Combined score of C-reactive protein level and neutrophil-to-lymphocyte ratio: A novel marker in distinguishing children with exacerbated asthma

Zhu, Xuming; Zhou, Lu; Li, Qingqing; Pan, Ruilin; Zhang, Jian; Cui, Yubao

doi:10.1177/20587384211040641

Cited by 14 publications

(10 citation statements)

References 18 publications

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“…The predictive role of the combination of both parameters in soft tissue cancer was also reported by Nakamura et al [20]. Recently, Zhu et al [11] investigated the combination of both parameters in asthma. These authors concluded that since both NLR and CRP are elevated in asthmatic patients, it is necessary to develop a novel markerthe combined score of CRP level and NLR (C-NLR score)that can take full advantage of meanings of both NLR and CRP in asthmatic patients.…”

Section: Discussionsupporting

confidence: 52%

“…In the late 2010s, the combination of CRP and NLR was discussed, and several types of research investigated its role in predicting the outcomes of some cancers and diseases [11,[20][21][22][23]. To our knowledge, no study has addressed the combination of CRP and NLR for patients with RCC.…”

Section: Discussionmentioning

confidence: 99%

“…The cutoff points for the parameters, CRP and NLR, were adapted from the associated previous studies [9,10]. The combined score of CRP and NLR levels was established as the C-NLR score, as reported by Zhu et al [11]. It is classified as C-NLR score 2; with elevated serum CRP and NLR levels, C-NLR score 1; with elevated serum level in one of them, and C-NLR score 0; with normal serum CRP and NLR levels.…”

Section: Methodsmentioning

confidence: 99%

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Serum C-NLR score, a new inflammatory marker, predicts tumor histopathology and oncological outcomes of localized clear cell renal carcinoma after nephrectomy: A single center retrospective analysis

et al. 2023

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Background/Aim: Several blood and serum-based parameters have been described as prognostic markers of clear cell renal cell carcinoma (ccRCC). But most of these markers have inconsistent results and are not used in routine clinical practice. Therefore, novel potential predictor biomarkers are needed for the management of ccRCC patients in clinical practice. Here, we investigate the predictive value of a novel marker, serum C-NLR score, for pathological characteristics and oncological outcomes of ccRCC. Methods: A total of 162 RCC patients who underwent radical or partial nephrectomy between January 2015 and January 2021 were evaluated in a retrospective cohort study setting. The serum C-NLR score was compared according to the tumor histopathology-associated parameters. The predictive role of those parameters and C-NLR score on the oncological outcomes of ccRCC was also investigated. Results: The median serum C-NLR scores exhibited statistically significant increases in ccRCC patients with pathological necrosis, lymphovascular invasion, and variant differentiation. Among histopathological characteristics, only tumor necrosis and variant differentiation were associated with overall survival (OS) and tumor grade with metastasis-free survival (MFS) (no metastasis detected in grade 1–2 tumors) in Kaplan Meier analyses. Serum C-NLR score was also associated with OS but not MFS. In the univariate analyses, tumor necrosis, variant differentiation, and C-NLR score were associated with OS of localized RCC patients who underwent nephrectomy (HR: 0.29; 95% CI: 0.08–1.01; P=0.04, HR: 6.01; 95% CI: 1.66–21.82; P=0.006 and, HR: 1.21; 95% CI: 0.20–5.16; P=0.04). However, in the multivariate analysis, only variant differentiation and C-NLR score were associated with OS (HR: 1.43; 95% CI: 0.82–2.98; P=0.03 and HR: 1.21; 95% CI: 0.20–5.16; P=0.04). Tumor grade was directly associated with MFS because grade 1–2 tumors did not exhibit any metastasis. Conclusion: Serum C-NLR score was higher in worse histopathological entities. Moreover, it predicts the OS for patients with ccRCC as an independent factor.

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Section: Discussionsupporting

confidence: 52%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Serum C-NLR score, a new inflammatory marker, predicts tumor histopathology and oncological outcomes of localized clear cell renal carcinoma after nephrectomy: A single center retrospective analysis

et al. 2023

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“…Zhu et al 22 have found that the combined score of CRP level and NLR is a promising marker to distinguish children with exacerbated asthma from healthy children. Huang et al 17 showed that children with asthma have a higher concentration of NLR.…”

Section: Discussionmentioning

confidence: 99%

Neutrophil–lymphocyte ratios in blood to distinguish children with asthma exacerbation from healthy subjects

Pan

Ren

et al. 2023

Int J Immunopathol Pharmacol

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Objective Airway inflammation is a prominent feature of asthma and may play an important role in disease pathophysiology. Despite the increasing incidence of asthma worldwide, reliable diagnostic biomarkers are lacking and widely lead to asthma misdiagnosis. Neutrophil–lymphocyte ratio (NLR) is a biomarker of systemic inflammation, in addition to NLR–alanine aminotransferase ratio (NAR) and NLR–albumin ratio (NBR). The aim of this study was to evaluate associations of NLR, NAR, and NBR with diagnosis of childhood asthma to determine if they can aid clinical childhood asthma diagnosis. Methods This retrospective case-control study included 89 children with asthma and 53 healthy children from the Wuxi Children’s Hospital affiliated with Nanjing Medical University. We applied various statistical tests to the dataset: Mann–Whitney U test to compare characteristics of the case and control groups; chi-squared test to compare categorical variables; Kruskal–Wallis test to compare statistical differences of asthma indicators among groups; receiver operating characteristic (ROC) curves to assess the diagnostic value of indices; and Spearman correlation analysis to evaluate relationships between NLR and lactate dehydrogenase, albumin, aspartate transaminase, and alanine transaminase levels. Results Compared with controls, the asthma case group had significantly higher white blood cell ( p < 0.01), neutrophil, lactate dehydrogenase, C-reactive protein, and NLR levels ( p < 0.01) and significantly lower lymphocyte ( p = 0.001), platelet ( p = 0.039), and albumin levels ( p = 0.04). We determined optimal cutoff levels for several metrics: 1.723 for NLR, with sensitivity of 0.73 and specificity of 0.906; 0.135 for NAR, with sensitivity of 0.685 and specificity of 0.887; and 0.045 for NBR, with sensitivity of 0.674 and specificity of 0.906. The areas under the curve (AUCs) were 0.824 for NLR, 0.788 for NAR, 0.818 for NBR, and 0.83 for the combination of NLR + NAR + NBR. Conclusion The combination of NLR, NAR, and NBR biomarkers distinguished asthmatic ones suffering from exacerbation of the condition from healthy children. Thus, our results indicate NLR + NAR + NBR could be used as a clinical biomarker for asthma in children.

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“…Some of these complex inflammatory mechanisms may be common to both asthma and COPD, which means that clinical features of asthma and COPD may overlap ( 11 ). For example, eosinophil is not only the characteristic diagnostic biomarker for asthma ( 12 ), but also closely related to COPD exacerbations ( 13 ); neutrophil-lymphocyte ratio (NLR) is associated with the exacerbation of asthma and COPD ( 14 – 16 ). Although the pathogenesis of ACO is not well established ( 17 ), some scholars have proposed that systemic inflammation may be a contributing factor to the increased morbidity associated with the ACO ( 18 ).…”

Section: Introductionmentioning

confidence: 99%

Using inflammatory index to distinguish asthma, asthma-COPD overlap and COPD: A retrospective observational study

Yang

Liu

et al. 2022

Front. Med.

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BackgroundAlthough asthma and chronic obstructive pulmonary disease (COPD) are two well-defined and distinct diseases, some patients present combined clinical features of both asthma and COPD, particularly in smokers and the elderly, a condition termed as asthma-COPD overlap (ACO). However, the definition of ACO is yet to be established and clinical guidelines to identify and manage ACO remain controversial. Therefore, in this study, inflammatory biomarkers were established to distinguish asthma, ACO, and COPD, and their relationship with the severity of patients’ symptoms and pulmonary function were explored.Materials and methodsA total of 178 patients, diagnosed with asthma (n = 38), ACO (n = 44), and COPD (n = 96) between January 2021 to June 2022, were enrolled in this study. The patients’ pulmonary function was examined and routine blood samples were taken for the analysis of inflammatory indexes. Logistic regression analysis was used to establish inflammatory biomarkers for distinguishing asthma, ACO, and COPD; linear regression analysis was used to analyze the relationship between inflammatory indexes and symptom severity and pulmonary function.ResultThe results showed that, compared with ACO, the higher the indexes of platelet, neutrophil-lymphocyte ratio (NLR) and eosinophil-basophil ratio (EBR), the more likely the possibility of asthma and COPD in patients, while the higher the eosinophils, the less likely the possibility of asthma and COPD. Hemoglobin and lymphocyte-monocyte ratio (LMR) were negatively correlated with the severity of patients’ symptoms, while platelet-lymphocyte ratio (PLR) was negatively correlated with forced expiratory volume in the 1 s/forced vital capacity (FEV1/FVC) and FEV1 percent predicted (% pred), and EBR was positively correlated with FEV1% pred.ConclusionInflammatory indexes are biomarkers for distinguishing asthma, ACO, and COPD, which are of clinical significance in therapeutic strategies and prognosis evaluation.

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Combined score of C-reactive protein level and neutrophil-to-lymphocyte ratio: A novel marker in distinguishing children with exacerbated asthma

Cited by 14 publications

References 18 publications

Serum C-NLR score, a new inflammatory marker, predicts tumor histopathology and oncological outcomes of localized clear cell renal carcinoma after nephrectomy: A single center retrospective analysis

Serum C-NLR score, a new inflammatory marker, predicts tumor histopathology and oncological outcomes of localized clear cell renal carcinoma after nephrectomy: A single center retrospective analysis

Neutrophil–lymphocyte ratios in blood to distinguish children with asthma exacerbation from healthy subjects

Using inflammatory index to distinguish asthma, asthma-COPD overlap and COPD: A retrospective observational study

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