operating characteristic curve (ROC) of NLR and PLR for prediction were 0.686 and 0.692,and the best boundary values were 2.64,92.56 respectively.The consensus combined with PLR could improve the specificity and positive predictive value (PPV),besides,the specificity and PPV could achieve 70.3％,54.2％ respectively while the sensitivity (92.9％) still remained at an ideal level after international consensus guideline combined with PLR.Conclusions NLR ≥ 2.64 and PLR ≥ 92.56 were predictive markers for the presence of BD-IPMN associated invasive tumor.The addition of PLR as a criterion to the international consensus guideline improved the accuracy of international consensus guidelines in estimating invasive BD-IPMN.