Neutrophil to lymphocyte ratio

Last updated

The neutrophil to lymphocyte ratio (NLR) reflects systemic inflammation, which plays an important role in the process of treating ischemic strokes. [1]

Contents

In medicine neutrophil to lymphocyte ratio (NLR) is used to show there is inflammation in the body. It is calculated by dividing the number of neutrophils by number of lymphocytes, usually from peripheral blood sample, [2] but sometimes also from cells that infiltrate tissue, such as tumor. [3] Recently Lymphocyte Monocyte ratio (LMR) has also been studied as a marker of inflammation including tuberculosis and various cancers.

Uses

Prognostic biomarker in acute ischemic stroke (AIS)

The NLR is associated with stroke severity, unfavorable functional outcomes and mortality in AIS. [1]

Prognosis of cardiovascular diseases

Higher NLR contributes to predicting mortality rates (prognostic marker) in patients undergoing certain medical procedures, such as angiography or cardiac revascularization. [2]

Prognostic marker in cancer

Increased NLR is associated with poor prognosis of various cancers, [4] such as esophageal, [5] liver, [6] ovarian, [7] pancreatic, [8] prostate [9] and stomach cancer. [10]

Prognostic marker in COVID-19

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. [11]

Reference values

A 2017 study found that the normal NLR range for healthy adults is between 0.78 and 3.53. [12]

History

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. [13]

The first study to demonstrate that pre-therapeutic 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. [14]

Related Research Articles

<span class="mw-page-title-main">Appendicitis</span> Inflammation of the appendix

Appendicitis is inflammation of the appendix. Symptoms commonly include right lower abdominal pain, nausea, vomiting, fever and decreased appetite. However, approximately 40% of people do not have these typical symptoms. Severe complications of a ruptured appendix include widespread, painful inflammation of the inner lining of the abdominal wall and sepsis.

<span class="mw-page-title-main">Chronic lymphocytic leukemia</span> Bone marrow cancer in which lymphocytes are overproduced

Chronic lymphocytic leukemia (CLL) is a type of cancer that affects the blood and bone marrow. In CLL, the bone marrow makes too many lymphocytes, which are a type of white blood cell. In patients with CLL, B cell lymphocytes can begin to collect in their blood, spleen, lymph nodes, and bone marrow. These cells do not function well and crowd out healthy blood cells. CLL is divided into two main types:

  1. Slow-growing CLL
  2. Fast-growing CLL
<span class="mw-page-title-main">Endothelium</span> Layer of cells that line the inner surface of blood vessels

The endothelium is a single layer of squamous endothelial cells that line the interior surface of blood vessels and lymphatic vessels. The endothelium forms an interface between circulating blood or lymph in the lumen and the rest of the vessel wall.

The health effects of tea have been studied throughout human history. In clinical research conducted over the early 21st century, tea has been studied extensively for its potential to lower the risk of human diseases, but there is no good scientific evidence to support any therapeutic uses other than possibly increasing alertness, an effect caused by caffeine in the tea leaves.

<span class="mw-page-title-main">Gastrointestinal bleeding</span> Bleeding in the gastrointestinal tract

Gastrointestinal bleeding, also called gastrointestinal hemorrhage (GIB), is all forms of bleeding in the gastrointestinal tract, from the mouth to the rectum. When there is significant blood loss over a short time, symptoms may include vomiting red blood, vomiting black blood, bloody stool, or black stool. Small amounts of bleeding over a long time may cause iron-deficiency anemia resulting in feeling tired or heart-related chest pain. Other symptoms may include abdominal pain, shortness of breath, pale skin, or passing out. Sometimes in those with small amounts of bleeding no symptoms may be present.

Fertility medications, also known as fertility drugs, are medications which enhance reproductive fertility. For women, fertility medication is used to stimulate follicle development of the ovary. There are very few fertility medication options available for men.

<span class="mw-page-title-main">CXCR4</span> Protein

C-X-C chemokine receptor type 4 (CXCR-4) also known as fusin or CD184 is a protein that in humans is encoded by the CXCR4 gene. The protein is a CXC chemokine receptor.

<span class="mw-page-title-main">CD31</span> Mammalian protein found in humans

Platelet endothelial cell adhesion molecule (PECAM-1) also known as cluster of differentiation 31 (CD31) is a protein that in humans is encoded by the PECAM1 gene found on chromosome17q23.3. PECAM-1 plays a key role in removing aged neutrophils from the body.

<span class="mw-page-title-main">P-selectin</span> Type-1 transmembrane protein

P-selectin is a type-1 transmembrane protein that in humans is encoded by the SELP gene.

Sialyl-Lewis <sup>X</sup> Chemical compound

Sialyl LewisX (sLeX), also known as cluster of differentiation 15s (CD15s) or stage-specific embryonic antigen 1 (SSEA-1), is a tetrasaccharide carbohydrate which is usually attached to O-glycans on the surface of cells. It is known to play a vital role in cell-to-cell recognition processes. It is also the means by which an egg attracts sperm; first, to stick to it, then bond with it and eventually form a zygote.

<span class="mw-page-title-main">CD24</span> Mammalian protein found in humans

Signal transducer CD24 also known as cluster of differentiation 24 or heat stable antigen CD24 (HSA) is a protein that in humans is encoded by the CD24 gene. CD24 is a cell adhesion molecule.

<span class="mw-page-title-main">Diet and cancer</span> Connections between dietary habits and cancer

Many dietary recommendations have been proposed to reduce the risk of cancer, few have significant supporting scientific evidence. Obesity and drinking alcohol have been correlated with the incidence and progression of some cancers. Lowering the consumption of sweetened beverages is recommended as a measure to address obesity.

<span class="mw-page-title-main">IGSF8</span> Protein-coding gene in the species Homo sapiens

Immunoglobulin superfamily member 8 is a protein that in humans is encoded by the IGSF8 gene. IGSF8 has also been designated as CD316. IGSF8 is an innate immune checkpoint that inhibits the cytotoxic activity of natural killer (NK) cells. IGSF8 acts by binding to the Killer Ig-like Receptor KIR3DL2. IGSF8 is frequently overexpressed relative to normal tissues in many cancers, included melanoma, urothelial carcinoma, and breast cancer, and has been proposed as a potential therapeutic target in gliomas. In normal tissues, IGSF8 is highly expressed in the brain, where it may contribute to the immune privilege of the central nervous system.

<span class="mw-page-title-main">Platelet-rich plasma</span> Blood product used in transfusion medicine

Platelet-rich plasma (PRP), also known as autologous conditioned plasma, is a concentrate of plasma protein derived from whole blood, centrifuged to remove red blood cells but retaining platelets. Though promoted for treating various medical conditions, evidence of its benefits was mixed as of 2020, showing effectiveness in certain conditions and ineffectiveness in others.

<span class="mw-page-title-main">Cancer biomarker</span> Substance or process that is indicative of the presence of cancer in the body

A cancer biomarker refers to a substance or process that is indicative of the presence of cancer in the body. A biomarker may be a molecule secreted by a tumor or a specific response of the body to the presence of cancer. Genetic, epigenetic, proteomic, glycomic, and imaging biomarkers can be used for cancer diagnosis, prognosis, and epidemiology. Ideally, such biomarkers can be assayed in non-invasively collected biofluids like blood or serum.

<span class="mw-page-title-main">Tumor microenvironment</span> Surroundings of tumors including nearby cells and blood vessels

The tumor microenvironment is a complex ecosystem surrounding a tumor, composed of cancer cells, stromal tissue and the extracellular matrix. Mutual interaction between cancer cells and the different components of the tumor microenvironment support its growth and invasion in healthy tissues which correlates with tumor resistance to current treatments and poor prognosis. The tumor microenvironment is in constant change because of the tumor's ability to influence the microenvironment by releasing extracellular signals, promoting tumor angiogenesis and inducing peripheral immune tolerance, while the immune cells in the microenvironment can affect the growth and evolution of cancerous cells.

The association between obesity, as defined by a body mass index of 30 or higher, and risk of a variety of types of cancer has received a considerable amount of attention in recent years. Obesity has been associated with an increased risk of esophageal cancer, pancreatic cancer, colorectal cancer, breast cancer, endometrial cancer, kidney cancer, thyroid cancer, liver cancer and gallbladder cancer. Obesity may also lead to increased cancer-related mortality. Obesity has also been described as the fat tissue disease version of cancer, where common features between the two diseases were suggested for the first time.

The CD4+/CD8+ ratio is the ratio of T helper cells (with the surface marker CD4) to cytotoxic T cells (with the surface marker CD8). Both CD4+ and CD8+ T cells contain several subsets.

<span class="mw-page-title-main">CMTM3</span> Protein-coding gene in the species Homo sapiens

CKLF-like MARVEL transmembrane domain-containing protein 3, also termed chemokine-like factor superfamily 3, is a member of the CKLF-like MARVEL transmembrane domain-containing family of proteins. In humans, CMTM2 protein is encoded by the CMTM3 gene located in band 22.1 on the long arm of chromosome 16. This protein is expressed in a wide range of tissues, including fetal tissues. It is highly expressed in the male reproductive system, particularly testicular tissues and may play a role in the development of this tissue. It is also highly expressed in the immune system including circulating blood cells, i.e. B lymphocytes, CD4+ T lymphocytes, and monocytes. However, CMTM3 protein is weakly expressed or unexpressed in the malignant tissues of several types of cancers. In many but not all of theses cancers, this decreased or lack of expression appears due to methylation of the GpC islands in the promoter region, and thereby the silencing, of the CMTM3 gene.

<span class="mw-page-title-main">White blood cell differential</span> Blood test

A white blood cell differential is a medical laboratory test that provides information about the types and amounts of white blood cells in a person's blood. The test, which is usually ordered as part of a complete blood count (CBC), measures the amounts of the five normal white blood cell types – neutrophils, lymphocytes, monocytes, eosinophils and basophils – as well as abnormal cell types if they are present. These results are reported as percentages and absolute values, and compared against reference ranges to determine whether the values are normal, low, or high. Changes in the amounts of white blood cells can aid in the diagnosis of many health conditions, including viral, bacterial, and parasitic infections and blood disorders such as leukemia.

References

  1. 1 2 Poyraz T, Çilengiroğlu ÖV (Aug 2024). "Blood biomarkers in acute ischemic stroke: The prognostic value of neutrophil-to-lymphocyte ratio and mean platelet volume". Adv Clin Exp Med. 33 (8): 791–803. doi: 10.17219/acem/172239 . PMID   38124461.
  2. 1 2 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.
  3. 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.
  4. 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.
  5. 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.
  6. 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.
  7. 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.
  8. 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.
  9. 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.
  10. 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.
  11. 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)
  12. 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.
  13. 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.
  14. 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