Neutrophils are the most abundant myeloid-derived eukaryotic cells in human blood with increasingly recognized as important regulators of cancer progression. However, the functional importance of tumor-associated neutrophils (TANs) is often overlooked due to their short-lived, terminally differentiated, non-proliferative properties. In recent years, a wealth of evidences obtained from experimental tumor models and cancer patients had indicated that TANs had obvious heterogeneity in morphology and function, and TANs had dual functions of pro- and anti-tumor in cancer patients. This review provides an adequate overview of the heterogeneity and distinct roles of neutrophils.
Objective To explore the differences in lung function, neutrophil polarization, and serum total immunoglobulin E (IgE) levels among bronchial asthma patients, chronic obstructive pulmonary disease (COPD) patients, and asthma-COPD overlap syndrome (ACO) patients. Methods The retrospective analysis enrolled 127 patients with respiratory system diseases diagnosed and treated in Wuwei People’s Hospital between March 2016 and March 2019. Among them, 45 patients with moderate and severe bronchial asthma were in included the asthma group, 42 patients with acute exacerbations of COPD were included in the COPD group, and 40 patients with moderately persistent and severely persistent ACO were included in the ACO group. Forty-eight healthy examinees in the same period were selected as the control group. The pulmonary function [forced expiratory volume in one second (FEV1), forced vital capacity (FVC), FEV1 to FVC (FEV1/FVC) ratio, and percentage of FEV1 to predicted value (FEV1%pred)], neutrophil polarization, and serum total IgE levels of the four groups were compared. Results In the control group, the ACO group, the asthma group, and the COPD group, the FEV1 values were (3.65±0.79), (2.04±0.58), (1.81±0.46), and (1.59±0.43) L, respectively, the FVC values were (4.13±0.92), (3.18±0.76), (2.69±0.63), and (2.43±0.58) L, respectively, the serum total IgE levels were (92.36±12.20), (334.81±55.96), (455.61±65.59), and (142.65±28.36) U/mL, respectively, and the between-group differences were all statistically significant (P<0.05). In addition, the FEV1/FVC ratios in the asthma group, the COPD group, and the ACO group were (67.93±11.51)%, (63.81±9.22)%, and (61.28±9.23)%, respectively, the FEV1%pred levels were (74.55±11.70)%, (63.29±8.60)%, and (61.34±7.91)%, respectively, which were lower than those in the control group [(83.60±7.18)% and (94.23±8.21)%] (P<0.05). The spontaneous polarization rates in the ACO group, the asthma group, the COPD group, and the control group were (29.43±5.58)%, (25.11±4.09)%, (16.28±4.51)%, and (7.18±2.12)%, respectively, the arbitrary polarization rates in the ACO group, the asthma group, the control group, and the COPD group were (30.01±5.29)%, (25.76±5.53)%, (21.42±4.36)%, and (19.85±5.00)%, respectively, the directional polarization rates in the asthma group, the ACO group, the control group, and the COPD group were (14.67±2.30)%, (8.21±1.81)%, (5.12±1.10)%, and (2.52±0.63)%, respectively, and the between-group differences were all statistically significant (P<0.05). Conclusion There are certain differences in lung function, neutrophil polarization, and serum immunoglobulin E level among patients with bronchial asthma, COPD, and asthma-COPD overlap syndrome.
ObjectiveTo investigate the predictive value of preoperative D-dimer, CA19-9, neutrophil-to-lymphocyte ratio (NLR) in the diagnosis of pancreatic cancer. MethodsThe clinicopathologic data of patients who underwent pancreaticoduodenectomy for pancreatic occupying lesions in the First and Fifth Affiliated Hospitals of Xinjiang Medical University from January 2016 to December 2019 were analyzed retrospectively. According to the pathological characteristics, the patients were divided into pancreatic cancer and pancreatic benign tumour. The gender, age, accompanying diseases, preoperative D-dimer, CA19-9, lymphocyte count, neutrophil count, NLR and so on were compared between them. The receiver operating characteristic (ROC) curves of preoperative D-dimer, CA19-9, and NLR for diagnosis of pancreatic cancer were draw. ResultsA total of 142 patients were collected, including 79 patients with pancreatic cancer and 63 patients with pancreatic benign tumour. Compared with the patients with pancreatic benign tumour, the age was older (P<0.05), the number of neutrophils was more (P<0.05), the number of lymphocytes was less (P<0.05), the preoperative levels of CA19-9 and D-dimer, and the preoperative NLR were higher (P<0.05) for the patients with pancreatic cancer. The multivariate analysis of logistic regression revealed that the preoperative higer CA19-9, D-dimer, and NLR increased the incidence of pancreatic cancer (P<0.05), then the optimal cut-off value of preoperative levels of CA19-9 and D-dimer, and preoperative NLR on diagnosis of pancreatic cancer was 108 U/mL, 306 μg/L and 3.2, respectively, the corresponding area under ROC curve was 0.900, 0.891, 0.768, respectively, and which of combination of preoperative CA19-9, D-dimer, and NLR was 0.931. For the pancreatic cancer patients with preoperative NLR, CA19-9, and D-dimer higher than the optimal cut-off value, the proportions of patients with pTNM stage Ⅲ and lymph node metastasis were higher than those for pancreatic cancer patients with below than optimal cut-off value (P<0.05). ConclusionFrom preliminary study results, preoperative CA19-9, D-dimer, and NLR values have certain values in diagnosis of pancreatic cancer, and diagnostic value of combined detection of 3 indexes is higher than single index.
ObjectiveTo explore value of preoperative neutrophil-to-lymphocyte ratio (NLR) combined with carbohydrate antigen 19-9 (CA19-9) in evaluating prognosis for patients with pancreatic head carcinoma.MethodsThe clinical data of patients with pancreatic head carcinoma underwent radical pancreaticoduodenectomy in the Lanzhou University Second Hospital from February 2011 to August 2017 were retrospectively analyzed. The preoperative serum albumin (ALB), CA19-9, NLR, carcino-embryonic antigen (CEA), alpha-fetoprotein (AFP), N stage, tumor differentiated degree, and other indicators were recorded and the patient’s overall survival was recorded. Linear correlation analysis was used to examine the association of NLR with serum CA19-9. The receiver operating characteristic (ROC) curve was used to calculate the cutoff values of NLR and CA19-9 corresponding to the overall survival rate of 2-year. Kaplan-Meier method was used for survival analysis. Cox proportional hazards regression model was used to evaluate the prognostic value of preoperative CA19-9 and NLR.Results① A total of 121 patients were enrolled in this study. There was no significant correlation between the preoperative serum CA19-9 and NLR (r=0.100 05, P=0.272 9). ② Multivariate analysis showed that higher NLR, higher CA19-9 level, higher N stage, and lower tumor differentiation were the risk factors for overall survival of pancreatic head carcinoma (P<0.05). ③ The cutoff values of CA19-9 and NLR in evaluating the 2-year overall survival rate were 123.3 U/mL and 2.34 respectively by the ROC curve analysis, the area under ROC curve of CA19-9, NLR, and CA19-9 combined with NLR were 0.763, 0.686, and 0.823, respectively. ④ The proportions of patients with CEA≥5 μg/L and ≥N1 stage were higher in the patients with CA19-9≥123.3 U/mL as compared with patients with CA19-9<123.3 U/mL (P<0.05); The proportions of patients with preoperative serum ALB level <35 g/L and CEA≥5 μg/L, ≥N1 stage, and poor differentiation were higher in the patients with NLR≥2.34 as compared with the patients with NLR<2.34 (P<0.05). ⑤ Kaplan-Meier survival analysis showed that patients with CA19-9≥123.3 U/mL and NLR≥2.34 had worse overall survival than those patients with CA19-9<123.3 U/mL and NLR<2.34 (HR=3.599, P<0.01; HR=2.506, P<0.01). The patients with CA19-9≥123.3 U/mL and NLR≥2.34 (n=42), CA19-9≥123.3 U/mL or NLR≥2.34 (n=48), CA19-9<123.3 U/mL and NLR<2.34 (n=31) had better overall survival in turn (overall and between groups, all P<0.01).ConclusionPreoperative serum CA19-9 combined with NLR has an important value in evaluating prognosis for patients with pancreatic head carcinoma.
Objective To investigate preoperative blood neutrophil-to-lymphocyte ratio （NLR） in patients with gastrointestinal stromal tumor （GIST） and analyze the relationship of the NLR to prognosis. Methods The data of NLR of peripheral blood samples on 3d before surgery and the results of immunohistochemistry of 42 patients with GIST were analyzed respectively，the relation between the NLR and the prognosis of patients with GIST was understood by the survival analysis. Results The patients with high NLR （NLR≥2.5） was found in 22 cases， low NLR （NLR＜2.5） in 20 cases.The NLR was related to mitotic figures （χ2=9.45，P=0.002） and tumor size （P=0.041）. The 3-year survival rate of the patients with high NLR was shorter than that of the low NLR （χ2=5.44，P=0.022）. The 3-year survival rate was associated with NLR，mitotic figures，and tumor size （P＜0.05） in univariate analysis. The NLR and mitotic figures were independent prognostic indicators of 3-year survival （P=0.018，P=0.000） in Cox multivariate analysis. Conclusion Blood NLR and mitotic figures have some predictive value for the prognosis of patients with GIST.
ObjectiveTo analyze dynamic characteristics of peripheral blood cells in patients with different types of coronavirus disease 2019 (COVID-19), so as to investigate the predictive value of peripheral blood cells and their dynamic changes for clinical outcome of patients with COVID-19.MethodsForty-eight patients with COVID-19 were collected and analyzed from East Hospital of Renmin Hospital of Wuhan University from February 2 to March 15, 2020. These patients were divided into general group (group A, 17 cases), severe survival group (group B, 21 cases), and severe death group (group C, 10 cases). Blood routine examination was done and analyzed before and after admission and among the three groups. The changes of neutrophils and lymphocytes were compared. The predictive power of neutrophils, lymphocytes, neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) for clinical outcomes was analyzed through the receiver operating characteristic (ROC) curve.ResultsIn group B, the lymphocyte count at discharge was significantly higher than at admission (P=0.002), and the neutrophil count, NLR and PLR were significantly lower than at admission (P values were 0.012, 0.001 and 0.007, respectively). The lymphocyte counts in the A, B, and C groups were ranked from high to low upon admission, and the differences among the three groups were statistically significant (P values were 0.020, <0.001 and 0.006 for the contrasts between groups A and B, groups A and C, groups B and C, respectively), the NLR were ranked from low to high, and the differences among the three groups were statistically significant (P values were 0.001, <0.001 and 0.026 for the contrasts between groups A and B, groups A and C, groups B and C, respectively). Before discharge or death, there was no significant difference in lymphocyte counts and NLR between A and B groups (P>0.05), and there were statistically significant differences between group C and groups A and B (all P values were<0.001). The proportions of “Neutrophils Lymphocytes Convergence” in groups A and B were 64.7% and 76.2%, respectively, which were significantly higher than that in group C (10.0%). The proportions of “Neutrophils Lymphocytes Separation” in group C was 70.0%, which was significantly higher than those in groups A (0) and B (4.8%). The area under the curve of NLR predicting patients with severe disease (excluding death) was 0.843, with the sensitivity and specificity of ≥3.55 be 0.810 and 0.882; The area under the curve of lymphocyte count predicting death in severe patients was 0.845, with the sensitivity and specificity be 0.700 and 0.905, respectively.ConclusionsDynamic changes in the composition of peripheral blood cells are one of the clinical features of COVID-19, “Neutrophils Lymphocytes Convergence” and “Neutrophils Lymphocytes Separation” predict better and worse clinical outcomes, respectively. NLR and lymphocyte counts are effective indicators for predicting the severity and death of COVID-19.
ObjectiveTo study the clinical significance of prognostic nutritional index (PNI) combined with neutrophil to lymphocyte ratio (NLR) in predicting the occurrence of anastomotic leakage after radical gastrectomy for gastric cancer.MethodsTo retrospectively analyze and collect the clinical data of 517 patients with gastric cancer who were diagnosed at the Third People’s Hospital of Shangqiu City from January 2016 to May 2020, all of the patients received radical gastrectomy. We explored the risk factors that affect the occurrence of postoperative anastomotic leakage, and explored the clinical significance of PNI combined with NLR on the third day after operation in predicting the occurrence of anastomotic leakage.ResultsAmong 517 patients undergoing radical gastrectomy, 61 had anastomotic leakage, and the incidence of anastomotic leakage was 11.8%. The results of multivariate logistic regression analysis showed that patients with preoperative diabetes and intraoperative blood loss ≥400 mL had a higher incidence of anastomotic leakage, and with the increase of NLR value on the 3rd and 5th day after operation, and the decrease of PNI value on the 3rd and 5th day after operation, the incidence of anastomotic leakage increased (P<0.05). The area under the curve of NLR, PNI, and NLR combined with PNI on the 3rd day after operation in predicting the occurrence of anastomotic leakage were 0.849, 0.581, and 0.949, respectively, and the differences were statistically significant (P<0.05), the sensitivity and specificity of NLR combined with PNI were higher than the individual indicator.ConclusionPNI combined with NLR on the 3rd day after operation has important clinical significance in predicting the occurrence of anastomotic leakage after radical gastrectomy for gastric cancer.
Acute cerebral infarction is characterized by high incidence rate, high recurrence rate, high disability rate and multiple complications. Early evaluation and treatment of acute cerebral infarction is particularly important to improve the survival rate and prognosis of patients. As an easily available clinical laboratory indicator, blood routine test can reflect the pathological changes in the body to a certain extent. In recent years, many studies have shown that the indicators such as red cell volume distribution width, mean platelet volume, neutrophil to lymphocyte ratio and platelet to lymphocyte ratio in blood routine examination have important values in the onset, severity and prognosis of acute cerebral infarction. This article reviews the correlations of the above parameters and ratio parameters with acute cerebral infarction, in order to provide some reference and basis for clinical diagnosis, treatment and prognosis evaluation of acute cerebral infarction.