Reduced lymphocyte count as an early marker for predicting infected pancreatic necrosis

Shen, Xiao; Sun, Jing; Ke, Lu; Zou, Lei; Li, Baiqiang; Tong, Zhihui; Li, Weiqin; Li, Ning; Li, Jieshou

doi:10.1186/s12876-015-0375-2

Cited by 33 publications

(32 citation statements)

References 22 publications

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“…Multivariate stepwise logistic analysis showed that sPD-L1 levels and lymphocyte count were independently associated with the development of infectious complications in AP. This is consistent with a previous study showing that reduced lymphocyte count within 48 h of AP onset were independently associated with the development of infected pancreatic necrosis [33]. Pronounced downregulation of HLA-DR expression was also seen in patients who had AP with infectious complications.…”

Section: Discussionsupporting

confidence: 92%

sPD‐L1 Expression is Associated with Immunosuppression and Infectious Complications in Patients with Acute Pancreatitis

Chen

Liu

et al. 2017

Scand J Immunol

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Acute pancreatitis (AP) with infectious complications has high mortality because of early-stage immunosuppression. The programmed cell death-1 (PD-1)/programmed cell death ligand 1 (PD-L1) pathway is an important host immunosuppression mechanism. Soluble PD-L1 (sPD-L1) expression regulates co-inhibitory signals in malignancies or autoimmune disorders; however, its effects in AP are unknown. Here, we evaluated whether serum sPD-L1 is involved in immune dysfunction and assessed its relationship with infectious complications in early AP. Blood samples were obtained from 56 patients with acute pancreatitis and 21 healthy individuals in this prospective study. Serum sPD-L1 levels within 48 h after AP onset were tested by enzyme-linked immunosorbent assays. Relevant immune parameters (human leucocyte antigen-DR, lymphocyte count) and inflammatory markers (C-reactive protein, white blood cell count) were analysed. sPD-L1 was significantly upregulated in patients with early AP, especially those with infectious complications, compared to healthy controls. Significant negative correlations were observed among monocyte HLA-DR expression, lymphocyte count and sPD-L1 levels in AP. Multivariate regression indicated that sPD-L1 was an independent risk factor for infectious complications in AP. The findings suggest that increased sPD-L1 expression appears to be involved in the development of immunosuppression in the early stage of AP and that sPD-L1 might be an early parameter for prediction of infectious complications in patients with AP.

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Section: Discussionsupporting

confidence: 92%

sPD‐L1 Expression is Associated with Immunosuppression and Infectious Complications in Patients with Acute Pancreatitis

Chen

Liu

et al. 2017

Scand J Immunol

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“…Neutrophils and lymphocytes are important components of the WBCs and high levels of neutrophil count are associated with a more pronounced inflammatory state. Several investigators also have demonstrated a significant decrease of lymphocyte count in SAP is significantly and independently associated with the development of AP 20 , 21 . Additionally, an elevated neutrophil count with a concomitant decreased lymphocyte count has been associated with bacteremia and sepsis but no differece of WBC count 12 , 22 .…”

Section: Discussionmentioning

confidence: 94%

The utility of neutrophil to lymphocyte ratio and fluid sequestration as an early predictor of severe acute pancreatitis

Han

Zeng

Lin

et al. 2017

Sci Rep

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It is important to identify the patients with high-risk progression to develop severe acute pancreatitis (SAP). The study was to assess whether neutrophil to lymphocyte ratio (NLR) and fluid sequestration (FS) could represent useful markers for predicting the severity. A total of 1639 patients who underwent clinical diagnosis of AP was performed. Various serologic and clinical parameters on admission were investigated. Chronologic change in NLR and FS were analyzed, and theirs utility for predicting severity of AP was evaluated by receiver operator characteristic (ROC) curve analysis. Correlation analysis was assessed by Spearman’s rank test. NLR and FS levels were both increased significantly in SAP and positively correlated with Ranson score and hospital stays. The ROC curve analyses showed the optimal cut-off values of NLR for admission with day0, day1, day2 were 9.64, 6.66 and 6.50, giving sensitivity of 77–82%. The optimal cut-off values of FS for admission with day1, day2, day3 were 1375 ml, 2345 ml and 3424 ml, giving sensitivity of 62–75%. Moreover, measurement of NLR and FS together exhibited a similar area under curve (AUC) and sensitivity for SAP prediction compared with the those of Ranson score. Increase of NLR and FS are correlated with severity and can be suggested as a predictive factor in an early stage of AP.

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“…In a study by Shen et al, the lymphocyte count was significantly associated with the development of infected pancreatic necrosis. 32 The pre-operative lymphocyte count was also evaluated in patients with adnexal torsion and several studies showed no significant diagnostic value. 29 According to our study, pre-operative lymphocyte count was lower in the torsion group compared to the non-torsion group, but it was higher in the infarction group than the non-infarction group.…”

Section: Discussionmentioning

confidence: 99%

Original Articles Preoperative Hematological Parameters for Predicting Ovarian Torsion in Patients with Mature Cystic Teratoma

Lee¹,

Park²,

Lee³

et al. 2021

IJWH

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Objective The objective of this study is to evaluate the preoperative hematological parameters to predict ovarian torsion in patients with ovarian mature cystic teratoma. We also analyzed the diagnostic value of these makers to predict ovarian necrosis in cases of torsion as well as the effect of torsion on ovarian reserve. Patients and Methods This is a retrospective study of 132 patients who received either laparoscopic or laparotomy surgery for OMCT at a single university hospital. Clinical characteristics and preoperative hematological parameters were compared between patients with or without torsion. Patients with torsion were further classified as infarction and non-infarction group. Preoperative parameters were compared between the two groups as well. Results White blood cell (WBC) count, neutrophil percent, neutrophil count, and neutrophil to lymphocyte ratio (NLR) were higher in the torsion group (n=37) than the non-torsion group (n=95) ( p <0.05 for all). Although statistically insignificant, the preoperative anti-Mullerian hormone (AMH) was lower in the torsion group than the non-torsion group (4.07 ± 3.38 vs 6.1 ± 3.6, p =0.122). In cases of torsion, the infarction group showed higher WBC count and lymphocyte count but lower hemoglobin level and platelet to lymphocyte ratio (PLR) than the non-infarction group ( p <0.05 for all). Conclusion The WBC count, neutrophil percent, neutrophil count, and NLR were higher in the cases of OMCT with torsion, and these parameters may be useful to diagnose OMCT with torsion. Also, adnexal torsion may deteriorate ovarian reserved as indicated by decreased AMH in torsion group.

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Reduced lymphocyte count as an early marker for predicting infected pancreatic necrosis

Cited by 33 publications

References 22 publications

sPD‐L1 Expression is Associated with Immunosuppression and Infectious Complications in Patients with Acute Pancreatitis

sPD‐L1 Expression is Associated with Immunosuppression and Infectious Complications in Patients with Acute Pancreatitis

The utility of neutrophil to lymphocyte ratio and fluid sequestration as an early predictor of severe acute pancreatitis

Original Articles Preoperative Hematological Parameters for Predicting Ovarian Torsion in Patients with Mature Cystic Teratoma

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