Distribution and reference interval establishment of neutral‐to‐lymphocyte ratio (NLR), lymphocyte‐to‐monocyte ratio (LMR), and platelet‐to‐lymphocyte ratio (PLR) in Chinese healthy adults

BackgroundNeutral‐to‐lymphocyte ratio (NLR), lymphocyte‐to‐monocyte ratio (LMR), and platelet‐to‐lymphocyte ratio (PLR) are associated with coronavirus disease 2019 (COVID‐19) and many diseases, but there are few data about the reference interval (RI) of NLR, LMR, and PLR.MethodsThe neutrophil count, lymphocyte count, monocyte count, and platelet count of 404,272 Chinese healthy adults (>18 years old) were measured by Sysmex XE‐2100 automatic hematology analyzer, and NLR, LMR, and PLR were calculated. According to CLSI C28‐A3, the nonparametric 95% percentile interval is defined as the reference interval.ResultsThe results of Mann‐Whitney U test showed that NLR (p < .001) in male was significantly higher than that in female; LMR (p < .001) and PLR (p < .001) in male were significantly lower than that in female. Kruskal‐Wallis H test showed that there were significant differences in NLR, LMR, and PLR among different genders and age groups (p < .001). The linear graph showed that the reference upper limit of NLR and PLR increased with age and the reference upper limit of LMR decreases with age in male population. In female population, the reference upper limit of NLR in 50–59 group, LMR in >80 group, and PLR in 70–79 group appeared a trough; the reference upper limit of NLR in >80 group, LMR in 50–59 group, and PLR in 40–49 group appeared peak.ConclusionThe establishment of RI for NLR, LMR, and PLR in Chinese healthy adults according to gender and age will promote the standardization of clinical application.     

中性粒细胞/淋巴细胞比值在评估早期脊髓损伤严重程度中的应用研究

目的:探讨脊髓损伤(SCI)患者入院首次外周血中性粒细胞与淋巴细胞比值(NLR)对其损伤严重程度的早期评估作用。方法:回顾性分析2010年6月至2021年1月由陆军军医大学附属西南医院急诊收入并转入康复科住院治疗的SCI患者62例,根据伤后ASIA损伤分级将纳入患者分为完全性运动损伤组(ASIA损伤分级A级或B级)35例,不完全性运动损伤组(ASIA损伤分级C级、D级)27例。收集2组患者的临床资料及实验室检验资料,根据入院时中性粒细胞计数、淋巴细胞计数计算NLR,应用单因素分析比较2组间资料差异,应用多因素Logistic回归分析完全性运动损伤的可能危险因素,利用受试者工作特征(ROC)曲线下面积评估各指标的评估能力。结果:完全性运动损伤组患者的入院后首次NLR值水平显著高于不完全性运动损伤组(P<0.05),淋巴细胞计数水平明显低于不完全性运动损伤组(P<0.01)。多因素Logistic回归分析显示,调整混杂因素后,淋巴细胞计数水平升高是脊髓损伤后完全性运动损伤的独立保护因素(OR=0.211,95%CI:0.051~0.878,P<0.05)。NLR值的曲线下面积为0.726(95%CI:0.598~0.854,P<0.05),当截断值为9.711时,有最大约登指数0.398,其敏感度为65.71%,特异度为74.07%;淋巴细胞计数的曲线下面积为0.740(95%CI:0.610~0.870,P<0.05),当截断值为1.220时,有最大约登指数0.461,其敏感度为94.29%,特异度为51.85%;二者联合的曲线下面积为0.751(95%CI:0.625~0.878,P<0.05)。结论:入院后首次NLR值作为简单、便宜、容易获得的检验指标,可能对早期SCI严重程度有一定评估价值。     

血浆中性粒细胞与淋巴细胞比值预测急性缺血性脑卒中机械取栓患者半年预后的价值

目的 探讨血浆中性粒细胞与淋巴细胞比值(NLR)预测急性缺血性脑卒中(AIS)机械取栓患者半年预后的价值.方法 将105例AIS机械取栓患者根据半年后改良Rankin量表(mRS)评分结果分为预后良好组48例和预后不良组57例,比较2组患者的临床资料.将有统计学差异的相关指标采用二元Logistic回归分析,采用受试者...     

中性粒细胞/淋巴细胞比率联合血小板/淋巴细胞比率检测对于重症急性胰腺炎早期预测价值

目的:评估中性粒细胞／淋巴细胞比率（Neutrophil to lymphocyte ratio,NLR）联合血小板/淋巴细胞比率（platelet to lymphocyteratio,PLR）检测(NLR-PLR)对于重症急性胰腺炎(severe acute pancreatitis,SAP)早期预测价值。方法:连续性收集2019年1月至2019年12月北京大学人民医院急诊科符合急性胰腺炎（acute pancreatitis, AP）诊断标准的216例患者。按病情严重程度分为轻症急性胰腺炎组（mild acute pancreatitis,MAP）(86例)、中度重症急性胰腺炎组（moderately severe acute pancreatitis,MSAP）(40例)及SAP组(90例)三组。所有患者均于发病48 h内采集外周血样进行分析,检测白细胞计数（WBC）、中性粒细胞计数(NEUT)、淋巴细胞计数(LYM)、血红蛋白(HGB)、血小板计数(PLT)、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)、血清肌酐(CR)、血糖(GLU)等实验室指标,同时完善CT影像学等检查,分别计算NLR和PLR,比较NLR和PLR在三组中是否具有统计学意义。比较NLR、PLR和APACHEⅡ评分及Ranson评分的相关性。同时绘制受试者工作特征曲线(ROC曲线)计算NLR和PLR的最佳阈值,分别依据NLR和PLR的最佳阈值,计算NLR-PLR,同时绘制ROC曲线研究NLR-PLR对于SAP的预测价值。结果:NLR [OR=1.071,95% CI（1.025,1.120）, P=0.002]和PLR[OR=1.003,95% CI（1.000,1.244）, P=0.044]是早期重症胰腺炎的危险因素。NLR与Ranson评分呈正相关（r=0.0342, P<0.05）;NLR与APACHEⅡ评分呈正相关（r=0.0210, P=0.003）;PLR与Ranson评分呈正相关（r=0.0218, P=0.002）;PLR与APACHEⅡ评分呈无相关性（ P=0.157）。NLR和PLR的ROC曲线下面积（AUC）分别为0.894和0.728。NLR的最佳阈值为6.105,敏感度为92.9%,特异度为76.1%,PLR的最佳阈值为154.358,敏感度为78.2%,特异度为73.2%。依据最佳阈值,计算NLR-PLR(NLR≥6.105且PLR≥154.358）,比较NLR-PLR、NLR(≥6.105)和PLR（≥154.358）的ROC曲线下面积,其中NLR-PLR曲线下面积最大,为0.864。 结论:NLR和PLR在AP发病48 h内对SAP患者病情的具有预测价值,NLR-PLR联合检测对于SAP具有早期预测价值。     

NLR、PLR和LMR对脑转移瘤患者全脑放疗预后的影响及相关因素分析

目的  探讨放疗前外周血中性粒细胞-淋巴细胞比值（NLR）、血小板-淋巴细胞比值（PLR）及淋巴细胞-单核细胞比值（LMR）对脑转移患者全脑放疗预后的影响。方法  回顾性纳入118例脑转移患者的临床资料,分析各个炎性复合指标和临床资料与脑转移瘤患者全脑放疗预后的关系。采用ROC曲线确定脑转移瘤患者全脑放疗预后NLR、PLR及LMR的临界值。采用Kaplan-Meier法进行单因素生存分析、Log-rank检验进行各组生存率之间的比较,采用Cox比例风险模型进行多因素回归分析。结果  118例脑转移瘤患者的中位生存期为12.5月,1年、2年生存率分别为72.8%和50.1%。通过ROC曲线确定NLR、PLR和LMR的临界值分别为4.28、217.8和1.95。Kaplan-Meier单因素分析显示,肿瘤分期、靶向治疗、NLR、PLR以及LMR均是影响脑转移瘤患者全脑放疗预后的危险因素（P=0.001、0.032、0.008、0.003、0.002）,进一步多因素Cox回归分析表明PLR是唯一的独立不良预后因素（P=0.003）。结论  放疗前外周血PLR升高是脑转移瘤患者全脑放疗的独立不良预后因素。     

Comparison of hemoglobin level and neutrophil to lymphocyte ratio as prognostic markers in patients with COVID-19

BackgroundAnemia can negatively affect the outcome of many diseases, including infections and inflammatory conditions.AimTo compare the prognostic value of hemoglobin level and the neutrophil/lymphocyte ratio (NLR) for prediction of coronavirus disease 2019 (COVID-19) severity.MethodsIn this retrospective cohort study, clinical data from patients with laboratory-confirmed COVID-19 were collected from hospital records from 10 April 2020 to 30 July 2020.ResultsThe proportions of patients with mild, moderate, and severe COVID-19 differed significantly in association with hemoglobin levels, neutrophil counts, lymphocyte counts, NLR, and total leukocyte counts. Patients with severe COVID-19 had significantly lower hemoglobin levels than those with moderate or mild COVID-19. There were statistically significant negative associations between hemoglobin and D-dimer, age, and creatinine. The optimal hemoglobin cut-off value for prediction of disease severity was 11.6 g/dL. Using this cut-off value, hemoglobin had higher negative predictive value and sensitivity than NLR (92.4% and 51.3%, respectively). The specificity of hemoglobin as a prognostic marker was 79.3%.ConclusionBoth NLR and hemoglobin level are of prognostic value for predicting severity of COVID-19. However, hemoglobin level displayed higher sensitivity than NLR. Hemoglobin level should be assessed upon admission in all patients and closely monitored throughout the disease course.     

The value of the neutrophil‐to‐lymphocyte ratio and platelet‐to‐lymphocyte ratio as complementary diagnostic tools in the diagnosis of rheumatoid arthritis: A multicenter retrospective study

BackgroundThe neutrophil‐to‐lymphocyte ratio (NLR) and platelet‐to‐lymphocyte ratio (PLR) have drawn attention in recent years as novel non‐specific inflammatory markers; however, only a few studies have been conducted to investigate their value in RA.ObjectiveTo investigate the value of the neutrophil‐to‐lymphocyte ratio (NLR) and the platelet‐to‐lymphocyte ratio (PLR) as complementary diagnostic tools in rheumatoid arthritis (RA).MethodThis study included 1009 patients with RA, 170 patients with other rheumatic diseases, and 245 healthy individuals from four medical centers. The patients'' general data, including complete blood count, C‐reactive protein (CRP), erythrocyte sedimentation rate (ESR), and rheumatoid factor (RF), were retrospectively analyzed, and the NLR and PLR were calculated. Potential effective indicators were screened by logistic regression analysis, and a receiver operating characteristic (ROC) curve was plotted to evaluate their diagnostic value for RA.Results(a) The NLR and PLR were significantly higher in the RA group than in the non‐RA group and the control group (P < .05). (b) Spearman''s Rho showed that the NLR was positively correlated with the PLR (r = .584, P < .05), RF (r = .167, P < .01), and CRP (r = .280, P < .01) but was not significantly correlated with ESR (r = .100, P > .05). The PLR was positively correlated with RF (r = .139, P < .01), CRP (r = .297, P < .01), and ESR (r = .262, P < .05). (c) Logistic analysis showed that RF, CRP, ESR, and the NLR had diagnostic value for RA. (d) For the NLR, the area under the curve (AUC) of the ROC curve was 0.831; at the cutoff value of 2.13, the diagnostic sensitivity, specificity, accuracy, and Youden index were 76.7%, 75.9%, 76.4%, and 0.5424, respectively.ConclusionThe NLR was less effective than CRP and RF but was superior to ESR in the diagnosis of RA. The NLR can thus be used as a complementary diagnostic indicator in the diagnosis of RA.     

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.     

Predictive value of NLR and PLR in missed miscarriage

BackgroundThe aim of the study was to investigate the predictive value of neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) in missed miscarriage.MethodsIn this retrospective cohort study, a total of 400 women (involving 200 with missed early miscarriage and 200 with normal pregnancy but terminate by artificial abortion) were included. General clinical data and complete blood count (CBC) such as white blood cells (WBC), red blood cells (RBC), platelet (PLT), red blood cell distribution width‐standard deviation (RDW‐SD), platelet distribution width (PDW), mean platelet volume (MPV), neutrophil count, and lymphocyte count were collected, and the NLR and PLR were calculated for both groups. Receiver operating characteristic curve (ROC) was used to calculate the predictive value.ResultsThere was no significant difference in the WBC, RBC, PLT, RDW‐SD, PDW, neutrophil, lymphocyte, NLR, and PLR between the two groups (p > 0.05).But MPV was lower in the missed early miscarriage group than in the control group (p < 0.05), and the area under the working curve (AUC) of ROC was 0.58, specificity and sensitivity was 69% and 47%, respectively.ConclusionNLR and PLR were not the suitable indictor for missed miscarriage, but MPV should be a concern in the first trimester.     

Study on perinatal‐related factors of maternity and newborn in parturients with intrapartum fever in part of Eastern China: A cross‐sectional study

BackgroundMaternal intrapartum fever has a serious impact on mother and child. However, the corresponding study seems to be in short.MethodsThe role of inflammatory cells in patients who were diagnosed with intrapartum fever lived in part of Eastern China was evaluated. The obstetrics outcomes, complete blood cell count (CBC) and thereby converted neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio, monocyte to lymphocyte ratio (MLR), and vaginal secretion were compared in different groups.ResultsPrepartum values of white blood cell (WBC), red blood cell (RBC), and hemoglobin (Hb) were all a little higher in the febrile group than in the afebrile group, and postpartum WBC in the afebrile group was still higher while postpartum RBC and Hb were inferior to non‐fever maternity. Postpartum NLR and MLR were all higher in the fever group but not preferred overtly difference before delivery. Additionally, the comparison of WBC, RBC, Hb, platelets, neutrophils, and monocytes in prepartum and postpartum all showed significant differences.ConclusionThe parturition could bring about the value change of CBC and intrapartum fever might aggravate or alleviate this change. Besides, the intrapartum fever might not be caused mainly by infection and the difference between bacteria and fungus could reflect in the CBC.     

Relationships of the neutrophil–lymphocyte and CRP–albumin ratios with the duration of hospitalization and fatality in geriatric patients with COVID-19

ObjectiveThe aim of this study was to determine the associations of the neutrophil–lymphocyte ratio (NLR) and C-reactive protein (CRP)–albumin ratio (CAR) with the duration of hospital stay and fatality rate in geriatric patients with coronavirus disease 2019 (COVID-19).MethodsPatients older than 65 years with polymerase chain reaction-positive COVID-19 were included. Neutrophil, lymphocyte, CRP, albumin, and demographic data and the duration of hospitalization were recorded.ResultsThe mean length of stay was 15 days. NLR and CAR were significantly higher in patients who died than in those who survived. The cutoffs predictive of mortality were 4.02 (area under the curve [AUC] = 0.717) for NLR and 23 for CAR (AUC = 0.781). The fatality rate among patients who required inpatient treatment was 33%.ConclusionNLR and CAR, which can be calculated inexpensively and quickly at the first admission to the hospital, are extremely useful for estimating the duration of hospitalization and risk of mortality in geriatric patients with COVID-19. Using these data, treatment can quickly be intensified when needed.     

外周血NLR，PLR和LMR水平分析在儿童流感病毒与疱疹性咽峡炎感染鉴别诊断中的临床意义

目的　探讨外周血全血细胞分析中的三项指标在鉴别儿童流感病毒和疱疹性咽峡炎的临床意义。方法　收集2019年11月1日 ～2020年1月31日商洛市中心医院就诊的有上呼吸道感染症状患儿189例,采用胶体金法检测甲乙流感病毒抗原,采集患儿初诊时外周血进行全血细胞分析。研究组纳入甲型流感85例,乙型流感43例。对照组纳入甲乙流感病毒阴性的疱疹性咽峡炎患儿61例。分别比较三组之间中性粒细胞和淋巴细胞计数比值（NLR）、血小板和淋巴细胞计数比值（PLR）、淋巴细胞和单核细胞计数比值（LMR）水平,并对结果进行统计学分析。结果　流感组与对照组的三项感染指标水平比较,差异均有统计学意义（F=11.51,13.00和29.37,均P<0.05）。进一步对甲流组和乙流组进行比较,两组之间的NLR,PLR和LMR水平差异有统计学意义（均P<0.05）。三项感染指标的ROC曲线下面积 (area under the curve,AUC)分别为0.723,0.837和0.725,当NLR截点为3.77时,灵敏度和特异度分别为60%和73%;PLR截点为147.83时,灵敏度和特异度分别为71.1%和80% ;LMR截点为2.57时,灵敏度和特异度分别为71.8%和65%。结论　在甲乙型流感病毒感染与疱疹性咽峡炎的辅助鉴别诊断中PLR优于NLR和LMR两项指标。     

Correlation between neutrophil/lymphocyte ratio and Ranson score in acute pancreatitis

Background

Acute pancreatitis (AP) is characterized by inflammation of the pancreas, elevated pancreatic enzymes, and abdominal pain. The neutrophil to lymphocyte ratio (NLR) is used as a marker of inflammation. In this retrospective study, we aimed to investigate novel early prognostic predictors of AP, such as NLR and its correlation with the Ranson score.

Methods

A total 435 patients (Male: 152; 34.9%, Age: 63.53 ± 17.22 years) were included in the study. Data were collected by two clinicians scanning the registered hospital records.

Results

Classification of the patients according to the aetiologies revealed gallstone(s) 58.6% (n = 255), hyperlipidaemia 2.2% (n = 9), viruses 0.7% (n = 3), malignancies 0.5% (n = 2), and alcohol 0.2% (n = 1). No reason was discovered in 37.9% (n = 165) of patients. Age, duration in the intensive care unit, serum aspartate aminotransferase (AST) levels, alanine aminotransferase (ALT), alkaline phosphatase (ALP), gamma‐glutamyl transferase (GGT), total bilirubin, direct bilirubin, lactate dehydrogenase (LDH), white blood cell (WBC) count, neutrophil count, lymphocyte count, and the NLR were greater in the group with a Ranson score ≥3 than the group with a Ranson score <3.

Discussion

Quick diagnosis is essential in AP. Current scoring systems for AP diagnosis are complicated, whereas NLP is a simple, practical, and effective marker.

     

中性粒细胞/淋巴细胞比值、血小板/淋巴细胞比值对溃疡性结肠炎的诊断价值

目的探讨中性粒细胞/淋巴细胞比值(NLR)和血小板/淋巴细胞比值(PLR)在溃疡性结肠炎(UC)患者外周血中的水平,评估两者对UC的诊断效能。方法收集87例UC患者纳入UC组,收集65例肠易激综合征(IBS)患者纳入对照组。分析患者临床资料,比较两组NLR和PLR水平差异;采用Pearson相关分析NLR、PLR与临床常用指标白细胞计数(WBC)、血小板计数(PLT)、C反应蛋白(CRP)、红细胞沉降率(ESR)的相关性;采用受试者工作特征(ROC)曲线计算NLR和PLR最佳临界值及曲线下面积(AUC),并与常用炎性指标进行比较。结果UC组患者外周血NLR和PLR均明显高于对照组(P<0.05)。相关性分析发现,NLR、PLR均与WBC、CRP和ESR呈正相关(P<0.05)。NLR用于诊断UC的最佳临界值为2.64,灵敏度和特异度分别为81.9%和62.6%,AUC为0.758,PLR用于诊断UC的最佳临界值为163.40,灵敏度和特异度分别为75.0%和60.6%,AUC为0.759,两者均优于WBC(AUC:0.687)和PLT(AUC:0.745),稍逊于ESR(AUC:0.783)和CRP(AUC:0.830)。NLR联合CRP、PLR联合CRP对UC的诊断价值均优于CRP单独检测。结论NLR和PLR在UC患者外周血中的水平升高。NLR、PLR诊断UC的效能优于常用指标WBC和PLT,其与CRP联合应用可提高UC的诊断效能。     

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 is associated with in-hospital mortality in older adults admitted to the emergency department

BackgroundThe objective of this study was to test the hypothesis that an elevated neutrophil to lymphocyte ratio (NLR) at admission is associated with and increased risk of mortality in older patients admitted to the emergency department (ED).MethodsWe performed a retrospective analysis of patients admitted to the ED between November 2016 and February 2017. We included patients who were older than 65 years who visited the ED with any medical problem. We excluded patients with hematologic malignancy. Baseline NLR values were measured at the time of admission to the ED. The primary outcome was all-cause in-hospital mortality. A multivariate logistic analysis was performed.ResultsA total of 2777 patients were included in this study. The median age was 75 years (IQR 70–81), and 1359 (48.9%) patients were male. The in-hospital mortality rate was 5.0% (140 patients). The NLR value was higher in nonsurvivors (median, 8.08, IQR 4.29–15.25) than in survivors (median, 3.69, IQR 2.1–6.92, P < 0.001). In the multivariate logistic regression analysis, the NLR was associated with all cause in-hospital mortality after adjusting for confounding factors (OR = 1.03, 95% CI = 1.014–1.046).ConclusionsThese results show that the NLR at admission is associated with in-hospital mortality among patients older than 65 years without hematologic malignancy. Thus, NLR at admission may represent a surrogate marker of disease severity.     

Inflammation‐based prognostic scoring system for predicting the prognosis of advanced small cell lung cancer patients receiving anlotinib monotherapy

BackgroundAccording to the randomized multicenter phase II trial (ALTER1202), anlotinib has been approved as a third‐line therapy for advanced small‐cell lung cancer (SCLC). Some studies showed the predictive function of inflammatory markers, including neutrophil‐to‐lymphocyte ratio (NLR), platelet‐to‐lymphocyte ratio (PLR), and lymphocyte‐to‐monocyte ratio (LMR) in the different cancers treated with anti‐vascular targeting drugs. However, none of the studies showed the roles of NLR, PLR, and LMR in SCLC patients receiving anlotinib. Thus, our objective was to establish a scoring system based on inflammation to individuate patient stratification and selection based on NLR, PLR, and LMR.MethodsNLR, PLR, and LMR and their variations were calculated in 53 advanced SCLC patients receiving anlotinib as a third‐ or further‐line treatment at Ningbo Medical Center Lihuili Hospital between January 2019 and December 2021. Kaplan–Meier curves were plotted. Both univariate and multivariate Cox regressions were used to identify predictors of survival.ResultsDisease control rate was related to pre‐NLR, pre‐PLR, pre‐LMR, post‐NLR elevation, post‐PLR elevation, and post‐LMR elevation. The multivariate analysis determined post‐NLR elevation, pre‐PLR > 240.56, and pre‐LMR ≤1.61 to be independently associated with progression‐free survival, not overall survival. The inflammation‐based prognostic scoring system demonstrated favorable predictive ability from the receiver operating characteristic curve (AUC: 0.791, 95% CI: 0.645–0.938).ConclusionsPost‐NLR variation, pre‐PLR, and pre‐LMR were independent prognostic factors for PFS in advanced SCLC receiving anlotinib monotherapy. The inflammation‐based prognostic scoring system can accurately predict effectiveness and survival.     

外周血中性粒细胞与淋巴细胞比值变化对非小细胞肺癌放疗近期疗效的预测价值

目的:外周血中白细胞的成分和计数不仅可以反映肿瘤微环境的炎症反应,还被认为是潜在有意义的肿瘤预后指标.本研究旨在评估晚期非小细胞肺癌患者胸部放疗对外周血淋巴细胞计数的影响,并分析放疗后中性粒细胞与淋巴细胞比值变化对近期疗效的预测价值.方法:回顾性分析了自2017年1月1日～2018年9月1日在山东第一医科大学第三附属医...     

中性粒细胞与淋巴细胞计数比值对类风湿关节炎的预测价值分析

目的采用回顾性分析的方法探讨中性粒细胞和淋巴细胞计数比值(NLR)对类风湿关节炎(RA)的预测价值。方法选取2014年1月至2015年2月某医院150例RA患者、101例非RA自身免疫病患者及151例健康体检人群进行血细胞分类计数检查,并比较NLR在3组人群中的差异。收集RA患者的临床与实验室资料,统计分析NLR与其他炎性指标的联系,并采用ROC曲线分析NLR对RA的诊断和预测价值。结果 RA患者NLR水平显著高于非RA自身免疫病患者及健康对照者。NLR与中性粒细胞计数(NC)诊断RA的敏感性相当(NLR:62.4%;NC:67.5%);但NLR的诊断特异性更高(NLR:85.5%;NC:68.7%)。相关性分析显示,NLR与ESR(r=0.210,P=0.043)、CRP(r=0.149,P=0.043)均呈较弱但具统计学意义的正相关。结论 NLR比CRP、NC及淋巴细胞计数等传统的炎症指标更具有预测价值,有望作为一种新的能独立预测RA患者体内炎症程度的生物标志物。     

急性创伤后早期中性粒细胞/淋巴细胞与创伤后应激障碍发病的关系研究

目的:探讨急性创伤后早期炎症水平变化与创伤后应激障碍（posttraumatic stress disorder, PTSD）发病的关系。方法:选2018年1月至2020年6月因急性创伤至徐州医科大学附属医院就诊患者为研究对象。于入院当天及伤后第3天、第7天采集患者外周静脉血检测血常规、C-反应蛋白（C-reaction protein, CRP）及降钙素原（procalcitonin, PCT）等检验指标,计算中性粒细胞与淋巴细胞比值（neutrophil-to-lymphocyte ratio, NLR）,1个月后使用PCL-5量表评估患者PTSD症状,以38分为界将患者分为PTSD组与非PTSD组。分析PTSD组和非PTSD组的NLR变化规律。结果:纳入创伤患者91例,其中PTSD组23例,非PTSD组68例。与健康对照组相比,91例创伤患者入院当天、第3天、第7天的NLR水平均升高（均 P< 0.01）,PTSD组在创伤后第7天的NLR值明显高于非PTSD组（ P= 0.025）;而非PTSD组则呈下降趋势,在创伤后第7天非PTSD组NLR值已明显低于入院当天（ P= 0.001）。此外,伤后7 d的NLR高水平（β= 0.206, P= 0.01）是影响PTSD发病的危险因素。 结论:动态监测急性创伤后的NLR值变化,对创伤后PTSD的早期预警具有重要的临床价值。