Neutrophil–Lymphocyte Ratio as a Prognostic Factor in Laryngeal Carcinoma

Aim of this study; investigate whether neutrophils/lymphocyte ratio (NLR) could be used as a prognostic factor in larynx cancer. The correlation between preoperative peripheral blood NLR and age, gender, smoking, alcohol use, clinical stage and differentiation degree was examined. One hundered fourty-four patients in Dicle University Department of Otorhinolaryngology between the years of 2005 and 2014 were included in the study. Clinical and preoperative laboratory data of patients were screened retrospectively from archive files of otorhinolaryngology and the pathology results were screened retrospectively from archive files of pathology. The study was approved by the local ethics committee of the department and carried out in accordance with the declaration of Helsinki as amended in 2013. Statistical analyses were performed using the SPSS 15.0 software package for Windows (SPSS inc., Chicago, IL, USA). There was a significant difference between NLR and clinical stage (p = 0.003) smoking (p = 0,001) and alcohol use (p = 0.001). When NLR was analyzed in detail according to the degree of tumor differentiation; significant differences were observed between G1 and G2 (p = 0.007) and between G1 and G3 (p = 0.001). Light of these findings, NLR is a cheap and easily accessible marker which can be used as a prognostic faxtor in laryngeal cancer. It is thougkt to shed light on the studies which will be conducted with more patients.     

May the Neutrophil/Lymphocyte Ratio Be a Predictor in the Differentiation of Different Thyroid Disorders?

Background: The neutrophil/lymphocyte ratio (NLR) is a simple index of systemic inflammatory response,and has been shown to be a prognostic indicator in some types of cancer. Inflammation has been implicatedin the initiation and progression of thyroid cancer. The aim of this study was to examine the relationship ofNLR with papillary thyroid cancer (PTC) and different benign thyroid pathologies like multinodular goiter(MNG) and lymphocytic thyroiditis (LT). Materials and Methods: We retrospectively evaluated the neutrophil,lymphocyte counts and NLR calculated from these parameters of 232 patients with histologically confirmed asmultinodular goiter (group MNG) (n=70), lymphocytic thyroiditis (group LT) (n=97), LT with PTC (group LTPTC)(n=25) and PTC (group PTC) (n=40). The optimal cut-off value for NLR was determined. Results: NLRlevel was significantly higher in groups LT-PTC and PTC as compared to groups MNG and LT (p<0.05). NLRof LT subgroups according to TSH levels were not different (p>0.05). When we grouped the patients as benignand malignant according to PTC presence, the optimum NLR cut-off point obtained from ROC analysis was 1.91(sensitivity 89.0% and specificity 54.5%). Conclusions: Since NLR was significantly elevated in group LT-PTCand group PTC, NLR value may give an opinion as a potential marker in differentiation of benign and malignthyroid disorders. For this purpose a cut-off value of 1.91 for NLR may be accepted.     

Neutrophil–Lymphocyte Ratio and Absolute Lymphocyte Count as Prognostic Markers in Patients Treated with Curative-intent Radiotherapy for Non-small Cell Lung Cancer

AimsThe neutrophil–lymphocyte ratio (NLR) and the absolute lymphocyte count (ALC) have been proposed as prognostic markers in non-small cell lung cancer (NSCLC). The objective of this study was to examine the association of NLR/ALC before and after curative-intent radiotherapy for NSCLC on disease recurrence and overall survival.Materials and methodsA retrospective study of consecutive patients who underwent curative-intent radiotherapy for NSCLC across nine sites in the UK from 1 October 2014 to 1 October 2016. A multivariate analysis was carried out to assess the ability of pre-treatment NLR/ALC, post-treatment NLR/ALC and change in NLR/ALC, adjusted for confounding factors using the Cox proportional hazards model, to predict disease recurrence and overall survival within 2 years of treatment.ResultsIn total, 425 patients were identified with complete blood parameter values. None of the NLR/ALC parameters were independent predictors of disease recurrence. Higher pre-NLR, post-NLR and change in NLR plus lower post-ALC were all independent predictors of worse survival. Receiver operator curve analysis found a pre-NLR > 2.5 (odds ratio 1.71, 95% confidence interval 1.06–2.79, P < 0.05), a post-NLR > 5.5 (odds ratio 2.36, 95% confidence interval 1.49–3.76, P < 0.001), a change in NLR >3.6 (odds ratio 2.41, 95% confidence interval 1.5–3.91, P < 0.001) and a post-ALC < 0.8 (odds ratio 2.86, 95% confidence interval 1.76–4.69, P < 0.001) optimally predicted poor overall survival on both univariate and multivariate analysis when adjusted for confounding factors. Median overall survival for the high-versus low-risk groups were: pre-NLR 770 versus 1009 days (P = 0.34), post-NLR 596 versus 1287 days (P ≤ 0.001), change in NLR 553 versus 1214 days (P ≤ 0.001) and post-ALC 594 versus 1287 days (P ≤ 0.001).ConclusionNLR and ALC, surrogate markers for systemic inflammation, have prognostic value in NSCLC patients treated with curative-intent radiotherapy. These simple and readily available parameters may have a future role in risk stratification post-treatment to inform the intensity of surveillance protocols.     

May the Platelet to Lymphocyte Ratio be a Prognostic Factor for Epithelial Ovarian Cancer?

Background: The study aimed to evaluate changes in hematologic parameters, including white blood cell,platelet count, platelet indices, the platelet to lymphocyte and neutrophil to lymphocyte ratios in patients withearly and advanced stages of epithelial ovarian cancers. Materials and Methods: The study included 100 patientswith epithelial ovarian cancer who underwent primary staging exploratory laparotomy. Preoperative hematologicparameters, tumor histopathologic type, grade, stage and serum CA-125 levels were retrospectively analyzed.These parameters were compared between the patients with early (stage I-II) and advanced (stage III-IV) ovariancancer. Results: White blood cell count and platelet indices, including mean platelet volume, platelet distributionwidth and platelet crit did not show a statistically significant difference between groups with early and advancedovarian cancer. However, the neutrophil to lymphocyte ratio, platelet count, the platelet to lymphocyte ratioand CA-125 level showed a statistically significant difference between the two groups (p<0.05, p<0.01, p<0.001,p<0.01 respectively). Conclusions: It was found that the neutrophil to lymphocyte ratio, platelet count and theplatelet to lymphocyte ratio increased with the increasing stage of ovarian cancer. Furthermore, it was seen thatthe platelet to lymphocyte ratio is an independent prognostic factor related to the stage of epithelial ovariancancer.     

Evaluation of Neutrophil–Lymphocyte Ratio as a Prognostic Factor in Cervical Intraepithelial Neoplasia Recurrence

Background: Immune system status is a factor related to cervical intraepithelial neoplasia (CIN) recurrence.neutrophil-lymphocyte ratio (NLR) is a useful factor in assessing the immune status. The aim of this study was toevaluate the prognostic value of NLR factor for CIN recurrence in patient who underwent excisional procedure and itsrelationship with recurrence free survival (RFS). Methods: In this historical cohort study, a population of 307 patientswith CIN (confirmed by excisional pathology) from 2009 to 2017 were selected. NLR and hematologic factors weremeasured before surgery and the follow-up records of these patient were analyzed. The recurrence rate and RFS wereassessed during the follow-up phase. Results: The NLR cut-off point of 1.9 was determined using the Youden Index.NLRUnivariate analysis showed that higher NLR values (P<0.001), absolute neutrophilic counts (ANC) (P<0.001) andplatelet lymphocytic ratios (PLR) (P=0.002) were significantly associated with reduction in RFS. The results of Coxregression showed that removing more tissue during excision (HR = 0.325; 95% CI (0.936-0.136) significantly reducedthe hazard of recurrence, higher NLR (HR = 4.55; 95% CI) (1.97-10.51) and white blood cell (WBC) count levels (HR=1.27; 95% CI, 1.04-1.55), significantly decreased RFS, but PLR and ANC associated with RFS were not confirmedby Cox regression. Conclusion: NLR and total WBC count might be prognostic factors involved in the prediction ofrecurrence and RFS in CIN patient underwent excisional procedure. To confirm these results, more prospective studieswith larger sample sizes are needed.     

Treatment of Metastatic Colorectal Cancer With or Without Bevacizumab: Can the Neutrophil/Lymphocyte Ratio Predict the Efficiency of Bevacizumab?

Background: The purpose of this study was to analyze the predictive value of neutrophil/lymphocyte ratio (NLR) to better clarify which patient groups will benefit the most from particular treatments like bevacizumab. Materials and Methods: A total of 245 treatment-naive metastatic colorectal cancern (mCRC) patients wereretrospectively enrolled and divided into 2 groups: 145 group A patients were treated with chemotherapy in combination with bevacizumab, and 100 group B patients were treated as above without bevacizumab. Results: Group A patients had better median overall survival (OS) and progression-free survival (PFS) (24.0 and 9.0 months) than group B patients (20 and 6.0 months) (p=0.033; p=0.015). In patients with low NLR, OS and PFS were significantly longer in group A patients (27 vs 18 months, p=0.001; 11 vs 7 months, p=0.017). Conclusions: We conclude that NLR, a basal cancer related inflammation marker, is associated with the resistance to bevacizumabbased treatments in mCRC patients.     

Could the Neutrophil to Lymphocyte Ratio be a Poor Prognostic Factor for Non Small Cell Lung Cancers?

Background: Although many prognostic factors have been identified for lung cancers, new ones are neededto determine the course of the disease. Recently, a high neutrophil to lymphocyte ratio (NLR) prior to surgeryor treatment has been shown to be an indicator of prognosis for cancer. The aim of this study was to investigatethe value of NLR as a prognostic factor and the correlation between NLR and other probable clinical prognosticfactors in non small cell lung cancer patients prior to treatment. Materials and Methods: Data of patients whowere diagnosed with non-small cell lung cancer in our institution were retrospectively reviewed. Demographicand clinicopathologic characteristics were recorded. NLR was calculated before the application of any treatment.Results: A total of 299 patients, 270 (90%) males and 29 (10%) females, were included in the study. Age (p<0.001)stage (p<0.001), Eastern Cooperative Oncology Group performance status (p<0.001), weight loss (p<0.001),anemia (p<0.001), histopatology (p<0.001), NLR ≥3 (p=0.048), NLR ≥4 (p=0.025) and NLR ≥5 (p=0.018) werefound to be the prognostic factors. Age, anemia, Eastern Cooperative Oncology Group performance status, thestage, NLR (≥5) were an independent prognostic factors. There was a positive correlation between NLR and theEastern Cooperative Oncology Group performance status (0.23, p=0.001), the C reactive protein levels (r=0.36,p<0.001). Conclusions: Prior to treatment high NLR was found as an independent poor prognosis factor. Besides,NLR correlated with Eastern Cooperative Oncology Group performance status and the C reactive protein levels.     

Are Neutrophil/Lymphocyte and Platelet/Lymphocyte Ratios Associated with Endometrial Precancerous and Cancerous Lesions in Patients with Abnormal Uterine Bleeding?

Background: An easy, reproducible and simple marker is needed to estimate phase of endometrial pathologiclesions such as hyperplasia and endometrial cancer and distinguish from pathologically normal results. Wehere aimed to clarify associations among neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio(PLR), endometrial hyperplasia and cancer in patients with abnormal uterine bleeding. Materials and Methods:Patients (n=161) who were admitted with abnormal uterine bleeding and the presence of endometrial cells oncervical cytology or thick endometrium were investigated. The study constituted of three groups accordingto pathologic diagnosis. Group 1 included endometrial precancerous lesions like hyperplasia (n=63), group 2included endometrial cancerous lesions (n=38) and group 3 was a pathologically normal group (n=60). Bloodsamples were obtained just before the curettage procedure and the NLR was defined as the absolute neutrophilcount divided by the absolute lymphocyte count; similarly, PLR was defined as the absolute platelet count dividedby the absolute lymphocyte count. Results: The white blood cell count was significantly higher in patients withcancer than in those with hyperplasia (p=0.005). The platelet count and neutrophil to lymphocyte ratio weresignificantly higher in patients with cancer than in control patients, but there was significantly no differencebetween patients with hyperplasia and other groups (p=0.001 and p=0.025 respectively). PLR was significantlylower in control subjects than in other groups (p<0.001), but there was no significant difference between patientswith hyperplasia and those with cancer. Conclusions: PLR was significantly lower in control subjects than inother groups. Thus both hyperplasia and cancer may be differentiated from pathologically normal patients byusing PLR. White blood cell count was significantly higher in patients with cancer than in those with hyperplasiaand pathologically normal patients. Therefore white blood cell count may be used for discriminate hyperplasia tocancer. By using multiple inflammation parameters, discrimination may be possible among endometrial cancer,endometrial precancerous lesions and pathologically normal patients.     

Are Neutrophil/Lymphocyte and Platelet/Lymphocyte Rates in Patients with Non-Small Cell Lung Cancer Associated with Treatment Response and Prognosis?

Background: Inflammation is a critical component of tumor progression. Many cancers arise from sites ofinfection, chronic irritation, and inflammation. It is now becoming clear that the tumour microenvironment,which is largely orchestrated by inflammatory cells, is an essential participant in the neoplastic process, promotingproliferation, survival and migration. Platelets can release some growth factors such as platelet-derived growthfactor, platelet factor 4, and thrombospondin. Such factors have been shown to promote hematogenous tumourspread, tumor cell adhesion and invasion, and angiogenesis and to play an important role in tumor progression.In this study, we aimed to investigate effects of the pretreatment neutrophil to lymphocyte ratio (NLR) and theplatelet to lymphocyte ratio (PLR) on survival and response to chemoradiotherapy in patients with non-small-celllung cancer (NSCLC). Materials and Methods: Ninety-four patients with non-metastatic NSCLC were includedand separated into two groups according to median valuse of NLR and PLR (low:<3.44 or high:≥3.44 andlow:<194 or high≥194, respectively). Results: Pretreatment high NLR and PLR were associated with significantlyshorter disease-free and overall survival rates. Multivariate analysis revealed that the overall survival rateswere significantly linked with PLR (OR: 1.87, CI: 1.20-2.91, p: 0.006) and response to chemoradiotherapy (OR:1.80, CI: 1.14-2.81, p: 0.012) and the disease-free survival rates were significantly associated with NLR (OR:1.81, CI: 1.16-2.82, p: 0.009) and response to chemoradiotherapy (OR: 2.30, CI: 1.45-3.66, p: 0.001). There wasno significant difference between patients with high and low NLR in terms of response to chemoradiotherapy.Similarly, there was no significant influence of the PLR. Conclusions: Pretreatment NLR and PLR measurementscan provide important prognostic results in patients with NSCLC and assessment of the two parameters togetherappears to better predict the prognosis in patients with NSCLC. The effect of inflammation, indicators of NLRand PLR, on survival seems independent of the response to chemoradiotherapy.     

Lymphocyte predominant Hodgkin’s disease

Lymphocyte predominant Hodgkin’s disease (LPHD) is a rare type of B-cell lymphoma with unique pathologic and clinical features that distinguish it from other types of Hodgkin’s disease. Patients with LPHD tend to be younger males who present with indolent and asymptomatic lymphadenopathy limited to peripheral lymph nodes. The immunophenotype of the malignant lymphocytic and/or histiocytic cells (CD20+, CD15-, CD30-) forms the basis of the pathologic distinction from the subtypes of classical Hodgkin’s disease. Despite an excellent response to aggressive upfront combined-modality treatment, patients with LPHD tend to relapse continuously over decades. The benign nature of these relapses and the incidence of late treatment-related toxicity have raised questions about the need for an aggressive upfront approach. Recent insights into the molecular pathogenesis of LPHD and the development of novel targeted therapies promise to improve future treatment.     

Correlation of Neutrophil to Lymphocyte Ratio and Absolute Neutrophil Count With Outcomes With PD-1 Axis Inhibitors in Patients With Advanced Non–Small-Cell Lung Cancer

Introduction

Programmed death-1 (PD-1) axis inhibitors have become standard therapy in advanced non–small-cell lung cancer (NSCLC). Response might be delayed and pseudo-progression occasionally occurs in patients who eventually benefit from treatment. Additional markers beyond programmed death ligand 1 (PD-L1) expression are needed to assist in patient selection, response evaluation, and treatment decisions.

Assessment of Prognostic Value of “Neutrophil to Lymphocyte Ratio” and “Prognostic Nutritional Index” as a Sytemic Inflammatory Marker in Non-small Cell Lung Cancer

Background: Systemic inflammatory response was shown to play an important role in development andprogression of many cancer types and different inflammation-based indices were used for determining prognosis.We aimed to investigate the prognostic effects of neutrophil to lymphocyte ratio (NLR) and prognostic nutritionalindex (PNI) in patients with non-small cell lung cancer (NSCLC). Materials and Methods: NSCLC patientsdiagnosed in our institution were retrospectively reviewed. Demographic and clinicopathologic characteristicswere recorded. NLR and PNI was calculated before the application of any treatment. Results: A total of 138patients were included in the study. Patients were divided into two groups according to NLR (<3.24 or ≥3.24)and PNI (<49.5 or ≥49.5). While median overall survival was 37.0 (95% CI 17.5-56.5) months in the group withlow NLR, it was calculated as 10.0 (95%CI 5.0-15.0) months in the group with high NLR (p<0.0001). Whilemedian overall survival was 7.0 (95%CI 3.5-10.5) months in the group with low PNI, it was calculated as 33.0(95% CI 15.5-50.4) months in the group with high PNI (p<0.0001). Stage, NLR and PNI levels were evaluatedas independent risk factors for overall survival for all patients in multivariate analysis (p<0.0001, p=0.04 andp<0.001, respectively). Conclusions: NLR (≥3.24) and PNI (<49.5) at diagnosis is an independent marker ofpoor outcome in patients with NSCLC. NLR and PNI is an easily measured, reproducible prognostic tests thatcould be considered in NSCLC patients.     

Increased Lymphocyte Replicative Index Following 2,4–Dichlorophenoxyacetic Acid Herbicide Exposure

Objective: Evaluate peripheral blood lymphocyte proliferation (replicative index:RI) and micronuclei frequency (MF) among 2,4–D herbicide applicators. Methods: Twelve applicators spraying only 2,4–D provided a blood and urine specimen upon enrollment, several urine samples during the spraying season, and a blood specimen at the study's end. Nine controls provided blood and urine specimens upon enrollment and at the study's end. Gas chromatography/tandem mass spectroscopy determined urinary 2,4–D levels and standard in-vitro assays determined RI and MF scores. Applicator RI and MF were compared before and after spraying and with controls. Results: Applicators contributed 45 urine specimens with concentrations ranging from 1.0 to 1700 (g 2,4–D/g creatinine/L urine) that logarithmically (ln) increased as spraying time increased. Applicator RI increased after spraying (p = 0.016), independent of tobacco and alcohol use, and demonstrated a weak dose-response with increasing urinary 2,4–D levels (p = 0.15). Among 2,4–D applicators, pre-exposure complete blood counts and lymphocyte immunophenotypes were not significantly different from post-exposure measurements. Conclusion: Urinary 2,4–D concentration, an exposure biomarker, may be associated with lymphocyte replicative index, a cell proliferation biomarker.     

Daidzein Induces Intrinsic Pathway of Apoptosis along with ER α/β Ratio Alteration and ROS Production

Background: Low risk of breast cancer is observed among females consuming a moderate quantity of soy throughout their life. The present study was conducted to evaluate the anticancer potential of Daidzein, one of the major Isoflavones in soy using Human breast cancer cells MCF-7. Methods: MCF-7 were subjected to various doses of Daidzein treatment to determine the IC50 value. Onset of apoptosis was ascertained by AnnexinV assay and caspase 3/7 activity post treatment. Expression of pro-apoptotic protein Bax and anti-apoptotic protein Bcl2 was also assessed to further confirm apoptotic mode of cell death. ROS production post treatment with Daidzein was assessed to ascertain the apoptosis via intrinsic pathway. Expression of ER α and ER β was evaluated by western blot analysis. Results: Human breast cancer cells MCF-7 were found to be sensitive to Daidzein treatment, with an IC50 value of 50µM. Increased percentage of treated cells stained with Annexin V confirmed apoptosis mediated cell death. Activity of Caspase 3/7 activity was found to be 1.4-fold higher in Daidzein treated cells than control cells, confirming apoptosis. Daidzein caused over expression of Bax and down-regulated expression of Bcl2. There has been an outburst of ROS in Daidzein treated cells indicating that Daidzein induces apoptosis via intrinsic pathway. A decrease in the expression of ER α and increase in levels of ER β has been observed which are conducive indicator of apoptosis. Conclusions: In conclusion, the present study suggests that Daidzein induces apoptosis in MCF-7 cells by mitochondrial pathway along with lowering the ratio of ER α/β and an outburst of Reactive Oxygen Species(ROS).     

Elevated Osteopontin Expression and Proliferative/Apoptotic Ratio in the Colorectal Adenoma–Dysplasia–Carcinoma Sequence

Colorectal cancer progression is characterized by altered epithelial proliferation and apoptosis and by changed expression of tumor development regulators. Our aims were to determine the proliferative/apoptotic epithelial cell ratio (PAR) in the adenoma–dysplasia–carcinoma sequence (ADCS), and to examine its association with osteopontin (OPN), a previously identified protein product related to cancer development. One mm diameter cores from 13 healthy colons, 13 adenomas and 13 colon carcinoma samples were included into a tissue microarray (TMA) block. TUNEL reaction and Ki-67 immunohistochemistry were applied to determine the PAR. The osteopontin protein was also immunodetected. Stained slides were semiquantitatively evaluated using digital microscope and statistically analyzed with logistic regression and Fisher’s exact test. The PAR continuously increased along the ADCS. It was significantly (p?<?0.001) higher in cancer epithelium (8.84?±?7.01) than in adenomas (1.40?±?0.78) and in normal controls (0.89?±?0.21) (p?<?0.001). Also, significant positive correlation was observed between elevated PAR and the expression of osteopontin. Cytoplasmic OPN expression was weak in healthy samples. In contrast, cytoplasmic immunoreaction was moderately intensive in adenomas, while in colon cancer strong, diffuse cytoplasmic immune staining was detected. Increasing PAR and OPN expression along ADCS may help monitoring colorectal cancer progression. The significantly elevated OPN protein levels we found during normal epithelium to carcinoma progression may contribute to the increased fibroblast–myofibroblast transition determining stem cell niche in colorectal cancer.     

Urinary Cell-Free DNA IQGAP3/BMP4 Ratio as a Prognostic Marker for Non–Muscle-Invasive Bladder Cancer

BackgroundDisease monitoring in non–muscle-invasive bladder cancer (NMIBC) patients is crucial for early identification of disease recurrence and progression. High IQGAP3/BMP4 and IQGAP3/FAM107A ratios in urinary cell-free DNA (ucfDNA) are a diagnostic biomarker for bladder cancer. We aimed to investigate whether the levels of these biomarkers in ucfDNA can be used to monitor disease recurrence or progression in patients with NMIBC.Patients and MethodsA total of 103 patients with NMIBC (pTa-pT1) were enrolled. The IQGAP3/BMP4 and IQGAP3/FAM107A ratios in ucfDNA were measured by real-time PCR, and the results were compared with clinical outcome by Kaplan-Meier curves and Cox regression analyses.ResultsOverall, 55 patients (53.4%) experienced recurrence and 29 (28.2%) experienced disease progression during a median follow-up of 42.7 months (range, 6.1-172.2 months). Kaplan-Meier analysis revealed that NMIBC patients with a high IQGAP3/BMP4 ratio had worse recurrence-free survival and progression-free survival (PFS) (P = .001 and < .001, respectively), and those with a high IQGAP3/FAM107A ratio had worse PFS (P = .006). Multivariate Cox regression analysis revealed that the IQGAP3/BMP4 ratio was independently associated with recurrence-free survival (hazard ratio, 2.462; P = .003) and PFS (hazard ratio = 3.871; P = .004), whereas the IQGAP3/FAM107A ratio was not an independent factor for PFS (P = .079).ConclusionThe IQGAP3/BMP4 ratio in ucfDNA might be a valuable novel biomarker for predicting disease recurrence and progression in patients with NMIBC.     

Evaluation of Significance of Lymphocyte Subpopulations and Non-specific Serologic Markers in B-cell Non-Hodgkin’s Lymphoma Patients

The use of rituximab brought attention to the hosts’ immune system and to the microenvironment in non-Hodgkin’s lymphoma cases. Our aim was to identify prognostic factors that can be measured easily to indicate the current state of the patient’s immune status and possible reaction against malignant cells. In the retrospective analysis (2000–2008), 66 patients diagnosed with B-cell non-Hodgkin’s lymphomas were enrolled (40 women, 26 men; mean age: 51 years). White blood cells, lymphocytes, CD3 +; CD4 +; CD8?+?T-cells, immunoglobulin types A; G; M, anti-cardiolipin antibody isotypes A; G; M; and levels of beta-2-microglobulin were measured before the initiation of the first cycle of chemotherapy, during and after 4-weeks treatment. As for CD 3+ T-lymphocytes, the absolute CD 3+ T –lymphocyte numbers were higher before (0.78?×?10⁹/L) versus during (0.27?×?10⁹/L) treatment, and increased percentages were detected in pre- (66.57 %) and post-treatment (75.32 %). Absolute numbers of CD 8+ T-lymphocyte levels showed reduction before (0.26?×?10⁹/L) versus during (0.10?×?10⁹/L) therapy, but were elevated after (0.28?×?10⁹/L) treatment, while increased percentage before (21.99 %) versus after (29.85 %), and during (24.56 %) versus after (29.85 %) therapy were seen. Average white blood cell numbers were increased before (9.71?×?10⁹/L) versus during (12.07?×?10⁹/L) treatment, while decreased numbers could be observed, after (5.47?×?10⁹/L) treatment. IgA levels were decreased before (2.51 g/L) versus after (1.63 g/L) therapy. IgG levels were higher before (12.25 g/L) vs. after (8.64 g/L) treatment. IgM levels were decreased before (1.76 g/L) and after (0.83 g/L) as well as before (1.76 g/L) versus during (0.73 g/L) treatment. Anti-cardiolipin antibody type A level were decreased before (2.76 U/ml) versus after (2.49 U/ml) treatment. Decreased level of beta-2-microglobulin could be observed before (2.91 mg/L) versus post (2.28 mg/L) chemotherapy. Findings may provide better insight into the effects of immuno-chemotherapy on the hosts’ immune system.     

Prognostic Value of Pretreatment Albumin-to-Globulin Ratio in Patients With Non–Muscle-Invasive Bladder Cancer

Purpose

To investigate the relationship between albumin-to-globulin ratio (AGR) and oncologic outcomes in patients with non–muscle-invasive bladder cancer (NMIBC).