Neutrophil-to-lymphocyte ratio in malignant pleural fluid: Prognostic significance

Popowicz, Natalia; Cheah, Hui Min; Gregory, Cynthia; Miranda, Alina; Dick, Ian M.; Lee, Y C Gary; Creaney, Jenette

doi:10.1371/journal.pone.0250628

Cited by 13 publications

(13 citation statements)

References 31 publications

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“…Furthermore, the abundance of malignant mesothelioma patients in our study, which is known by its short life expectancy (12-21 months), with a median overall survival of about 15 months, rendering it one of the worst tumors as regard prognosis 21 , makes our results parallel to those of a recent study with 117 (MPE) patients which exposed that NLR (>0.745) in malignant pleural fluid was indicative to unfavorable prognosis. 22 Finally, in our work we found that the mean hematological (NLR) was significantly lower in (TPE) group compared with other groups. At the same time, this ratio was significantly lower in (MPE) group versus (PPE) group.…”

Section: Discussionsupporting

confidence: 51%

Diagnostic Value of Neutrophil-Lymphocyte Ratio in Exudative Pleural Effusion

Ewida¹,

Elnaby²,

Deraz³

et al. 2022

Al-Azhar International Medical Journal

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Background: As many patients may be unfit to undergo medical thoracoscopy, in addition to the low yield of closed pleural biopsy in malignant conditions, finding novel hematological or pleural fluid biomarkers to unmask the diagnosis of exudative pleural effusion and guide management plan becomes of increasing importance. Aim of The Work:To assess the role of neutrophil to lymphocyte ratio in either blood or pleural fluid as a simple biomarker in detecting the underlying etiology of exudative pleural effusion. Patients and Methods: This cross sectional study took place at Bab Al-Sha'reia University Hospital in the period between February 2021 and February 2022. It included 100 patients with exudative pleural effusion according to Light's criteria. Patients were divided according to the underlying cause into three groups; 1) malignant pleural effusion group, 2) tuberculous pleural effusion group and 3) para-pneumonic effusion group. Results:The mean pleural fluid neutrophil to lymphocyte ratio was significantly lower in tuberculous pleural effusion group compared with other groups. As well, the same ratio was significantly lower in malignant pleural effusion group than para-pneumonia effusion group (p <0.001). Similar findings were met when comparing the means of hematological neutrophil to lymphocyte ratio among the three studied groups. Conclusion:Neutrophil to lymphocyte ratio in either blood or pleural fluid is an easily-obtained and cost-effective biomarker which can differentiate between malignant pleural effusion, tuberculous pleural effusion and para-pneumonic effusion.

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Section: Discussionsupporting

confidence: 51%

Diagnostic Value of Neutrophil-Lymphocyte Ratio in Exudative Pleural Effusion

Ewida¹,

Elnaby²,

Deraz³

et al. 2022

Al-Azhar International Medical Journal

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“…Although a number of studies have looked at pleural fluid biochemical parameters for prognostication of malignancy, few have investigated pleural fluid lymphocyte predominance in MPM. A recent study by Popowicz and colleagues found that in malignant effusions of all types (n = 117) a higher ratio of lymphocytes to neutrophils was associated with improved survival, although the study protocol did not specify that the sample needed to be collected at the time of diagnosis [ 10 ]. In our study we found that where the pleural fluid predominance was calculable this was an independent prognostic marker.…”

Section: Discussionmentioning

confidence: 99%

Lymphocyte predominance in blood, pleural fluid, and tumour stroma; a prognostic marker in pleural mesothelioma

et al. 2022

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Background As promising novel treatments develop for malignant pleural mesothelioma (MPM), early prognostication has become increasingly important. Circulating and local inflammatory cells are known to play a significant role in other tumour types. We assessed the proportion of lymphocyte populations within blood, pleural fluid and tumour stroma to prognosticate patients with MPM at diagnosis. Methods Consecutive patients diagnosed with biopsy-proven MPM were prospectively recruited to an observational cohort study and followed up for a minimum of 7.5 years. Blood and pleural fluid results at presentation were extracted from the medical records. Biopsy specimens were independently reviewed by 2 pathologists who scored the degree of lymphocytic and neutrophilic infiltration. Results Baseline results were available for 184 patients. The predominant pleural fluid cell type was calculable for 84 patients and 118 patients had biopsy specimens available for review. A low blood neutrophil/lymphocyte ratio (NLR < 4) inferred a better prognosis with a median survival of 420 days versus 301 days (p < 0.01). Survival was better for patients with a lymphocyte-predominant pleural effusion (430 vs 306 days, p < 0.01). Lymphocyte infiltration of tumour stroma was also associated with improved survival (n = 92, survival 430 days) compared with neutrophilic or acellular samples (n = 26, survival 342 days p < 0.01). In multivariable modelling lymphocyte predominance in blood, pleural fluid and tumour stroma were all associated with a better prognosis. Conclusions Lymphocyte predominance within tumour stroma, pleural fluid or blood infers a better prognosis in patients with MPM.

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“…Interestingly, Natalia's study found that it is the increased neutrophils rather than decreased lymphocytes that drive the predictive value of NLR. [35]. Neutrophils play a critical role in the metastasis of cancer cells [36,37].…”

Section: Discussionmentioning

confidence: 99%

A Retrospective Analysis: A Predictive Model Using Platelets and Neutrophil-to- Lymphocyte Ratio for the Number of Lymph Node Metastasis in Papillary Thyroid Carcinoma

Chen,

Wu,

et al. 2024

Preprint

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Objective The aim of this study was to investigate the high-risk clinical factors for large-number lymph node metastases (LNLNM) inthyroid papillary carcinoma (PTC). Methods The clinicopathological data from the 731 PTC patients who underwent thyroid operation between September 2021to October 2022 in the surgical oncology of Affiliated Hangzhou First People’s Hospital, Westlake University School of Medicine were collected. Univariate and multivariate logistic analyses were conducted to identify risk factors for LNLNM in PTC. A predictive model for assessing LNLNM in PTC was established and validated by using receiver operating characteristic curves (ROC), the Hosmer-Lemeshow (HL)test, calibration curves, and decision curve analysis (DCA). Results Age, tumor diameter, platelets and neutrophil-to-lymphocyte ratio (NLR) were identified as independent risk factors for LNLNM in PTC patients. A predictive model was developed to evaluate the risk of LNLNMwith an area under the curve (AUC) of 0.827 (P<0.001, 95%CI: 0.784-0.870) and the specificity and sensitivity were both 75.8%. The AUC of the validation group was 0.824(P<0.001, 95%CI: 0.757-0.890) with a specificity of 79.5% and a sensitivity of 76.0%. Furthermore, themodel demonstrated good calibration through the HL test and favorable diagnostic value by calibration curve and DCA. Conclusion Age, tumor diameter, platelets and NLRare high-risk factors for LNLNM in PTC, and the predictive model established in combination with the above factors couldeffectively predict the occurrence of LNLNM in PTC. This study provides support for surgeons to accurately predict the possibility of LNLNM and develop personalized treatment plans before surgery.

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Neutrophil-to-lymphocyte ratio in malignant pleural fluid: Prognostic significance

Cited by 13 publications

References 31 publications

Diagnostic Value of Neutrophil-Lymphocyte Ratio in Exudative Pleural Effusion

Diagnostic Value of Neutrophil-Lymphocyte Ratio in Exudative Pleural Effusion

Lymphocyte predominance in blood, pleural fluid, and tumour stroma; a prognostic marker in pleural mesothelioma

A Retrospective Analysis: A Predictive Model Using Platelets and Neutrophil-to- Lymphocyte Ratio for the Number of Lymph Node Metastasis in Papillary Thyroid Carcinoma

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