Neutrophil to lymphocyte ratio

The Neutrophil to lymphocyte ratio (NLR) is calculated by dividing the absolute count of neutrophils by the absolute count of lymphocytes.

https://www.mdcalc.com/calc/10305/neutrophil-lymphocyte-ratio-nlr-calculator

Normal Neutrophil to lymphocyte ratio values in an adult, non-geriatric, population in good health are between 0.78 and 3.53. These data may help the researcher as the clinician searching for a cut-off for the NLR, until now lacking ¹⁾.

A normal range of NLR is between 1-2, values higher than 3.0 and below 0.7 in adults are pathological. NLR in a grey zone between 2.3-3.0 may serve as an early warning of pathological states or processes such as cancer, atherosclerosis, infection, inflammation, psychiatric disorders, and stress.

see Neutrophil to lymphocyte ratio for delayed cerebral ischemia.

see Neutrophil to lymphocyte ratio for subarachnoid hemorrhage.

see Neutrophil to lymphocyte ratio for glioma.

see Neutrophil to lymphocyte ratio for intracerebral hemorrhage.

see Neutrophil to lymphocyte ratio for traumatic intracerebral hemorrhage.

Hematologic inflammatory markers are simple, inexpensive prognostic markers for various conditions. The prognostic significance of representative markers neutrophil to lymphocyte ratio (NLR), Platelet-to-lymphocyte ratio (PLR), monocyte lymphocyte ratio (MLR) and red cell distribution width (RDW) in patients exist in a variety of tumors.

Inflammatory response plays a vital role in the pathological mechanism of intracerebral hemorrhage. It has been recently reported that neutrophil to lymphocyte ratio (NLR) could represent a novel composite inflammatory marker for predicting the prognosis of intracranial hemorrhage (ICH).

Lymphocyte-to-monocyte ratio (LMR) is an independent predictive factor of clinical outcome of acute ischemic stroke and cancer, but the predictive effect of LMR in spontaneous intracerebral hemorrhage (ICH) is unknown. Thus, the aim of this study was to explore the impact of peripheral LMR on the neurological deterioration (ND) during the initial week after spontaneous ICH onset, as well as 90-day mortality. MATERIAL AND METHODS The clinical data of 558 consecutive patients with ICH were retrospectively analyzed. LMR is calculated by absolute lymphocyte count divided by absolute monocyte count. RESULTS Of these patients, 166 patients experienced ND during the first week after admission and 72 patients died within 90 days. Multivariate analysis indicated that white blood cells (WBC), absolute neutrophil count (ANC), absolute lymphocyte count (ALC), neutrophil-to-lymphocyte ratio (NLR), LMR were significantly associated with ND during the initial week after ICH onset and also were associated with 90-day mortality. Moreover, NLR and LMR showed a higher predictive ability in ND during the initial week after ICH onset than 90-day mortality in receiver operating characteristic analysis. The best cut-off points of NLR and LMR in predicting ND and 90-day mortality were 10.24 and 2.21 and 16.81 and 2.19, respectively. CONCLUSIONS Our results suggest that LMR on admission is a predictive factor for ND during the initial week after ICH onset, as well as 90-day mortality ²⁾.

In a study Zhang et al. evaluate the prognostic role of neutrophil to lymphocyte ratio (NLR) in patients with glioma. PubMed, EMBASE, Cochrane Library and China National Knowledge Infrastructure were searched for relevant literature. The study and patient characteristics were extracted. Hazard ratios (HRs) with 95% confidence intervals (CIs) were pooled to estimate the prognostic role of NLR in patients with glioma. Subgroup analysis and sensitivity analysis were also performed. Six studies with 1,021 patients were included. The pooled HR of elevated NLR for OS in patients with glioma was 1.48 (95% CI, 1.25-1.76). Among the included studies, five studies used 4 as the cut-off value of NLR. The pooled HR for OS of the five studies was 1.67 (95% CI, 1.37-2.03). No significant heterogeneity was observed (I2 = 42.4%, P=0. 122). Publication bias was not present. Elevated NLR was associated with poorer overall survival in patients with glioma ³⁾.