ObjectiveTo study the clinical significance of prognostic nutritional index (PNI) combined with neutrophil to lymphocyte ratio (NLR) in predicting the occurrence of anastomotic leakage after radical gastrectomy for gastric cancer.MethodsTo retrospectively analyze and collect the clinical data of 517 patients with gastric cancer who were diagnosed at the Third People’s Hospital of Shangqiu City from January 2016 to May 2020, all of the patients received radical gastrectomy. We explored the risk factors that affect the occurrence of postoperative anastomotic leakage, and explored the clinical significance of PNI combined with NLR on the third day after operation in predicting the occurrence of anastomotic leakage.ResultsAmong 517 patients undergoing radical gastrectomy, 61 had anastomotic leakage, and the incidence of anastomotic leakage was 11.8%. The results of multivariate logistic regression analysis showed that patients with preoperative diabetes and intraoperative blood loss ≥400 mL had a higher incidence of anastomotic leakage, and with the increase of NLR value on the 3rd and 5th day after operation, and the decrease of PNI value on the 3rd and 5th day after operation, the incidence of anastomotic leakage increased (P<0.05). The area under the curve of NLR, PNI, and NLR combined with PNI on the 3rd day after operation in predicting the occurrence of anastomotic leakage were 0.849, 0.581, and 0.949, respectively, and the differences were statistically significant (P<0.05), the sensitivity and specificity of NLR combined with PNI were higher than the individual indicator.ConclusionPNI combined with NLR on the 3rd day after operation has important clinical significance in predicting the occurrence of anastomotic leakage after radical gastrectomy for gastric cancer.
ObjectiveTo explore value of preoperative neutrophil-to-lymphocyte ratio (NLR) combined with carbohydrate antigen 19-9 (CA19-9) in evaluating prognosis for patients with pancreatic head carcinoma.MethodsThe clinical data of patients with pancreatic head carcinoma underwent radical pancreaticoduodenectomy in the Lanzhou University Second Hospital from February 2011 to August 2017 were retrospectively analyzed. The preoperative serum albumin (ALB), CA19-9, NLR, carcino-embryonic antigen (CEA), alpha-fetoprotein (AFP), N stage, tumor differentiated degree, and other indicators were recorded and the patient’s overall survival was recorded. Linear correlation analysis was used to examine the association of NLR with serum CA19-9. The receiver operating characteristic (ROC) curve was used to calculate the cutoff values of NLR and CA19-9 corresponding to the overall survival rate of 2-year. Kaplan-Meier method was used for survival analysis. Cox proportional hazards regression model was used to evaluate the prognostic value of preoperative CA19-9 and NLR.Results① A total of 121 patients were enrolled in this study. There was no significant correlation between the preoperative serum CA19-9 and NLR (r=0.100 05, P=0.272 9). ② Multivariate analysis showed that higher NLR, higher CA19-9 level, higher N stage, and lower tumor differentiation were the risk factors for overall survival of pancreatic head carcinoma (P<0.05). ③ The cutoff values of CA19-9 and NLR in evaluating the 2-year overall survival rate were 123.3 U/mL and 2.34 respectively by the ROC curve analysis, the area under ROC curve of CA19-9, NLR, and CA19-9 combined with NLR were 0.763, 0.686, and 0.823, respectively. ④ The proportions of patients with CEA≥5 μg/L and ≥N1 stage were higher in the patients with CA19-9≥123.3 U/mL as compared with patients with CA19-9<123.3 U/mL (P<0.05); The proportions of patients with preoperative serum ALB level <35 g/L and CEA≥5 μg/L, ≥N1 stage, and poor differentiation were higher in the patients with NLR≥2.34 as compared with the patients with NLR<2.34 (P<0.05). ⑤ Kaplan-Meier survival analysis showed that patients with CA19-9≥123.3 U/mL and NLR≥2.34 had worse overall survival than those patients with CA19-9<123.3 U/mL and NLR<2.34 (HR=3.599, P<0.01; HR=2.506, P<0.01). The patients with CA19-9≥123.3 U/mL and NLR≥2.34 (n=42), CA19-9≥123.3 U/mL or NLR≥2.34 (n=48), CA19-9<123.3 U/mL and NLR<2.34 (n=31) had better overall survival in turn (overall and between groups, all P<0.01).ConclusionPreoperative serum CA19-9 combined with NLR has an important value in evaluating prognosis for patients with pancreatic head carcinoma.
ObjectiveTo investigate the value of neutrophil/lymphocyte ratio (NLR) in acute exacerbation of chronic obstructive pulmonary disease (AECOPD) by detecting the relationship between NLR and other well-known inflammatory biomarkers.MethodsRetrospective study of 610 AECOPD cases was performed. In order to analyze the influence of NLR level on disease condition, treatment plan and prognosis, the clinical data with acute exacerbation were collected and the value of NLR in AECOPD were analyzed.ResultsThe level of NLR was higher in the group with pneumonia than that in the non-pneumonia group (P<0.05), and the more severe the pulmonary inflammation, the higher the NLR level (P<0.05). The level of NLR was higher in the group with heart failure and the group treated with ventilator and glucocorticoid (P<0.05). The NLR level was higher in the group of hospital stay over 14 days than the group of hospital stay less than 14 days (P<0.05). The NLR value of the death group was higher than that of the survival group (P<0.05). With the increase of NLR value, the mortality rate in hospital increased gradually. Compared with C-reactive protein and interleukin-6, NLR had the highest odds ratio by binary regression analysis. Cutoff value of NLR was 5.92 by analysis of receiver-operating characteristic curve with a sensitivity of 88% and a specificity of 51%, and the area under the curve in predicting in-hospital death was 0.727 (OR=4.112, 95% confidence interval 0.609 - 0.849, P=0.02).ConclusionsNLR can be used as an inflammatory marker to evaluate the severity of AECOPD and to predict the prognosis.
ObjectiveTo explore the combined application of neutrophil to lymphocyte ratio (NLR) and systemic immune inflammation index (SII) on the prognosis of hepatitis B-related hepatocellular carcinoma after resection.MethodsRetrospectively collected data of 180 patients with hepatitis B-related hepatocellular carcinoma who were hospitalized in the Department of Infectious Diseases and Hepatobiliary Surgery of the Affiliated Hospital of Southwest Medical University and received surgical treatment from January 2013 to December 2019, including general information, laboratory examination and abdominal CT or MRI results. NLR and SII values were measured at one week before operation, and their critical values of NLR and SII were determined by ROC curve analysis. Univariate and multivariate analysis were performed to determine the risk factors to predict the survival status of patients with hepatitis B-related hepatocellular carcinoma after hepatectomy.ResultsUnivariate analysis showed that AFP, platelets, TNM staging, portal vein tumor thrombus, tumor differentiation, NLR, SII, and NLR+SII combined score were significantly correlated with the prognosis of patients with hepatitis B-related hepatocellular carcinoma (P<0.05). Multivariate analysis showed that PLT [HR=1.791, 95%CI (1.124, 2.854), P=0.014], NLR [HR=4.289, 95%CI (2.571, 7.156), P<0.001], SII [HR=5.317, 95%CI (3.016, 9.374), P<0.001], and NLR+SII combined score [HR=7.901, 95%CI (4.124, 15.138), P<0.001] were independently correlated with the survival of patients with hepatitis B-related hepatocellular carcinoma.ConclusionsThe preoperative NLR+SII combined score can be used to evaluate the postoperative prognosis of patients with hepatitis B-related hepatocellular carcinoma. The higher the score, the lower the postoperative survival rate.
ObjectiveTo summarize the blood routine indexes and predictive systems that can predict the severity of acute pancreatitis (AP). MethodThe recent domestic and foreign literatures on the predictive value of blood routine indexes for the severity of AP were reviewed.ResultsFrom the current research results at domestic and foreign, independent blood routine indexes such as red blood cell distribution width, average platelet volume, hematocrit (TCT), platelet (PLT) count, platelet distribution width, percentage of immature granulocytes (IG%), and some blood routine calculation indexes such as neutrophil to lymphocyte ratio (NLR), PLT to lymphocyte ratio (PLR), red blood cell distribution width to PLT ratio (RPR), neutrophil-monocyte product, and so on, all had different predictive value for the severity of AP. In addition, multiple prediction modes such as blood routine indexes combined with some serological indexes or other scoring systems could also be used to predict the severity of AP. In general, the predictive value of the NLR, IG%, and HCT on the severity of AP had been unanimously recognized by researchers. However, the conclusions of related studies on the predictive values of PLT, PLR, and RPR on the severity of AP were still controversial. ConclusionsAt present, there are a variety of blood routine indexes can be used to predict severity of AP, but their predictive values are different. Further researches are still needed.
ObjectiveTo investigate the application progress of peripheral blood neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) in various treatment methods of hepatocellular carcinoma(HCC), aiming to fully understand the value of NLR and PLR in various treatments of HCC.MethodRetrieved and reviewed domestic and foreign literatures related to peripheral blood NLR and PLR and HCC in recent years.ResultsThe treatment of HCC mainly included liver resection, liver transplantation, transarterial chemoembolization, radiofrequency ablation, and sorafenib. Peripheral blood NLR and PLR were related to the survival of HCC patients after treatment. High NLR and PLR often indicated poor prognosis for HCC patients.ConclusionNLR and PLR play a certain role in various treatment methods of HCC, and have a certain value in judging tumor prognosis, recurrence, and metastasis.
Objective To investigate the correlation between the neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), systemic immune inflammation index (SII) and clinicopathological characteristics and prognosis in patients with gastrointestinal stromal tumor (GIST). Methods The clinicopathological data and blood routine results of 101 patients with GIST who were treated surgically in the General Hospital Western Theater Command PLA from December 2014 to December 2018 were collected retrospectively, samples were obtained to calculate NLR, PLR and SII. The optimal cutoff value of NLR, PLR and SII were evaluated by receiver operating characteristic (ROC) curve. The Chi-square test and t-test were used to analyze the relationship between NLR, PLR, SII and clinicopathological characteristics of GIST. The Kaplan-Meier plots and the log-rank test were used to analyze the influence factors affecting the recurrence-free survival (RFS) of patients with GIST. Multivariate Cox regression analyses was used to identify the independent influence factors affecting the RFS of patients with GIST. Results The preoperative peripheral blood NLR, PLR and SII of patients with GIST were correlated with the tumor site, tumor diameter and modified NIH risk stratification (P<0.05), but not with the mitotic count of tumor cells (P>0.05). Kaplan-Meier plots and log-rank test showed that NLR, PLR, SII, surgical method, tumor site, tumor diameter, mitosis rate and modified NIH risk stratification were the influential factors of RFS in with GIST. The multivariate Cox regression analysis revealed that postoperative whether to accept regular imatinib adjuvant therapy (HR=32.876, P<0.001), modified NIH risk stratification (HR=129.182, P<0.001), and PLR (HR=5.719, P=0.028) were independent influence factors affecting the RFS of patients with GIST. Conclusions Preoperative peripheral blood PLR, NLR, and SII are correlated with clinicopathological characteristics such as the tumor location, tumor diameter and modified NIH risk stratification, and are the influencing factors of postoperative RFS in patients with GIST. PLR is an independent predictor of RFS in patients with GIST.
Objective To summarize the important role of tumor associated neutrophils (TANs) in the occurrence, development and prognosis of hepatocellular carcinoma (HCC). Methods The basic and clinical application research literatures on the correlation between TANs and the occurrence, development and prognosis of HCC were reviewed. Results As the most abundant inflammatory cells in human body, neutrophils were also an important part of the immunosuppressive microenvironment of HCC, which was closely related to the occurrence and development, immune escape and drug sensitivity of HCC. In the tumor microenvironment, the interaction between TANs, HCC cells and other components such as neutrophil extracellular traps was regulated by a variety of signal pathways. Some parameters related to neutrophils, such as neutrophils to lymphocytes ratio, had been used as effective biomarkers for predicting the clinical prognosis of HCC patients. Conclusions The exact role of neutrophils in HCC remains to be further studied. With the continuous accumulation of research results on the function of tumor associated immunosuppressive neutrophils and new therapies targeting neutrophils, more patients with HCC will benefit from immunotherapy and personalized targeted therapy.
Objective To investigate the correlation of red blood cell distribution width (RDW) and neutrophil to lymphocyte ratio (NLR) with total imaging load of cerebral small vessel disease (CSVD), and the clinical diagnostic value of RDW, NLR and their combined indicators for high load of CSVD imaging. Methods The medical records of CSVD patients hospitalized in the Department of Neurology of Baotou Central Hospital between October 2018 and October 2022 were retrospective collected. The total imaging load of CSVD was obtained by evaluating the cranial MRI and divided into a low load group and a high load group. The general clinical data, past medical history, and blood biochemical indicators were compared between the two groups. The correlation analysis method was used to analyze the relationship between the relevant indicators and the total imaging load. Logistic regression analysis was used to analyze the risk factors of the total imaging load of CSVD. The receiver operating characteristic (ROC) curve was used to evaluate the diagnostic value of the detection indicators for clinical diagnosis. Results A total of 320 patients were included. Among them, there were 201 cases (62.81%) in the low load imaging group and 119 cases (37.19%) in the high load imaging group. Excepted for age, gender, history of hypertension, RDW, and NLR (P<0.05), there was no statistically significant difference in the comparison of other indicators between the two groups (P>0.05). Spearman correlation analysis showed that RDW (r=0.445, P<0.001) and NLR (r=0.309, P<0.001) were positively correlated with the total imaging load of CSVD. The results of multivariate logistic regression analysis showed that age, male gender, RDW, and NLR were risk factors for high imaging load of CSVD. The areas under the ROC curve of RDW, NLR, and their combined indicators were 0.733, 0.644, and 0.792, respectively.Conclusions In patients with CSVD, the levels of RDW and NLR are related to the total imaging load of CSVD, which are independent risk factors for high imaging load of CSVD. The levels of RDW and NLR have clinical diagnostic value in predicting CSVD high load.