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European Archives of... Jan 2022Many studies have investigated the prognostic value of tumor-infiltrating lymphocytes (TILs) and tumor-infiltrating macrophages (TIMs) in patients with nasopharyngeal... (Meta-Analysis)
Meta-Analysis Review
PURPOSE
Many studies have investigated the prognostic value of tumor-infiltrating lymphocytes (TILs) and tumor-infiltrating macrophages (TIMs) in patients with nasopharyngeal carcinoma (NPC), but the results remain controversial. Here, we performed a meta-analysis to evaluate the prognostic significance of TILs/TIMs in patients with NPC METHODS: The study was registered with PROSPERO (CRD42021234078). PubMed, Embase, and Web of Science databases were searched up to Dec 30, 2020. We reviewed studies that evaluated the relationship between TILs/TIMs and overall survival (OS), disease-free survival (DFS), or progression-free survival (PFS) in NPC. For TILs, CD3, CD4, CD8, and FOXP3 were searched as T-cell markers, CD19 and CD20 as B-cell markers, and CD56 as a natural killer cell marker. For TIMs, CD68 and CD163 were searched as total and M2 macrophage markers, respectively.
RESULTS
In total, 19 studies with 3708 NPC were included in this meta-analysis. We found that high total numbers of TILs were significantly associated with favorable OS [hazard ratio (HR) 0.46, 95% confidence interval (CI) 0.38-0.57 and PFS (HR 0.48, 95% CI 0.38-0.62)]. In contrast, tumor infiltration by CD3+ T cells (HR 0.55, 95% CI 0.39-0.76), CD4+ T cells (HR 0.40, 95% CI 0.18-0.85), and CD8+ T cells (HR 0.56, 95% CI 0.34-0.93) correlated positively with OS. No significant relationship was found between survival and tumor infiltration by FOXP3+ T cells, CD68+ macrophages, or CD163+ macrophages.
CONCLUSION
Our findings revealed that tumor infiltration by CD3+ , CD4+ , and CD8+ T cells could be prognostic biomarkers in NPC.
Topics: Humans; Lymphocytes, Tumor-Infiltrating; Macrophages; Nasopharyngeal Carcinoma; Nasopharyngeal Neoplasms; Prognosis
PubMed: 34027599
DOI: 10.1007/s00405-021-06879-2 -
The Journal of Arthroplasty Mar 2024The neutrophil-to-lymphocyte ratio (NLR) has shown promising results as a diagnostic tool for periprosthetic joint infection (PJI) after total joint arthroplasty. We... (Meta-Analysis)
Meta-Analysis
BACKGROUND
The neutrophil-to-lymphocyte ratio (NLR) has shown promising results as a diagnostic tool for periprosthetic joint infection (PJI) after total joint arthroplasty. We conducted a systematic review and meta-analysis to determine the utility of NLR in the diagnosis of PJI.
METHODS
We searched PubMed, Scopus, and Web of Science from inception up to 2022 and evaluated the quality of the included literature.
RESULTS
Based on the 12 eligible studies, NLR levels were significantly higher in patients who had PJI compared to those who had aseptic loosening (standard mean difference (SMD) = 1.05, 95% Confidence Interval (CI) = 0.71 to 1.40, P < .001). In the subgroup analysis according to type of PJI, NLR levels were significantly higher in patients who had either acute (SMD = 1.04, 95% CI = 0.05 to 2.03, P < .001) or chronic PJI (SMD = 1.08, 95% CI = 0.55 to 1.61, P < .001), compared to those who had aseptic loosening. According to type of arthroplasty, NLR levels were significantly higher in patients who had either total knee arthroplasty (SMD = 1.81, 95% CI = 1.48 to 2.13, P < .001) or total hip arthroplasty (SMD = 1.76, 95% CI = 1.54 to 1.98, P < .001) compared to aseptic loosening. The pooled sensitivity of the 12 studies was 0.73 (95% CI, 0.65 to 0.79), and the pooled specificity was 0.75 (95% CI, 0.71 to 0.78). The pooled positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio of NLR were 2.94 (95% CI = 2.44 to 3.54), 0.35 (95% CI = 0.27 to 0.46), and 8.26 (95% CI = 5.42 to 12.58), respectively.
CONCLUSION
In summary, this meta-analysis indicates that NLR is a reliable marker in the diagnosis of PJI.
Topics: Humans; Prosthesis-Related Infections; Neutrophils; Arthroplasty, Replacement, Knee; Arthroplasty, Replacement, Hip; Arthritis, Infectious; Biomarkers; Sensitivity and Specificity
PubMed: 37633509
DOI: 10.1016/j.arth.2023.08.067 -
Frontiers in Immunology 2023The use of immune checkpoint inhibitors (ICIs) in cancer treatment has led to an increase in immune-related adverse events (irAEs), which can cause treatment... (Meta-Analysis)
Meta-Analysis
Neutrophil to Lymphocyte ratio as a predictor for immune-related adverse events in cancer patients treated with immune checkpoint inhibitors: a systematic review and meta-analysis.
BACKGROUND
The use of immune checkpoint inhibitors (ICIs) in cancer treatment has led to an increase in immune-related adverse events (irAEs), which can cause treatment discontinuation and even fatal reactions. The purpose of this study was to evaluate the usefulness of the peripheral biomarker neutrophil to lymphocyte ratio (NLR) in predicting irAEs.
METHODS
A systematic search of databases was conducted to identify studies on the predictive value of NLR for irAEs. The standardized mean difference (SMD) was used to compare continuous NLR, while crude odds ratios (ORs) were calculated for categorized NLR if adjusted ORs and 95% confidence intervals (CIs) were not provided in the original study.
RESULTS
The meta-analysis included 47 studies with a total of 11,491 cancer patients treated with ICIs. The baseline continuous NLR was significantly lower in patients with irAEs compared to those without (SMD=-1.55, 95%CI=-2.64 to -0.46, P=0.006). Similarly, categorized NLR showed that lower baseline NLR was associated with increased irAEs (OR=0.55, 95%CI=0.41-0.73, P<0.001). Subgroup analysis revealed that the OR for predicting irAEs with NLR cut-off values of 3 and 5 was 0.4 and 0.59, respectively. Interestingly, increased baseline NLR was associated with a higher incidence of immune-related liver injury (OR=2.44, 95%CI=1.23-4.84, I2 = 0%, P=0.010).
CONCLUSION
Our study suggests that lower baseline NLR is associated with a higher risk of overall irAEs. However, further studies are needed to determine the best cut-off value and explore the efficacy of NLR in predicting specific types of irAEs.
Topics: Humans; Databases, Factual; Immune Checkpoint Inhibitors; Lymphocytes; Neoplasms; Neutrophils; Odds Ratio
PubMed: 37622124
DOI: 10.3389/fimmu.2023.1234142 -
Journal of Cardiothoracic and Vascular... May 2022Neutrophil-lymphocyte ratio (NLR) is an inflammatory biomarker that has been evaluated across a variety of surgical disciplines and is widely predictive of poor... (Meta-Analysis)
Meta-Analysis
OBJECTIVES
Neutrophil-lymphocyte ratio (NLR) is an inflammatory biomarker that has been evaluated across a variety of surgical disciplines and is widely predictive of poor postoperative outcome, but its value in cardiac surgery is unclear. The authors did this systematic review and meta-analysis to determine the impact of elevated perioperative NLR on survival after cardiac surgery.
DESIGN
Systematic review and meta-analysis of study-level data.
SETTING
Multiple hospitals involved in an international pool of studies.
PARTICIPANTS
Adults undergoing cardiac surgery.
INTERVENTIONS
None.
MEASUREMENTS AND MAIN RESULTS
The authors searched multiple databases from inception until November 2020. They generated summary hazard ratios (HR) and odds ratios (OR) for the association of elevated preoperative NLR with long-term and short-term mortality following cardiac surgery. They separately reported on elevated postoperative NLR. Between-study heterogeneity was explored using metaregression. The authors included 12 studies involving 13,262 patients undergoing cardiac surgery. Elevated preoperative NLR was associated with worse long-term (>30 days) (hazard ratio [HR] 1.56; 95% CI [confidence interval], 1.18-2.06; 8 studies) and short-term (<30 days) mortality (OR 3.18; 95% CI, 1.90-5.30; 7 studies). One study reported the association of elevated postoperative NLR with long-term mortality (HR 8.58; 95% CI, 2.55-28.85). There was considerable between-study heterogeneity for the analysis of long-term mortality (I statistic 94.39%), which mostly was explained by study-level variables, such as the number of variables adjusted for by included studies and how many of these significantly increased the risk of long-term mortality, high risk of bias, and number of study centers, as well as participant level factors, such as average participant age and hypertension prevalence.
CONCLUSIONS
Perioperative NLR is an independent predictor of short-term and long-term postoperative mortality following cardiac surgery. Further research is required to determine which patient-level factors modify the prognostic value of NLR and to evaluate its role in routine clinical practice.
Topics: Adult; Biomarkers; Cardiac Surgical Procedures; Humans; Lymphocytes; Neutrophils; Prognosis
PubMed: 34404595
DOI: 10.1053/j.jvca.2021.07.001 -
Journal of Gastrointestinal Cancer Sep 2018A meta-analysis was performed to evaluate the prognostic value of neutrophil-lymphocyte ratio (NLR) in patients undergoing potentially curative gastrectomy for cancer... (Meta-Analysis)
Meta-Analysis Review
PURPOSE
A meta-analysis was performed to evaluate the prognostic value of neutrophil-lymphocyte ratio (NLR) in patients undergoing potentially curative gastrectomy for cancer (GC).
METHODS
Thomson Reuters Web of Science, Ovid MEDLINE(R) and PUBMED databases were searched for relevant articles using search terms neutrophil-lymphocyte ratio (NLR), GC and survival. Articles reporting overall survival (OS), cancer-specific survival and disease-free survival (DFS), in patients undergoing R0 gastrectomy, were studied.
RESULTS
Articles numbering 365 were identified during the preliminary search, and 10 containing 4164 patients were included in the final review. Most patients were > 60 years of age, male (67%) and 2239 (53.8%) had pT3 disease. The number of NLR dichotomization thresholds reported numbered 7, with 2.00 and 3.00 (n = 2) the most common. NLR was associated with poor survival in eight studies with hazard ratios ranging from 1.54 (95% confidence interval (CI) 1.26-1.89) to 2.99 (1.99-4.49). Pooled odds ratio (OR) for OS was 2.31 (1.40-3.83, p = 0.001) and for DFS 2.72 (1.14-6.54, p = 0.020). Four studies presented T-stage data, OR 1.62 (1.33-1.96, p < 0.001).
CONCLUSION
NLR is an important prognostic indicator associated with both OS and DFS after R0 resection of GC, but the critical level is equivocal.
Topics: Aged; Female; Gastrectomy; Humans; Leukocyte Count; Lymphocytes; Male; Middle Aged; Neutrophils; Postoperative Period; Prognosis; Stomach Neoplasms; Survival Analysis
PubMed: 29949048
DOI: 10.1007/s12029-018-0127-y -
International Journal of Molecular... Nov 2022Autism spectrum disorder (ASD) is a neurodevelopmental condition with a so far unknown etiology. Increasing evidence suggests that a state of systemic low-grade... (Meta-Analysis)
Meta-Analysis Review
Activation of the Monocyte/Macrophage System and Abnormal Blood Levels of Lymphocyte Subpopulations in Individuals with Autism Spectrum Disorder: A Systematic Review and Meta-Analysis.
Autism spectrum disorder (ASD) is a neurodevelopmental condition with a so far unknown etiology. Increasing evidence suggests that a state of systemic low-grade inflammation may be involved in the pathophysiology of this condition. However, studies investigating peripheral blood levels of immune cells, and/or of immune cell activation markers such as neopterin are lacking and have provided mixed findings. We performed a systematic review and meta-analysis of studies comparing total and differential white blood cell (WBC) counts, blood levels of lymphocyte subpopulations and of neopterin between individuals with ASD and typically developing (TD) controls (PROSPERO registration number: CRD CRD42019146472). Online searches covered publications from 1 January 1994 until 1 March 2022. Out of 1170 publication records identified, 25 studies were finally included. Random-effects meta-analyses were carried out, and sensitivity analyses were performed to control for potential moderators. Results: Individuals with ASD showed a significantly higher WBC count (k = 10, g = 0.29, p = 0.001, I2 = 34%), significantly higher levels of neutrophils (k = 6, g = 0.29, p = 0.005, I2 = 31%), monocytes (k = 11, g = 0.35, p < 0.001, I2 = 54%), NK cells (k = 7, g = 0.36, p = 0.037, I2 = 67%), Tc cells (k = 4, g = 0.73, p = 0.021, I2 = 82%), and a significantly lower Th/Tc cells ratio (k = 3, g = −0.42, p = 0.008, I2 = 0%), compared to TD controls. Subjects with ASD were also characterized by a significantly higher neutrophil-to-lymphocyte ratio (NLR) (k = 4, g = 0.69, p = 0.040, I2 = 90%), and significantly higher neopterin levels (k = 3, g = 1.16, p = 0.001, I2 = 97%) compared to TD controls. No significant differences were found with respect to the levels of lymphocytes, B cells, Th cells, Treg cells, and Th17 cells. Sensitivity analysis suggested that the findings for monocyte and neutrophil levels were robust, and independent of other factors, such as medication status, diagnostic criteria applied, and/or the difference in age or sex between subjects with ASD and TD controls. Taken together, our findings suggest the existence of a chronically (and systemically) activated inflammatory response system in, at least, a subgroup of individuals with ASD. This might have not only diagnostic, but also, therapeutic implications. However, larger longitudinal studies including more homogeneous samples and laboratory assessment methods and recording potential confounding factors such as body mass index, or the presence of comorbid psychiatric and/or medical conditions are urgently needed to confirm the findings.
Topics: Humans; Monocytes; Autism Spectrum Disorder; Neopterin; Leukocytes; Lymphocyte Subsets; Th17 Cells; Macrophages
PubMed: 36430805
DOI: 10.3390/ijms232214329 -
PANoptosis is a compound death in periodontitis: A systematic review of ex vivo and in vivo studies.Oral Diseases May 2024The purpose of the systematic review is to verify the presence of PANoptosis in periodontitis based on the published literatures studying cell death in periodontitis. (Review)
Review
OBJECTIVE
The purpose of the systematic review is to verify the presence of PANoptosis in periodontitis based on the published literatures studying cell death in periodontitis.
MATERIALS AND METHODS
We conducted a comprehensive review of literature studying the types of cell death in vitro cellular experiments, in vivo rodent studies and clinical studies from three major databases: PubMed, Scopus, and Web of Science. The present systematic review was recorded in the PROSPERO database, under registration number CRD42022383456.
RESULTS
In total, 51 articles were included in this study. Our analysis of in vitro cell models revealed that pyroptosis, necroptosis, and apoptosis could be induced by periodontal pathogens in macrophages, fibroblasts, stem cells, and periodontal ligament cells. Furthermore, three types of cell death were detected in in vivo rodent periodontitis models. Clinical studies on human periodontitis tissue specimens and gingival crevicular fluid (GCF) showed that some key proteins related to pyroptosis, necroptosis, and apoptosis were elevated in periodontitis.
CONCLUSIONS
Various studies have established similar in vivo and in vitro models with three modes of death detected under the same conditions, revealing complex interactions between different types of cell death pathways in periodontitis and the potential for PANoptosis to occur in periodontitis.
Topics: Humans; Periodontitis; Pyroptosis; Animals; Necroptosis; Apoptosis; Fibroblasts; Macrophages; Periodontal Ligament; Cell Death
PubMed: 37650218
DOI: 10.1111/odi.14726 -
Acta Ophthalmologica May 2022The neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) are emerging haematological inflammatory biomarkers. However, their significance in retinal... (Meta-Analysis)
Meta-Analysis
The neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) are emerging haematological inflammatory biomarkers. However, their significance in retinal vein occlusion (RVO) and its subtypes, branch and central RVO (BRVO and CRVO, respectively), is uncertain. This systematic review and meta-analysis aimed to clarify the association of NLR and PLR with RVO. We searched MEDLINE (Ovid), EMBASE (Ovid) and the Cochrane Library for studies investigating the association of NLR and PLR with RVO from inception to 2 December 2020. We used random-effects inverse-variance modelling to generate pooled effect measures. We used bivariate Bayesian modelling to meta-analyse the ability of NLR and PLR to differ between individuals with and without RVO and performed meta-regression and sensitivity analyses to explore inter-study heterogeneity. Eight studies published encompassing 1059 patients were included for analysis. Both NLR and PLR were significantly elevated in RVO, with pooled mean differences of 0.63 (95% confidence interval (CI) 0.31-0.95) and 21.49 (95% CI 10.03-32.95), respectively. The pooled sensitivity, specificity and area under the Bayesian summary receiver operating characteristic curve were, respectively, 0.629 (95% credible interval (CrI) 0.284-0.872), 0.731 (95% CrI 0.373-0.934) and 0.688 (95% CrI 0.358-0.872) for NLR; and 0.645 (95% CrI 0.456-0.779), 0.616 (95% CrI 0.428-0.761) and 0.621 (95% CrI 0.452-0.741) for PLR. Mean and variability of age and diabetes mellitus prevalence partially explained between-study heterogeneity. NLR and PLR are significantly elevated in RVO. Future research is needed to investigate the potential prognostic value and independence of these findings.
Topics: Bayes Theorem; Blood Platelets; Humans; Lymphocytes; Neutrophils; Prognosis; Retinal Vein Occlusion; Retrospective Studies
PubMed: 34219390
DOI: 10.1111/aos.14955 -
Disease Markers 2022Ischemic and hemorrhagic strokes have multiple downstream consequences for patients. One of the most critical is poststroke infection (PSI). The goal of this systematic... (Meta-Analysis)
Meta-Analysis Review
Ischemic and hemorrhagic strokes have multiple downstream consequences for patients. One of the most critical is poststroke infection (PSI). The goal of this systematic review and meta-analysis was to critically evaluate the literature regarding the use of the neutrophil to lymphocyte ratio (NLR) as a reliable means to detect early PSI development, particularly poststroke pneumonia (PSP) development to help clinicians institute early interventions and improve outcomes. The following were the inclusion criteria: (1) cross-sectional, case-control, and cohort studies; (2) studies comparing NLR data from PSI or PSP patients to controls; and (3) studies with a control group of stroke patients without infection. There was not any language or publication preference. The Newcastle-Ottawa Scale was used by two writers to assess the quality of the included studies. We assessed the certainty of the associations with GRADE methods. Web of Science, PubMed, and Scopus were searched, and 25 studies were included in the qualitative review. Among them, 15 studies were included in the meta-analysis. Standardized mean difference (SMD) was reported with a 95% confidence interval (CI) for the NLR levels. Patients with PSI had significantly higher NLR levels than stroke patients without infection (SMD = 1.08; CI 95% = 0.78-1.39, value < 0.001). In addition, the NLR levels of the stroke patients with pneumonia were significantly higher than those without pneumonia (SMD = 0.98; CI 95% = 0.81-1.14, value < 0.001). However, data extracted from the qualitative review suggested that NLR could not predict urinary tract infection, sepsis, or ventriculitis in stroke patients. Our study indicated that NLR could be recommended as an inexpensive biomarker for predicting infection, particularly pneumonia, in stroke patients. It can help clinicians institute early interventions that can reduce PSI and improve outcomes.
Topics: Case-Control Studies; Cross-Sectional Studies; Humans; Lymphocytes; Neutrophils; Stroke
PubMed: 35313569
DOI: 10.1155/2022/1983455 -
Journal of Cancer Research and... 2016There is a growing body of evidence showing the functional relationship between inflammation index like netrophil.lymphocyte ratio. (NLR) and colorectal cancer. (CRC) in... (Meta-Analysis)
Meta-Analysis Review
INTRODUCTION
There is a growing body of evidence showing the functional relationship between inflammation index like netrophil.lymphocyte ratio. (NLR) and colorectal cancer. (CRC) in both experimental and clinical situations. The serum carcinoembryonic antigen. (CEA) level is the most widely used marker and associate with poor prognosis in most studies. For these factors to be clinically useful, they should be routinely available, well standardized, and validated in different patient cohorts.
AIMS
There is a growing body of evidence showing the functional relationship between inflammation index like netrophil-lymphocyte ratio. (NLR) and colorectal cancer. (CRC) in both experimental and clinical situations. The serum carcinoembryonic antigen. (CEA) level is the most widely used marker and associate with poor prognosis in most studies. For these factors to be clinically useful, they should be routinely available, well standardized, and validated in different patient cohorts.
MATERIALS AND METHODS
We systemically searched PubMed, Embase, and SciVerse Scopus databases, and performed a meta.analysis by Review Manager 5.2 software. (The Cochrane Collaboration, Software Update, Oxford). Two reviewers selected studies, assessed risk of bias, and extracted data independently. Newcastle.Ottawa Scale was applied to assess the quality of included studies.
RESULTS
Fifteen studies involving 7741 patients with CRC were analyzed. Patients with an NLR < 5 before treatment were significantly more likely to have 5-year overall survival (odds ratio [OR] = 2.03; 95% confidence interval [CI] = 1.56-2.63) and 5-year disease-free survival (OR = 1.67; 95% CI = 1.19-2.35). Pretreatment CEA level < 5 were significantly associated with complete tumor response and tumor downstaging after neoadjuvant treatment. The result also showed that patients with NLR > 5 were expected to have a larger tumor, poorer tumor differentiation, and higher CEA level.
CONCLUSION
NLR and CEA are valuable tools for the prediction of prognosis in CRC and adjusting the treatment strategy.
Topics: Carcinoembryonic Antigen; Colorectal Neoplasms; Humans; Lymphocytes; Neutrophils; Prognosis
PubMed: 27461614
DOI: 10.4103/0973-1482.144356