术前血小板/淋巴细胞比值和淋巴细胞/单核细胞比值对胃癌患者预后的影响分析

目的探讨术前血小板与淋巴细胞比值(PLR)和淋巴细胞与单核细胞比值(LMR)对胃癌患者预后的评估价值。方法收集该院2013年1月至2014年7月入院行胃癌根治术治疗的458例患者的临床病理资料及随访信息,根据受试者工作特征曲线和约登指数确定的术前PLR、LMR的最佳临界值将患者分为高PLR组(PLR126)、低PLR组(PLR≤126)及高LMR组(4.59)、低LMR组(≤4.59),比较不同组间患者临床病理资料和生存率,采用Cox回归模型分析胃癌患者预后的影响因素。结果术前高PLR组1年、3年生存率分别为66.6%、38.0%,低于低PLR组的73.5%、55.5%(P 0.05);高LMR组1年、3年生存率分别为73.9%、54.8%,高于低LMR组的66.0%、37.8%(P0.05)。单因素分析提示,年龄、肿瘤位置、肿瘤最大径、淋巴结转移、T分期、N分期、TNM分期、脉管浸润、神经浸润、PLR和LMR均为胃癌预后的影响因素(P 0.05);多因素分析显示,年龄55岁[HR=1.331(95%CI:1.043～1.699)]、有淋巴结转移[HR=1.582(95%CI:1.047～2.390)]、N分期为N2～N3期[HR=1.395(95%CI:1.005～1.936)]、有脉管浸润[HR=1.539(95%CI:1.059～2.238)]和LMR≤4.59[HR=1.645(95%CI:1.294～2.091)]是影响胃癌患者预后的独立危险因素(P0.05)。结论术前PLR和LMR均与胃癌预后相关,低LMR是胃癌预后的独立预测因子。     

外周血淋巴/中性粒细胞比值及淋巴/单核细胞比值对鼻咽癌患者预后的评估

目的 探讨鼻咽癌患者治疗前外周血淋巴细胞与中性粒细胞比值(LNR)和淋巴细胞与单核细胞比值(LMR)等指标评估鼻咽癌患者预后的价值。方法 回顾性分析2015年12月～2017年10月在安徽省肿瘤医院行鼻咽癌放、化疗治疗的160例鼻咽癌患者的血常规结果,纳入本组研究的临床分期为Ⅰ期6例、Ⅱ期21例、Ⅲ期62例、Ⅳ期71例,采用Sysmex–XE 5000血细胞分析仪检测患者外周血白细胞计数(WBC)、中性粒细胞计数(N)、淋巴细胞计数(L)、单核细胞计数(M)等指标,计算淋巴细胞与中性粒细胞比值(LNR)、淋巴细胞与单核细胞比值(LMR)。结果 鼻咽癌患者与健康体检对照组比较,白细胞计数(WBC)、中性粒细胞百分率(NEUTR%)、淋巴细胞百分率(LYR%)、 LNR的差异无统计学意义(P0.05);鼻咽癌病情稳定患者治疗前LNR、LMR值明显低于发现远处转移及复发鼻咽癌患者(P0.05)。结论 定期测定鼻咽癌患者治疗前外周血LNR、LMR可以作为评价鼻咽癌患者无进展生存预后的有用指标。     

中性粒细胞/淋巴细胞比值及单核细胞/淋巴细胞比值在多发性骨髓瘤患者中的预后意义

目的:研究中性粒细胞/淋巴细胞比值(NLR)、单核细胞/淋巴细胞比值(MLR)对多发性骨髓瘤(MM)患者预后的影响.方法:回顾性分析甘肃省人民医院收治的初发MM患者82例,根据血常规结果分别计算出NLR、MLR;根据患者工作特征曲线(ROC曲线)分别确定NLR和MLR的最佳截断点,将患者分为高NLR组、低NLR组和高M...     

非霍奇金淋巴瘤预后相关因素研究进展

本文从细胞增殖与凋亡、血清细胞因子和粘附分子水平、肿瘤细胞耐药情况以及P16、P53基因异常等方面综述非霍奇金预后相关的因素。     

非霍奇金淋巴瘤的预后模式及其相关因素

本文综述了不同预后模式和β２－微球蛋白等其它生物学预后因素对进展性和低度恶性非霍奇淋巴瘤的预后作用，认为国际非霍奇金淋巴瘤预后因素方案简便有效，适用不同恶性程度的非霍奇金淋巴瘤。     

单核细胞淋巴细胞比值与急性百草枯中毒患者预后的相关性

目的:本研究旨在探讨血清中单核细胞淋巴细胞比值（monocytes to lymphocyte ratio, MLR）与急性百草枯（paraquat,PQ）中毒患者全因死亡之间的关系。方法:本研究回顾性选取2013年12月至2018年10月收治于南昌大学第一附属医院的急性PQ中毒患者,随访至2019年7月1日。主要终点...     

非霍奇金淋巴瘤的预后模式及其相关因素

本文综述了不同预后模式和β_2-微球蛋白等其它生物学预后因素对进展性和低度恶性非霍奇金淋巴瘤的预后作用,认为国际非霍奇金淋巴瘤预后因素方案简便有效、适用不同恶性程度的非霍奇金淋巴瘤。     

老年胃癌患者术前纤维蛋白原、淋巴细胞与单核细胞比值对预后的影响

目的 探究老年胃癌患者术前纤维蛋白原(FIB),淋巴细胞/单核细胞比值(LMR)与预后的影响。方法 回顾性研究126例60岁以上老年胃癌患者的临床病理资料,记录并计算所有患者的术前LMR和FIB值。将所有患者按LMR和FIB值分为LMR高FIB低、LMR高FIB高或者LMR低FIB低、LMR低FIB高三组,比较各组之间的临床病理学资料和3年无复发生存率。结果 LMR≥4.19的老年胃癌患者3年无复发生存率比LMR<4.19的患者高(χ²=16.21,P<0.05),FIB<2.74 g/L的老年胃癌患者3年无复发生存率比FIB≥2.74 g/L的患者高(χ²=35.41,P<0.05)。LMR高FIB低组患者3年无复发生存率明显高于LMR低而FIB高的患者及LMR低FIB低与LMR高FIB高的患者,差异均有统计学意义(χ²分别=52.30、42.64,P均<0.05)。结论 FIB与LMR可作为一个易于获取的预测老年胃癌患者预后可靠指标。     

淋巴细胞/单核细胞比值在多发性骨髓瘤预后中的预测价值

目的 探讨淋巴细胞/单核细胞比值(LMR)在多发性骨髓瘤(MM)患者预后中的预测价值。方法 选择197例MM患者,测定LMR值,绘制ROC确定LMR的最佳临界值,按照LMR最佳临界值分为高LMR组(104例)和低LMR组(93例),分析LMR水平与临床病理特征的相关性,然后利用Log-rank方法比较不同LMR水平的MM患者无进展生存时间(PFS)的差异。结果 通过ROC曲线确定LMR预测生存的最佳临界值为3.55,不同LMR水平患者的血清乳酸脱氢酶、ISS分期和血钙比较,差异均有统计学意义(χ²分别=17.10、17.72、4.38,P均<0.05)。高LMR患者PFS高于低LMR水平的患者,差异有统计学意义(χ²=6.69,P<0.05)。结论 高LMR的患者PFS较低LMR的患者高,低LMR可能是MM患者预后不良的因素。     

非霍奇金淋巴瘤并发单核细胞增多性李氏杆菌脑膜炎一例

非霍奇金淋巴瘤并发单核细胞增多性李氏杆菌脑膜炎一例李卫杜玲珍非霍奇金淋巴瘤（ＮＨＬ）并发单核细胞增多性李氏杆菌脑膜炎在临床上极少见，我们于１９９５年４月收治１例，报告如下。患儿，女，８岁。在患脑膜炎之前半年诊为ＮＨＬⅣ期（骨髓转移），经半年住院化疗，...     

外周血淋巴细胞和单核细胞比值对预测弥漫大B细胞淋巴瘤复发的研究

目的 研究外周血中淋巴细胞和单核细胞比值（LMR）与弥漫性大B细胞淋巴瘤(DLBCL）患者临床特征的关系,判断预后及预测复发情况。方法 回顾性收集初治126例DLBCL患者的临床资料,应用统计学方法分析其与临床特征、预后、复发的相关关系,探讨其预测复发的价值。结果 低LMR（＜2.25）组患者常伴随B症状、国际预后指数(IPI)评分增高、临床分期较晚、β2 微球蛋白水平升高（P<0.05）。126例患者有43例（37.7%）复发,中位复发时间12（2~70）个月。多因素分析（OR=2.586,P=0.028）提示随访时低LMR与复发显著相关,低LMR比高LMR复发风险高,并且低LMR与较短总生存时间（OS）及无病生存时间（PFS）有关(OS:P=0.015;PFS:P=0.006）。结论 这项研究表明,LMR＜2.25提示不良的预后,随诊时较低的LMR可以用作预测DLBCL患者复发的指标。     

外周血中性粒细胞与淋巴细胞比值在非酒精性脂肪肝诊断中的应用

目的外周血中性粒细胞与淋巴细胞比值(NLR)在非酒精性脂肪肝(NAFLD)临床诊断中的价值。方法随机选取214例临床明确诊断为NAFLD且未经过药物治疗的患者作为NAFLD患者组,同时随机选取214例年龄及性别匹配的健康受试者作为健康对照组。两组研究对象均接受血常规检查并计算NLR,比较两组间NLR差异是否有统计学意义。结果 NAFLD患者组外周血平均NLR为(1.87±0.69),显著高于健康对照组的(1.66±0.26),差异有统计学意义(P0.05)。受试者工作特征曲线下面积为0.791,其95%置信区间为0.706~0.876,当cut off值取1.63时,敏感度为79.6%,1-特异性为69.0%,提示NAFLD可能存在肝损害。结论 NAFLD患者血清NLR明显高于健康人群,NLR对NAFLD的诊断有一定价值。     

Neutrophil to lymphocyte ratio,lymphocyte to monocyte ratio and platelet to lymphocyte ratio to predict the severity of COVID-19

IntroductionIn this study, we aimed to investigate and compare the prognostic impacts of C-reactive protein (CRP), white blood cell (WBC) count, neutrophil (NEU)-to-lymphocyte (LYM) ratio (NLR), platelet-to-lymphocyte ratio (PLR), Red Cell Distribution Width (RDW) biomarkers in laboratory-confirmed COVID-19 cases as well as to explore the most useful diagnostic biomarkers and optimal cutoff values in COVID-19 patients.MethodsA total of 233 patients were admitted to Emergency Department (ED) of Pamukkale University Hospital during two months (March–April 2020) and underwent Sars CoV-2 PCR (Polymerase Chain Reaction), complete blood count (CBC), and CRP tests in sequence due to complaints of COVID-19. The laboratory results and demographic findings were collected from the public health management system retrospectively. The patients with positive Sars CoV-2 PCR test along with hospitalization data were also recorded.ResultsThe CRP (p = 0.0001), lactate dehydrogenase (LDH) (p = 0.038), PLR (p = 0.0001) and NLR (p = 0.001) remained significantly higher in the patients with positive Sars CoV-2 PCR test result. By contrast, eosinophil (p = 0.0001), lymphocyte (p = 0.0001), platelet levels (p = 0.0001) were calculated as significantly higher in negative Sars CoV-2 patients.ConclusionIn the light of the obtained results, the CRP, LDH, PLR and NLR levels remained significantly higher in COVID-19 positive patients, while eosinophil, lymphocyte, and platelet levels were significantly elevated in COVID-19 negative patients.     

NLR联合MLR在非ST段抬高型心肌梗死危险分层中的预测价值

目的探讨中性粒细胞/淋巴细胞比率(NLR)联合单核细胞/淋巴细胞比率(MLR)在非ST段抬高型心肌梗死(NSTEMI)危险分层中的价值。方法纳入2013年6月至2014年12月于第三军医大学附属新桥医院行冠状动脉照影的患者288例,分为对照组(110例),稳定性心绞痛(SAP)组(66例)和NSTEMI组(112例),对NSTEMI组患者计算GRACE评分,并根据GRACE评分分为低危组和中高危组。收集所有受试者的血常规指标并计算NLR、MLR。结果 NSTEMI组的NLR、MLR明显高于对照组和SAP组(P0.01)。Spearman相关分析表明NLR、MLR与GRACE评分呈正相关(r=0.342,P0.01;r=0.398,P0.01);中高危组比低危组的NLR(P0.01)、MLR(P0.01)高。通过受试者工作曲线(ROC)分析,预测NSTEMI危险分层的ROC曲线下面积(AUC)分别是NLR的AUC为0.747(95%CI:0.656~0.837,P0.01);MLR的AUC为0.765(95%CI:0.677~0.852,P0.01);NLR联合MLR的AUC为0.778(95%CI:0.693~0.863,P0.01)。结论NLR、MLR与GRACE评分呈正相关,NLR联合MLR对NSTEMI患者的危险分层有一定的预测价值。     

血管免疫母细胞性T细胞淋巴瘤患者外周血淋巴细胞亚群检测的临床意义

目的 分析血管免疫母细胞性T细胞淋巴瘤(AITL)患者诊断时外周血淋巴细胞亚群与临床预后的相关性及其化疗后的动态变化。方法 回顾性分析2016年3月至2021年9月就诊于苏州大学附属第三医院的16例初治AITL患者的临床资料,以同期10例健康人群的淋巴细胞亚群结果为对照组。采用Kaplan-Meier法及COX回归模型进行生存分析。采用ROC曲线计算CD4/CD8临界值,并将患者分为低CD4/CD8组和高CD4/CD8组。结果 与对照组相比,AITL患者诊断时外周血中CD3⁺T细胞、CD4⁺T细胞、CD3⁺CD25⁺活化T细胞计数及CD4/CD8比值明显降低;同时,CD19⁺B细胞、CD20⁺B细胞、CD5⁺CD19⁺及CD19⁺CD23⁺活化B细胞计数皆明显降低。在第一疗程化疗后,患者CD3⁺T细胞比例较初诊时明显升高,在完成3疗程治疗后,CD4...     

高血压患者外周血中性粒细胞与淋巴细胞比例对高血压患者心脑血管事件的预测价值

目的探讨高血压患者外周血中性粒细胞与淋巴细胞比值(N/L比值)对高血压患者心脑血管事件的预测价值。方法选取2013年5月至2014年5月在该院治疗的高血压治疗的660例患者,记录患者纳入研究时外周血N/L比值,所有患者均随访到2016年5月31日,根据患者是否出现心脑血管事件,分为观察组和对照组,对比两组患者白细胞分类结果。采用Logistic回归模型探讨N/L比值对心脑血管事件的预测价值。结果观察组患者吸烟、糖尿病、高脂血症发病率分别为87.5%、72.5%、77.5%,平均动脉压(MAP)水平为(95±12)mmHg,均明显高于对照组(P0.05)。观察组患者白细胞计数、中性粒细胞比例(N%)、单核细胞计数比例、N/L比值分别为(11.6±2.5)×10~9/L、(70.8±5.9)%、(8.3±5.5)%、3.7±1.5,均高于对照组患者(P0.05)。N/L上升10%(P=0.04)、MAP升高10mmHg(P=0.02)、N%上升15%(P=0.03)是心脑血管事件的独立风险因素。结论 N/L比值、MAP是高血压患者心脑血管事件的独立风险因素。     

The potential value of the neutrophil to lymphocyte ratio for early differential diagnosis and prognosis assessment in patients with aortic dissection

ObjectivesThe aim of the study was to assess the diagnostic performance and clinical utility of the neutrophil to lymphocyte ratio (NLR) in patients with suspected aortic dissection (AD) and investigate its role in predicting in-hospital mortality in AD.MethodsNLR values were calculated and compared in 467 consecutive patients with initially suspected AD. A receiver operating characteristic (ROC) curve analysis with the area under the curve (AUC) was used to evaluate the discriminative accuracy and predictive capability of the NLR for AD. Clinical utility was determined by decision curve analysis (DCA). The association between NLR and in-hospital mortality was investigated by logistic regression analyses in patients diagnosed with AD.ResultsThe NLR was significantly elevated in patients with AD, and the optimal cut-off point for the NLR to distinguish AD from other acute chest pain diseases was 5.67 [AUC (95% CI): 0.877 (0.844–0.905)]. We recommended an NLR of 2.43 as the appropriate cut-off point with 96.9% sensitivity and a negative likelihood ratio (LR) of 0.09 to satisfy clinical requirements for diagnosis. DCA showed that the use of NLR had a positive net benefit. The deceased patients with AD had a higher NLR than the discharged patients. Moreover, the NLR was an independent predictor of in-hospital mortality for AD [adjusted odds ratio (OR): 1.084 (1.029–1.142)], and patients with higher NLR values tended to have a higher risk of in-hospital mortality. The optimal cut-off point for the NLR to predict in-hospital mortality was 9.20 [AUC (95% CI): 0.695 (0.619–0.765)].ConclusionsAs an easily available and inexpensive parameter, the NLR could serve as a valuable clinical biomarker for early differential diagnosis and prognosis assessment of AD.     

Diagnostic performances of neutrophil to lymphocyte ratio and lymphocyte to monocyte ratio in acute ischemic stroke caused by cervicocranial arterial dissection

BackgroundInflammation plays an important role in the initiation and progression of cervicocranial arterial dissection (CCAD). New inflammatory indices derived from full cell blood count may be associated with increased risk of acute ischemic stroke (AIS) caused by CCAD. The goal of this study is to evaluate the diagnostic performances of neutrophil to lymphocyte ratio (NLR) and lymphocyte to monocyte ratio (LMR) in CCAD.MethodWe retrospectively analyzed 52 patients with AIS caused by CCAD from emergency room (group I), 51 patients with CCAD from emergency room or clinic(group II) and 52 controls (group III), age and sex matched. Data were collected on the admission including NLR and LMR.ResultsNeutrophil to lymphocyte ratio and LMR have significant differences among three groups, especially in group I vs both groups II and III (P < .001). There was a negative correlation between admission NLR and LMR. Low LMR level and high NLR level may be associated with severity of AIS caused by CCAD and significantly predict AIS in CCAD. The area under the curve of NLR and LMR were 0.77 and 0.71, respectively, on receiver operating characteristic curve analysis. The optimal cutoff values of NLR and LMR that best discriminated AIS were 2.35 (81% sensitivity and 63% specificity) and 3.67 (64% sensitivity and 77% specificity).ConclusionsNeutrophil to lymphocyte ratio neutrophil to lymphocyte ratio and LMR may contribute to the diagnostic evaluation and prompt immediate therapy in patients with CCAD.     

A difficult diagnosis of Hodgkin lymphoma due to immune thrombocytopenia

We report a rare clinical presentation of childhood Hodgkin lymphoma with immune thrombocytopenia. Diagnostic biopsy of the abdominal mass was performed after administration of intravenous immunoglobulins, steroids, and platelet transfusion. Concomitant thrombocytopenia complicated the whole diagnosis work up and the initial management of neoplasia.