Neutrophil-to-Lymphocyte Ratio in Patients With Cirrhosis

The combination of baseline neutrophil to lymphocyte ratio and dynamic changes during treatment can better predict the survival of osteosarcoma patients

Background

Osteosarcoma is a primary malignant bone tumor with a high metastatic potential that accounts for a significant proportion of all bone tumors. The prognosis for patients with metastatic or recurrence disease remains poor. The neutrophil-to-lymphocyte ratio (NLR) has become a potential prognostic biomarker for cancer. Recent evidence suggests that the dynamic changes in neutrophil-to-lymphocyte ratio (NLR) during treatment may be more informative in predicting patient prognosis, but the value of dynamic NLR in osteosarcoma has not yet been determined.

Methods

This retrospective study retrospectively analyzed the clinical information of 251 osteosarcoma patients diagnosed and treated in West China Hospital of Sichuan University, explored the impact of baseline NLR and changes in NLR during treatment on the prognosis of osteosarcoma patients, and further combined baseline NLR with Delta NLR to build an NLR staging system.

Results

The results showed that both baseline NLR and delta NLR had some predictive ability for the prognosis of osteosarcoma patients (P = 6.90e-4, P = 0.022). Patients with high baseline NLR were more likely to have a decrease in delta NLR (P = 1.24e-10). The NLR stage had a better predictive ability than baseline NLR and delta NLR, and was an independent prognostic factor for overall survival in osteosarcoma patients HR: 2.456 (1.625-3.710) (P = 1.97e-05).

Conclusion

NLR has value in continuous monitoring, and continuous monitoring of NLR can better predict the survival of osteosarcoma patients compared to baseline NLR.

Usefulness of neutrophil-to-lymphocyte ratio (NLR) as a prognostic predictor after treatment of hepatocellular carcinoma." Review article

The neutrophil-to-lymphocyte ratio (NLR) is an inflammatory marker which has been investigated as a prognostic indicator in post-therapeutic recurrence and survival of patients with HCC. Our aim was to review all studies that assessed the prognostic value of pre-treatment NLR in predicting patient survival, cancer recurrence, and graft survival in patients undergoing various therapies for HCC. We searched the database of PubMed and Google Scholar to review all studies that have the word "NLR" and the word "HCC." We included all studies that assessed pre-treatment NLR as a prognostic factor in predicting outcomes in HCC patients. We excluded studies that assessed the correlation between post-treatment NLR or dynamic changes in NLR after treatment and HCC outcomes in an effort to minimize the confounding effect of each treatment on NLR. We reviewed 123 studies that studied the correlation between pre-treatment NLR and patient survival, 72 studies that evaluated the correlation between pre-treatment NLR and tumor recurrence, 21 studies that evaluated the correlation between NLR and tumor behavior, and 4 studies that assessed the correlation between NLR and graft survival. We found a remarkable heterogeneity between the methods of the studies, which is likely responsible for the differences in outcomes. The majority of the studies suggested a correlation between higher levels of pre-treatment NLR and poor outcomes. We concluded that NLR is a reliable and inexpensive biomarker and should be incorporated into other prognostic models to help determine outcomes following HCC treatment.

Functional activity of blood neutrophilic granulocytes in patients with opisthorchiasis, depending on the severity of liver fibrosis

Aim. To study the activity of neutrophilic granulocytes in patients with opisthorchiasis, depending on the severity of liver fibrosis. Materials and methods. A total of 74 patients with chronic opisthorchiasis (39 men and 35 women, average age 42.3 years) and 32 practically healthy patients (17 men and 15 women, average age 41.5 years) aged 24 to 60 years were examined. Diagnosis of opisthorchiasis was carried out by two methods: coprooscopy and identification of eggs or bodies of adult parasites in duodenal content. Liver fibrosis was determined by the method of elastometry according to the METAVIR scale in all 74 patients with opisthorchiasis. The study of the functional activity of neutrophils in the blood was performed to all 74 patients with opisthorchiasis and 32 healthy individuals from the control group by chemiluminescent analysis with measurement of the reactive oxygen species (ROS) production intensity in a spontaneous and zymosan-induced reaction in lucigenin and luminol-dependent processes. Results. Liver fibrosis F2 by METAVIR was registered in 20.3% of the examined individuals, liver fibrosis F3F4 by METAVIR was detected in 17.6% of patients with opisthorchiasis. In patients with opisthorchiasis with liver fibrosis F3F4 by METAVIR, a significant decrease in the functional activity of neutrophilic granulocytes was registered in comparison with individuals with liver fibrosis F0F1 by METAVIR, as evidenced by a significant decrease in the maximum intensity of ROS production (Imax) and the area under the curve (S) chemiluminescence in lucigenin and luminol-dependent processes both in the spontaneous and zymosan-induced reaction. Conclusion. These results provide new information to explain the mechanisms of liver fibrosis in patients opisthorchiasis and create opportunities for the development of diagnostics and preventive technologies.