Neutrophil to lymphocyte ratio
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In medicine neutrophil to lymphocyte ratio (NLR) is used as a marker of subclinical inflammation. It is calculated by dividing the number of neutrophils by number of lymphocytes, usually from peripheral blood sample,[1] but sometimes also from cells that infiltrate tissue, such as tumor.[2] Recently Lymphocyte Monocyte ratio (LMR) has also been studied as a marker of inflammation including tuberculosis and various cancers.
Uses[edit]
Prognosis of cardiovascular diseases[edit]
Higher NLR is independent predictor of mortality in patients undergoing angiography or cardiac revascularization.[1]
Prognostic marker in cancer[edit]
Increased NLR is associated with poor prognosis of various cancers,[3] such as esophageal,[4] liver,[5] ovarian,[6] pancreatic,[7] prostate[8] and stomach cancer.[9]
Prognostic marker in COVID-19[edit]
NLR can be used as a prognostic marker for COVID-19 given the significant difference of NLR between those died and recovered from COVID-19.[10]
Reference values[edit]
A 2017 study found that the normal NLR range for healthy adults is between 0.78 and 3.53.[11]
History[edit]
Neutrophil to Lymphocyte ratio was first demonstrated as useful parameter after a correlation of a relationship between the neutrophil lymphocyte ratio to reactions of the immune response was noted. A study in 2001 was conducted by the Department of Anaesthesiology and Intensive Care Medicine, St. Elizabeth Cancer Institute in Bratislava by Zahorec which suggested the routine used of the ratio as a stress factor in clinical ICU practice in intervals of 6-12 and 24 hours.[12]
The first study to demonstrate that pretherapuetic NLR can be used as a predictor of chemotherapy sensitivity to thoracic esophageal cancer was demonstrated by Hiroshi Sato, Yasuhiro Tsubosa, and Tatsuyuki Kawano in a 2012 study published in World Journal of Surgery journal.[13]
References[edit]
- ^ a b Wang X (Mar 2014). "Neutrophil to lymphocyte ratio in relation to risk of all-cause mortality and cardiovascular events among patients undergoing angiography or cardiac revascularization : A meta-analysis of observational studies". Atherosclerosis. 234 (1): 206–213. doi:10.1016/j.atherosclerosis.2014.03.003. PMID 24681815.
- ^ Wang J (Jan 2014). "The clinical significance of tumor-infiltrating neutrophils and neutrophil-to-CD8+lymphocyte ratio in patients with resectable esophageal squamous cell carcinoma". J. Transl. Med. 12: 7. doi:10.1186/1479-5876-12-7. PMC 3895663. PMID 24397835.
- ^ Templeton AJ, McNamara MG, Šeruga B, Vera-Badillo FE, Aneja P, Ocaña A, Leibowitz-Amit R, Sonpavde G, Knox JJ, Tran B, Tannock IF, Amir E (2014). "Prognostic role of neutrophil-to-lymphocyte ratio in solid tumors: a systematic review and meta-analysis". J. Natl. Cancer Inst. 106 (6): dju124. doi:10.1093/jnci/dju124. PMID 24875653.
- ^ Pirozzolo G, Gisbertz SS, Castoro C, van Berge Henegouwen MI, Scarpa M (July 2019). "Neutrophil-to-lymphocyte ratio as prognostic marker in esophageal cancer: a systematic review and meta-analysis". J Thorac Dis. 11 (7): 3136–3145. doi:10.21037/jtd.2019.07.30. PMC 6688029. PMID 31463142.
- ^ Wang Y, Peng C, Cheng Z, Wang X, Wu L, Li J, Huang C, Guo Q, Cai H (July 2018). "The prognostic significance of preoperative neutrophil-lymphocyte ratio in patients with hepatocellular carcinoma receiving hepatectomy: A systematic review and meta-analysis". Int J Surg. 55: 73–80. doi:10.1016/j.ijsu.2018.05.022. PMID 29787804. S2CID 44102006.
- ^ Yin X, Wu L, Yang H, Yang H (November 2019). "Prognostic significance of neutrophil-lymphocyte ratio (NLR) in patients with ovarian cancer: A systematic review and meta-analysis". Medicine (Baltimore). 98 (45): e17475. doi:10.1097/MD.0000000000017475. PMC 6855616. PMID 31702609.
- ^ Yang JJ, Hu ZG, Shi WX, Deng T, He SQ, Yuan SG (March 2015). "Prognostic significance of neutrophil to lymphocyte ratio in pancreatic cancer: a meta-analysis". World J Gastroenterol. 21 (9): 2807–15. doi:10.3748/wjg.v21.i9.2807. PMC 4351235. PMID 25759553.
- ^ Guo J, Fang J, Huang X, Liu Y, Yuan Y, Zhang X, Zou C, Xiao K, Wang J (December 2018). "Prognostic role of neutrophil to lymphocyte ratio and platelet to lymphocyte ratio in prostate cancer: A meta-analysis of results from multivariate analysis". Int J Surg. 60: 216–223. doi:10.1016/j.ijsu.2018.11.020. PMID 30468905.
- ^ Szor DJ, Dias AR, Pereira MA, Ramos MF, Zilberstein B, Cecconello I, Ribeiro-Júnior U (2018). "Prognostic Role of Neutrophil/Lymphocyte Ratio in Resected Gastric Cancer: A Systematic Review and Meta-analysis". Clinics (Sao Paulo). 73: e360. doi:10.6061/clinics/2018/e360. PMC 5996440. PMID 29924187.
- ^ Eslamijouybari M, Heydari K, Maleki , Moosazadeh M, Hedayatizadeh-Omran A, Vahedi L (2020). "Neutrophil-to-Lymphocyte and Platelet-to-Lymphocyte Ratios in COVID-19 Patients and Control Group and Relationship with Disease Prognosis". Caspian J Intern Med. 11 (Supplement 1): 531–535. PMC 7780872. PMID 33425271.
{{cite journal}}: CS1 maint: multiple names: authors list (link) - ^ Forget, Patrice (2017). "What is the normal value of the neutrophil-to-lymphocyte ratio?". BMC Research Notes. 10 (1): 12. doi:10.1186/s13104-016-2335-5. PMC 5217256. PMID 28057051.
- ^ Zahorec, R. (2001). "Ratio of neutrophil to lymphocyte counts--rapid and simple parameter of systemic inflammation and stress in critically ill". Bratislavske Lekarske Listy. 102 (1). Bratisl Lek Listy: 5–14. PMID 11723675.
- ^ Sato, Hiroshi; Tsubosa, Yasuhiro; Kawano, Tatsuyuki (March 2012). "Correlation Between the Pretherapeutic Neutrophil to Lymphocyte Ratio and the Pathologic Response to Neoadjuvant Chemotherapy in Patients With Advanced Esophageal Cancer". World Journal of Surgery. 36 (3): 617–622. doi:10.1007/s00268-011-1411-1. PMID 22223293. S2CID 13393640.
Further reading[edit]
- Socorro Faria, Sara; Fernandes Jr, Paulo César; Barbosa Silva, Marcelo José; Lima, Vladmir C; Fontes, Wagner; Freitas-Junior, Ruffo; Eterovic, Agda Karina; Forget, Patrice (12 December 2016). "The neutrophil-to-lymphocyte ratio: a narrative review". ecancermedicalscience. 10: 702. doi:10.3332/ecancer.2016.702. PMC 5221645. PMID 28105073. for risk stratification for breast cancer
- Tang, Xingxing; Du, Peng; Yang, Yong (27 July 2017). "The clinical use of neutrophil-to-lymphocyte ratio in bladder cancer patients: a systematic review and meta-analysis". International Journal of Clinical Oncology. 22 (5): 817–825. doi:10.1007/s10147-017-1171-5. PMID 28752351. S2CID 4910519.
- Huang, Qi-tao; Zhou, Lin; Zeng, Wen-juan; Ma, Qian-qian; Wang, Wei; Zhong, Mei; Yu, Yan-hong (2017). "Prognostic Significance of Neutrophil-to-Lymphocyte Ratio in Ovarian Cancer: A Systematic Review and Meta-Analysis of Observational Studies". Cellular Physiology and Biochemistry. 41 (6): 2411–2418. doi:10.1159/000475911. PMID 28467978.
- Yin, Xiaotao; Xiao, Yi; Li, Fanglong; Qi, Siyong; Yin, Zhaoyang; Gao, Jiangping (January 2016). "Prognostic Role of Neutrophil-to-Lymphocyte Ratio in Prostate Cancer". Medicine. 95 (3): e2544. doi:10.1097/MD.0000000000002544. PMC 4998274. PMID 26817900.
- Azab, Basem; Camacho-Rivera, Marlene; Taioli, Emanuela; Zhang, Jian (6 November 2014). "Average Values and Racial Differences of Neutrophil Lymphocyte Ratio among a Nationally Representative Sample of United States Subjects". PLOS ONE. 9 (11): e112361. Bibcode:2014PLoSO...9k2361A. doi:10.1371/journal.pone.0112361. PMC 4223021. PMID 25375150.