Correlation between neutrophil/lymphocyte ratio, platelet/lymphocyte ratio and postoperative cognitive dysfunction in elderly patients with esophageal cancer

Abstract

The present study intends to investigate the correlation between neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR) and postoperative cognitive dysfunction (POCD) in elderly patients with esophageal cancer. Elderly patients >65 years old with esophageal cancer in our department from October 2017 to June 2021 were included in the study. The cognitive function of the patients was assessed by the mini-mental state examination (MMSE) Scale at 1day, 3 days, and 7days after surgery. POCD was considered when the scores were <27 points, and the remaining patients were included in the control group. A total of 104 elderly patients with esophageal cancer were included in this study, and 24 patients developed POCD, with an incidence of 23.1%. The expression of NLR and PLR in both 2 groups was increased on the 1st postoperative day compared with that before surgery. There was no significant difference in the expression of NLR and PLR between the 2 groups before operation, but the expression of both in the POCD group was significantly higher than that in the control group after operation (P < .05). Logistic regression analysis showed that smoking, postoperative NLR and postoperative PLR were independent risk factors for POCD. Spearman test showed that NLR was negatively correlated with MMSE scores at postoperative 1 day and 3 days (P < .05), while PLR was negatively correlated with MMSE scores at postoperative 1 day, 3 days and 7 days (P < .05). The Area Under receiver operating characteristic curve (AUC) of postoperative NLR for predicting POCD in elderly patients with esophageal cancer was 0.656, and the AUC of postoperative PLR was 0.722. After combination of NLR and PLR, the AUC increased to 0.803 with the sensitivity of 66.7% and specificity of 82.5%. The expression level of postoperative NLR and PLR in elderly patients with esophageal cancer combined with POCD is significantly increased, which is associated with postoperative cognitive impairment. Moreover, the combination of NLR and PLR has a good predictive ability for POCD, which could be used as a potential biomarker for early diagnosis of POCD.

Platelet-to-lymphocyte ratio correlates with mild cognitive impairment and the hippocampal atrophy

“…Increased PLR is also an early prognostic factor for post-stroke depression [13]. Previous studies have demonstrated that PLR may be associated with cognitive decline in type-II diabetes mellitus patients [14], older postoperative esophageal cancer patients [15], and breast cancer survivors 20 years after completion of chemotherapy [16]. However, this was the rst study to demonstrate the relationship of PLR with MCI and hippocampal volume loss.…”

Application of electroencephalography in the management of postoperative cognitive dysfunction

“…Nevertheless, they also acknowledged the potential application of EEG in the prevention of POCD, believing that the reduction of α power during surgery may serve as a biomarker to identify patients with possible impaired preoperative cognitive function, allowing for intervention to prevent POCD. In the study by Hao et al, it was pointed out that the γ power ratio after anesthesia was lower than that in the awake state in the non-POCD group, and in the anesthetic state, the percentage of δ power in the total power was significantly higher in the POCD group than in the non-POCD group [46]. There were differences in EEG patterns between POCD and non-POCD patients, but the reduction in α power ratio and α power may not be risk factors for the occurrence of POCD [46].…”

“…In the study by Hao et al, it was pointed out that the γ power ratio after anesthesia was lower than that in the awake state in the non-POCD group, and in the anesthetic state, the percentage of δ power in the total power was significantly higher in the POCD group than in the non-POCD group [46]. There were differences in EEG patterns between POCD and non-POCD patients, but the reduction in α power ratio and α power may not be risk factors for the occurrence of POCD [46]. θ band activity in the EEG is one of the most sensitive indicators of perioperative brain injury, and the increase in θ power in the EEG is associated with mild cognitive impairment and dementia [47,48].…”

The pathogenesis of cognitive decline after cardiac surgery: A Narrative Review

“…17 Pokazano je kako je poslijeoperacijska vri jednost CRPa, kalprotektina, NLRP3 proteina, omjer neutrofila i limfocita, omjer trombocita i limfocita, te učestalost SIRSa, usko povezana s nastankom POKPa. [18][19][20][21] Stavivši upalni odgovor na kirurški za hvat u središte zbivanja nastanka POKPa, nekolicina istraživača je odlučila ispitati učinak perioperacijske primjene kortikosteroida na kognitivne funkcije. Vo đeni istom tezom, mi smo randomiziranom kontroli ranom studijom pokazali kako prijeoperacijska pri mjena niske doze deksametazona, značajno smanjuje poslijeoperacijske vrijednosti CRPa i učestalost SIRSa, čime se posljedično značajno smanjuje učestalost ranih POKPa.…”