外周血NLR、MLR、SII在甲状腺髓样癌中的应用价值

目的:探讨外周血中性粒细胞与淋巴细胞比值（NLR）、单核细胞与淋巴细胞比值（MLR）、系统免疫炎症指数（SII）在甲状腺髓样癌（MTC）中的应用价值。方法:以我院2012年2月至2020年7月收治的MTC患者50例（MTC组）、甲状腺乳头状癌患者50例（PTC组）、健康体检者50例（健康对照组）为研究对象,比较三组患者外周血NLR、MLR、SII水平的差异,并采用受试者工作特征曲线（ROC）分析上述三个指标及其联合检测在MTC中的诊断效能,进一步根据上述三个指标在诊断MTC中的最佳诊断界值分析其与MTC临床病理特征的相关性。结果:比较各组间外周血NLR、MLR、SII水平示:MTC组NLR显著高于PTC组,差异有统计学意义（P＜0.05）;MTC组MLR、SII水平显著高于PTC组与HC组,差异有统计学意义（P＜0.05）。通过ROC曲线分析发现, NLR、MLR、SII单独诊断MTC患者的ROC曲线下面积分别为0.620、0.681、0.634,NLR、MLR、SII三者联合检测ROC曲线下面积为0.726。MLR单独检测及联合检测对MTC的诊断效能高于NLR、SII单独检测（P＜0.05)。MTC患者MLR与淋巴结转移及TNM分期有关,比较差异有统计学意义（P＜0.05）。结论:NLR、MLR、SII对MTC具有诊断价值,MLR单独检测及联合检测对MTC的诊断效能高于NLR、SII单独检测。MLR与MTC患者淋巴结转移及TNM分期有关。     

The combination of systemic inflammation-based marker NLR and circulating regulatory T cells predicts the prognosis of resectable pancreatic cancer patients

BackgroundThe systemic inflammation response and immune impairment are closely related to the development and progression of various tumours, such as pancreatic cancer. In this study, we evaluated circulating inflammation factors and circulating regulatory T cells (Tregs) as markers of immunosuppression in a cohort of Chinese patients with resectable pancreatic cancer.MethodsSamples were retrospectively collected from a series of 195 pathological stage I/II pancreatic cancer patients who underwent potentially curative surgery between June 2010 and April 2014. To examine the prognostic factors, circulating systemic inflammation-based markers and Tregs, detected by flow cytometry, were analysed.ResultsUnivariate analyses revealed that the neutrophil-lymphocyte ratio (NLR), TNM stage, differentiation, chemotherapy, CA19-9 levels and presence of Tregs are significantly associated with overall survival in patients with resectable pancreatic cancers. NLR (p = 0.001, HR = 0.538), TNM stage (p = 0.004, HR = 0.593), differentiation (p = 0.011, HR = 0.46), chemotherapy (p = 0.006, HR = 0.516) and Tregs (p = 0.001, HR = 0.558) are identified as independent prognostic markers by multivariate analyses. Interestingly, we also found that high NLR levels combined with a high proportion of Tregs (p < 0.001, HR = 3.521) correlate strongly with worse survival, with a greater than 3.5–fold increased risk of death compared with those with concurrent low levels of NLR and Tregs.ConclusionsThe preoperative NLR and circulating regulatory T cells are potentially independent prognostic factors for overall survival in resectable pancreatic cancer patients. High NLR levels combined with poor immune state before surgery, as measured by Tregs, are associated with an extremely poor prognosis.     

术前中性粒细胞与淋巴细胞比值在临床评估急性胆管炎伴胆总管结石患者病情中的价值

目的探讨术前中性粒细胞与淋巴细胞比值(NLR)对急性胆管炎伴胆总管结石患者手术预后评估的临床意义。 方法选取江苏大学附属武进人民医院普外科2016年1月至2019年6月收治的急性胆管炎伴胆总管结石行手术治疗的患者60例为研究对象进行回顾性研究，其中男性27例，女性33例；年龄46～88岁，平均(67.93±11.46)岁。术前NLR <5.435患者作为低NLR组(31例)，NLR≥5.435患者作为高NLR组(29例)。比较两组患者术前白细胞计数、C反应蛋白、谷草转氨酶、谷氨酰转肽酶水平；同时分析两组住院总天数、术后住院天数、住院总费用等。 结果低NLR组白细胞计数低于高NLR组[(6.28±1.66)×10⁹/L比(10.59±3.55)×10⁹/L，P<0.05 ]；低NLR组C反应蛋白水平低于高NLR组[(57.63±47.68)ug/mL比(81.38±38.25)ug/mL，P<0.05 ]；低NLR组谷草转氨酶水平低于高NRL组[(96.17±71.25)U/L比(281.90±438.30)U/L，P<0.05]；低NLR组谷氨酰转肽酶水平均低于高NLR组[(297.57±255.97)U/L比(509.70±462.06)U/L，P<0.05]，差异有统计学意义(P<0. 05)。低NLR组住院总天数[(13.34±4.55)d比(15.49±3.94)d，P<0.05]、术后住院天数[(10.07±2.80)d比(11.6±3.41)d，P<0.05]及住院总费用[(26 984.78±4 316.30)元比(30 875.35＝±4 305.50)元，P<0.05]等均低于高NLR组，差异有统计学意义(P<0. 05)。 结论急性胆管炎伴胆管结石患者外周血NLR值与其炎症感染程度呈正相关，临床上可将NLR作为对其病情及手术预后进行评估的指标。     

Pretreatment lymphocyte-to-monocyte ratio as an independent prognostic factor for hypopharyngeal squamous cell carcinoma

Objective: The aim of this work was to analyze the clinical characteristics and pretreatment peripheral blood cell counts of patients with hypopharyngeal squamous cell carcinoma (HPSCC) and determine their relationship with clinical outcomes.

Methods: One hundred ninety-seven patients were eligible for the study. The relationship between survival and pretreatment peripheral absolute neutrophil count (ANC), absolute lymphocyte count (ALC), absolute monocyte count (AMC), neutrophil-to-lymphocyte ratio (NLR), and lymphocyte-to-monocyte ratio (LMR) were analyzed by one-way analysis of variance, t-test, and univariate and multivariate analysis.

Results: The median follow-up time was 30.95 months (range 1–82 months). The 3-year disease-free survival (DFS), cancer-specific survival (CSS), and overall survival (OS) rates for all patients were 40.8, 51.0, and 48.1%, respectively. The ANC, AMC, NLR, and LMR were significantly associated with tumor stage and clinical stage (p?NLR (≥2.69) and low LMR (<2.98) were significantly associated with poor DFS, CSS, and OS. The LMR was a significant independent prognostic factor for DFS, CSS, and OS (p?=?.035, .047, and .045, respectively).

Conclusion: The pretreatment LMR should be considered as an independent prognostic factor for patients with HPSCC.     

NLR联合ACR评估2型糖尿病早期肾损伤的临床分析

目的探讨中性粒细胞/淋巴细胞比值(NLR)联合尿微量白蛋白/尿肌酐比值(ACR)评估2型糖尿病早期肾损伤的临床价值。方法选取我院2018年1月至2019年5月期间收治的146例2型糖尿病患者,根据是否合并早期肾损伤分为糖尿病组(n=97)和早期糖尿病肾损伤组(n=49),选取同期体检的50例健康人员作为对照组。比较三组的实验室指标,探讨NLR、ACR在2型糖尿病早期肾损伤评估中的价值。结果早期糖尿病肾损伤组、糖尿病组的糖化血红蛋白、空腹血糖、餐后2h血糖、中性粒细胞及尿微量白蛋白均显著高于对照组(P<0.05);早期糖尿病肾损伤组的中性粒细胞、尿微量白蛋白均显著高于糖尿病组(P<0.05)。早期糖尿病肾损伤组的NLR、ACR水平均显著高于糖尿病组及对照组(P<0.05);糖尿病组的NLR、ACR水平与对照组相比,差异无统计学意义(P>0.05)。2型糖尿病早期肾损伤与NLR、ACR水平均呈正相关(r>0, P<0.05)。结论 NLR、ACR均是评估2型糖尿病早期肾损伤的敏感指标,可为疾病的早期诊断及治疗提供重要依据。     

中性粒细胞与淋巴细胞比值和支气管扩张症急性加重期严重程度的相关分析

目的 探讨中性粒细胞与淋巴细胞比值(NLR)与支气管扩张症(支扩症)急性加重期严重程度的相关性 。方法 回顾性分析2016年1月—2019年4月在本院呼吸科住院治疗的支扩症患者481例,纳入符合入组条件的191例,其中男性75例,女性116例,年龄17～86岁,平均(59.23±13.34)岁。分析NLR、血红蛋白(HB)、血小板与淋巴细胞比值(PLR)、C反应蛋白(CRP)和支气管扩张严重程度(bronchiectasis severity index,BSI)以及FAECD积分的相关性;用多重线性回归分析法分别分析BSI及FACED积分的影响因素;分别根据支气管扩张严重程度(BSI)、FACED积分将入组患者分为轻、中、重组,用单因素方差分析NLR在不同组之间的差异 。结果 血清NLR(r=0.67)、PLR(r=0.45)、CRP(r=0.56) 和BSI积分呈正相关(P值均<0.01)。血清NLR(r=0.53)、PLR(r=0.43)、CRP(r=0.45)和FACED积分呈正相关(P值均<0.01)。多重线性回归分析显示:NLR(β系数1.29,95%CI 0.95～1.72,P=0.01)、CRP(β系数1.24,95%CI 0.68～1.55,P<0.01)对BSI积分的影响均有统计学意义,NLR(β系数1.25,95%CI 0.70～1.66,P=0.02)、CRP(β系数1.20,95%CI 0.53～1.60,P=0.01)对FACED积分的影响均有统计学意义。BSI及FACED积分越高NLR水平越高,NLR分别在两种积分不同严重程度组间差别均有统计学意义(P值均<0.05)。结论 NLR是预测支扩症急性加重期严重程度的有用指标。     

Predictors of Survival after Yttrium-90 Radioembolization for Colorectal Cancer Liver Metastases

Purpose

To identify clinical parameters that are prognostic for improved overall survival (OS) after yttrium-90 radioembolization (RE) in patients with liver metastases from colorectal cancer (CRC).

中性粒细胞与淋巴细胞比值与肿瘤预后的关系

越来越多的研究表明,炎性指标,如中性粒细胞与淋巴细胞比值（neutrophil-to-lymphocyte ratio,NLR）可作为肿瘤进展和预后的重要评判依据。由于NLR是一种廉价易得的炎性标志物,具有获取的便利性和较高的临床参考价值,逐渐为人们所重视。本文将根据文献报道就NLR与各类肿瘤进展及预后的关系作一综述。     

Significant Association Between Low Baseline Neutrophil-to-Lymphocyte Ratio and Improved Progression-free Survival of Patients With Locally Advanced or Metastatic Breast Cancer Treated With Eribulin But Not With Nab-Paclitaxel

Introduction

Although eribulin and nab-paclitaxel are chemotherapy agents widely used for locally advanced or metastatic breast cancer (MBC), their predictive factors remain unknown. Because the absolute neutrophil-to-lymphocyte ratio (NLR) is a significant prognostic factor for early-stage breast cancer, we investigated its usefulness in terms of the eribulin or nab-paclitaxel treatment efficacy for MBC.