Neutrophil or platelet-to-lymphocyte ratios in blood are associated with poor prognosis of pulmonary large cell neuroendocrine carcinoma

Shi, Minxing; Zhao, Wencheng; Zhou, Fei; Chen, Hao; Tang, Liang; Su, Bo; Zhang, Jie

doi:10.21037/tlcr.2020.01.17

Cited by 23 publications

(20 citation statements)

References 34 publications

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“…In addition, a series of studies have reported that many inflammation-based markers were directly related to poor prognosis or post-operative complications in patients with hip fracture, including prognostic nutritional index ratio (PNI) [9], CRP/PNI ratio [10], and neutrophil-tolymphocyte ratio (NLR) [11,12]. Platelet-to-lymphocyte ratio (PLR), a novel marker of systemic inflammation, has been reported to be closely related to the prognosis of many diseases, such as inflammatory diseases [13], cardiovascular disease [14], and various malignancies [15][16][17], even in the 2019-novel coronavirus disease (COVID-19) [18].…”

Section: Introductionmentioning

confidence: 99%

High platelet-to-lymphocyte ratio predicts poor survival of elderly patients with hip fracture

Wang¹,

Wang²,

Yang³

et al. 2020

International Orthopaedics (SICOT)

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Purpose The platelet-to-lymphocyte ratio (PLR) has been extensively studied in various diseases. However, the relationship between PLR and hip fracture remains unknown. The aim of this study was to evaluate whether PLR would be an independent prognostic factor in elderly hip fracture patients. Methods Between January 2014 and December 2018, a retrospective cohort study was conducted in a orthopaedic centre, China. A total of 460 hip fracture patients were included. PLR was calculated as the ratio of platelet to lymphocyte counts and divided into high PLR group (≥ 189) and low PLR group (< 189) by using the receiver operating characteristic (ROC) curve. The relationship between PLR and one year all-cause mortality rate was assessed by univariate and multivariate Cox proportional hazard models. Further subgroup analysis stratified by different clinical and biological characteristics was performed to make the results more accurate. Results After a median follow-up of 32.0 months (range, 12.0-75.4), 92 patients (mortality rate: 20.0%) died within one year. PLR was significantly higher in dead patients compared with alive patients (p < 0.05), and high PLR group also had a high mortality rate (32.21% vs. 14.15%, p < 0.001). After multivariate adjustment, high PLR remained an independent predictor for one year all-cause mortality (adjusted hazard ratio (HR) 1.56, 95% confidence interval (CI) 1.02-2.41, p = 0.041). Moreover, advanced age (HR 1.05, 95% CI 1.01-1.08), male (HR 1.62, 95% CI 1.06-2.45), CCI ≥ 2 (HR 2.83, 95% CI 1.64-4.89), conservative treatment (HR 5.94, 95% CI 3.71-9.73), low haemoglobin level (HR 1.02, 95% CI 1.01-1.04), and low albumin level (HR 1.07, 95% CI 1.02-1.13) were independent risk factors for survival. Furthermore, subgroup analysis results were consistent with the main findings in most stratified groups. Conclusion This study highlights that high PLR (≥ 189) is associated with increased one year all-cause mortality in elderly hip fracture patients. As PLR is a simple indicator that can be calculated from the blood routine test, it can be easily performed in usual clinical practice.

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Section: Introductionmentioning

confidence: 99%

High platelet-to-lymphocyte ratio predicts poor survival of elderly patients with hip fracture

Wang¹,

Wang²,

Yang³

et al. 2020

International Orthopaedics (SICOT)

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“…Although SAPS III had a better predictive ability, there were too many missing values due to the need for data within 1 hour after admission [42], so we chose to use SAPS II. Some studies had suggested that PLR also had the ability to predict mortality [10,43,44], therefore, we evaluated the predictive power of the PLR, and found that it does have prediction ability but not as good as NLR. When we continued to add PLR to the new SAPS II scoring model with NLR, the AUC value did not increase signi cantly, so we did not incorporate PLR into this model.…”

Section: Discussionmentioning

confidence: 98%

“…Together with the overall trend that higher NLR level is associated with worse prognosis, the small number of patients with low NLR and poor prognosis may have been neglected; 2) The main outcome indicators may have a certain in uence on the conclusion. Previous studies have mostly focused on late-death (≥ 5 days) [8,10,13,20,22] and found that high NLR level could predict poor prognosis. But Riché et al reported that low NLR level was associated with early death (< 5 days), while high NLR level was associated with late death [12].…”

Section: Discussionmentioning

confidence: 99%

“…In addition to total white blood cell (WBC) and differential counts, combined markers such as neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) have also attracted extensive attention in recent years. A lot of research has focused on the prognostic value of the in ammatory markers in routine blood test [6][7][8][9][10][11][12][13], but which one is the most sensitive indicator, and how exactly does this indicator predict the mortality of all ICU patients are still not clear. Therefore, we performed this study to nd the best in ammatory predictor of mortality in ICU patients, and to further assess its prognostic value.…”

Section: Introductionmentioning

confidence: 99%

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Neutrophil-to-lymphocyte Ratio as a Predictor of Mortality in ICU Patients: An Analysis of MIMIC-III Database

Luo

et al. 2020

Preprint

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Background: Identifying high-risk patients in intensive care unit (ICU) is very important because of the high mortality rate. Existing scoring systems are numerous but lack effective inflammatory markers. Our objective was to identify and evaluate a low-cost, easily accessible and effective inflammatory marker that can predict mortality in ICU patients.Methods: We conducted a retrospective study using data from the Medical Information Mart for Intensive Care III database. We first divided the patients into the survival group and the death group based on in-hospital mortality. Receiver operating characteristic analyses were performed to find the best inflammatory marker (i.e. neutrophil-to-lymphocyte ratio, NLR). We then re-divided the patients into three groups based on NLR levels. Univariate and multivariate logistic regression were performed to evaluate the association between NLR and mortality. The area under the curve (AUC), Net Reclassification Improvement (NRI) and Integrated Discrimination Improvement (IDI) were used to assess whether the incorporate of NLR can improve the predictive power of existing predictive model. Results: A total of 21,822 patients were included in this study, with an in-hospital mortality rate of 14.43%. Among all inflammatory marker in routine blood test results, NLR had the best predictive ability, with a median (interquartile range) NLR of 5.40 (2.95, 10.46) in the survival group and 8.32 (4.25, 14.75) in the death group. We then re-divided the patients into low (≤1), medium (1-6) and high (≥6) groups based on NLR levels. Compared with the median NLR group, the in-hospital mortality rates were significantly higher in the low (odds ratio [OR] = 2.09; 95% confidence interval [CI], 1.64 to 2.66) and high (OR=1.64; 95%CI, 1.50-1.80) NLR groups. The addition of NLR to Simplified Acute Physiology Score II (SAPS II) improved the AUC from 0.789 to 0.798 (P<0.001), with NRI of 16.64% (P<0.001) and IDI of 0.27% (P<0.001).Conclusion: NLR is a good predictor of mortality in ICU patients, both low and high levels of NLR are associated with elevated mortality rate. The inclusion of NLR might improve the predictive power of SAPS II.

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“…6 Neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR), as inflammation-associated indices, have been evaluated to predict survival for a variety of malignancies. [7][8][9] Lactate dehydrogenase (LDH) is tightly linked to tumor cell load and distant metastasis. 10,11 In particular, NLR, PLR and LDH can be obtained from routine blood analysis and have been assessed to be cost-effective biomarkers for cancer survival.…”

Section: Introductionmentioning

confidence: 99%

<p>Inflammatory Marker Predicts Outcome of Oral Squamous Cell Carcinoma Receiving Chemo-Radiotherapy</p>

Sun

Gao

2020

CMAR

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Background: Inflammation is involved in the progression of oral squamous cell carcinoma. We therefore postulate that a blood-based inflammatory marker, the neutrophil-tolymphocyte ratio, could help to predict the prognosis in patients with oral squamous cell carcinoma receiving chemo-radiotherapy, and build a prognostic nomogram. Methods: In 111 cases of oral squamous cell carcinoma, several baseline variables, including inflammatory markers and lactate dehydrogenase, were measured within the week of chemoradiotherapy initiation as predictors of mortality and separate risk scores were developed. Results: Dichotomized neutrophil-to-lymphocyte ratio was found to be associated with AJCC stage (p<0.001). Patients with oral squamous cell carcinoma with a low neutrophil-tolymphocyte ratio survived longer than those with a high neutrophil-to-lymphocyte ratio (overall survival HR=2.39, 95% CI 1.24-4.61, p=0.009). The Harrell's concordance (C)-statistic of the nomogram was 0.74 and the calibration curve demonstrated the goodness of fit. Conclusion: The inflammatory marker neutrophil-to-lymphocyte ratio, obtained before chemo-radiotherapy, was an independent factor of survival prediction for oral squamous cell carcinoma. The nomogram incorporating immunological markers could more accurately predict individualized survival probability than the existing models. These findings are significant for the creation of personalized treatment strategies in the clinical setting.

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Neutrophil or platelet-to-lymphocyte ratios in blood are associated with poor prognosis of pulmonary large cell neuroendocrine carcinoma

Cited by 23 publications

References 34 publications

High platelet-to-lymphocyte ratio predicts poor survival of elderly patients with hip fracture

High platelet-to-lymphocyte ratio predicts poor survival of elderly patients with hip fracture

Neutrophil-to-lymphocyte Ratio as a Predictor of Mortality in ICU Patients: An Analysis of MIMIC-III Database

<p>Inflammatory Marker Predicts Outcome of Oral Squamous Cell Carcinoma Receiving Chemo-Radiotherapy</p>

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