Inflammatory Indexes as Predictive Biomarkers of Postoperative Complications in Oncological Thoracic Surgery

Abstract

The role of inflammatory responses in predicting outcomes in oncological thoracic surgery is still unclear. The aim of this study was to evaluate a series of blood count inflammation indexes as predicting factors for postoperative complications. We retrospectively studied 249 patients undergoing elective thoracic surgery in our institution between 2008 and 2020. A total of 184 patients underwent open surgery, and 65 underwent VATS. The neutrophil-to-lymphocyte (NLR), monocyte-to-lymphocyte (MLR), and platelet-to-lymphocyte (PLR) ratios, Systemic Inflammation Response Index (SIRI) were calculated preoperatively and on the first and fourth postoperative days, as well as a new derivative index, the Aggregate Inflammation Systemic Index (AISI). Univariate correlations evidenced a statistically significant association between the NLR at the fourth postoperative day and the occurrence of surgical complications in the global cohort (rho = 0.15, p = 0.03). A similar significant association with MLR on the fourth postoperative day is found in the open group (rho = −0.15, p = 0.048). NLR and LMR on the fourth postoperative day are associated with postoperative complications in the whole and open groups, respectively. Simple, easy-to-perform and inexpensive, blood cell count indexes may be useful in predicting complications in oncological thoracic surgery. A greater number of broader, prospective, randomized studies are necessary to confirm these findings.

Predictive role of blood-based indicators in neuromyelitis optica spectrum disorders

“…Platelets have been found to drive inflammation in experimental autoimmune encephalomyelitis (EAE) models and infiltrate the central nervous system (CNS) early in the disease ( D’Souza et al, 2018 ; Orian et al, 2021 ). In addition, recent studies have also found that neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), monocyte × NLR (systemic inflammation response index, SIRI), platelet × NLR (systemic immune inflammation index, SII) have been found to be markers of inflammation and can predict the prognosis of a number of tumors ( Chen et al, 2021 ; Li et al, 2021 , 2022 ; Ginesu et al, 2022 ). In addition to predicting the prognosis of a variety of tumors, the appeal indicators have recently been used to predict other diseases.…”

Prognostic Nutritional Index, Controlling Nutritional Status (CONUT) Score, and Inflammatory Biomarkers as Predictors of Deep Vein Thrombosis, Acute Pulmonary Embolism, and Mortality in COVID-19 Patients

“…Furthermore, the predictive role of these markers has been proven in the cases of renal pathologies [ 32 , 33 , 34 ], cardiovascular pathologies [ 35 , 36 , 37 , 38 , 39 , 40 ], oncological pathologies [ 41 , 42 , 43 , 44 ], and, most recently, for COVID-19 patients [ 45 , 46 , 47 , 48 , 49 , 50 , 51 ].…”

Carotid Plaque Features and Inflammatory Biomarkers as Predictors of Restenosis and Mortality Following Carotid Endarterectomy

“…Among the systemic inflammatory biomarkers, the most accessible and easy to implement in current medical practice are hematological reports based on the total number of monocytes, neutrophils, lymphocytes, and platelets, respectively: monocyte-to-lymphocyte ratio (MLR), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic inflammatory index (SII), systemic Inflammation Response Index (SIRI), and aggregate index of systemic inflammation (AISI), whose predictive role has been demonstrated in the case of cardiovascular pathologies [ 17 , 18 , 19 , 20 , 21 , 22 , 23 ], oncological pathologies [ 24 , 25 , 26 , 27 ], chronic kidney disease [ 28 , 29 , 30 ], and, more recently, in the case of COVID-19 patients [ 31 , 32 , 33 , 34 , 35 , 36 , 37 ].…”