• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.42 no.5
• /
• pp.243-250
• /
• 2016

Objectives: Many studies have examined histopathological factors and various prognostic scores related to inflammation to predict outcomes. Here, we examined the prognostic value of the C-reactive protein/albumin (CRP/alb) ratio in oral squamous cell carcinoma (OSCC). Materials and Methods: This retrospective study included 40 patients with OSCC. Using univariate and multivariate analyses, we focused on the correlation of the CRP/alb ratio with clinicopathological characteristics and with overall survival. We then compared five inflammation-based prognostic scores, CRP/alb ratio, modified Glasgow Prognostic Score (mGPS), neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and prognostic nutritional index (PNI), based on receiver operating characteristic (ROC) curves. Results: The optimal cut-off value for the CRP/alb ratio was 0.085. The group with a high CRP/alb ratio had a high TNM clinical stage (P=0.002) and larger primary tumors (P=0.029), with statistically significant differences in lymph node metastasis and distant metastasis. In addition, when the CRP/alb ratio was high, multivariate analysis showed a lower survival rate (P=0.002; hazard ratio=6.078), and the ROC curve showed more outstanding discriminatory ability regarding overall survival compared to other inflammation-based prognostic scores. Conclusion: The CRP/alb ratio can be an independent prognostic factor when predicting prognosis in OSCC and has good prognostic ability.

• Journal of Audiology & Otology
• /
• v.25 no.1
• /
• pp.27-35
• /
• 2021

Background and Objectives: This study aimed to evaluate the clinical features and the clinical factors associated with prognosis of sudden sensorineural hearing loss (SSNHL) in diabetic patients. Subjects and Methods: Forty-nine diabetic with unilateral SSNHL were retrospectively included. All patients received systemic high dose steroid therapy within one month after onset and had more than one month of follow-up audiogram. The basic characteristics of the patients, initial and follow-up audiograms, laboratory data, and methods of steroid treatment were collected. Results: Compared to reference values in healthy subjects, 79%, 55%, and 45% of the patients had higher values of mean neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and lymphocyte-monocyte ratio (LMR), respectively. Older patients had significantly less degree of hearing loss, but they also had significantly worse hearing thresholds in the unaffected ear. After steroid treatment, less than half patients (47%) showed hearing recovery. Simultaneous intratympanic dexamethasone (ITD) injections with systemic steroid did not confer an additional hearing gain or an earlier recovery rate in diabetic patients with SSNHL. In the multivariate analysis, initial hearing thresholds of affected ear and timing of steroid treatment were significantly associated with hearing prognosis in diabetic patients with SSNHL. Conclusions: Diabetic patients with SSNHL tended to have increased NLR, LMR, and PLR, which are reported to be associated with microvascular angiopathy. Simultaneous ITD injections to improve hearing recovery in diabetic patients with SSNHL seems unnecessary.

• Korean Journal of Audiology
• /
• v.25 no.1
• /
• pp.27-35
• /
• 2021

Background and Objectives: This study aimed to evaluate the clinical features and the clinical factors associated with prognosis of sudden sensorineural hearing loss (SSNHL) in diabetic patients. Subjects and Methods: Forty-nine diabetic with unilateral SSNHL were retrospectively included. All patients received systemic high dose steroid therapy within one month after onset and had more than one month of follow-up audiogram. The basic characteristics of the patients, initial and follow-up audiograms, laboratory data, and methods of steroid treatment were collected. Results: Compared to reference values in healthy subjects, 79%, 55%, and 45% of the patients had higher values of mean neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and lymphocyte-monocyte ratio (LMR), respectively. Older patients had significantly less degree of hearing loss, but they also had significantly worse hearing thresholds in the unaffected ear. After steroid treatment, less than half patients (47%) showed hearing recovery. Simultaneous intratympanic dexamethasone (ITD) injections with systemic steroid did not confer an additional hearing gain or an earlier recovery rate in diabetic patients with SSNHL. In the multivariate analysis, initial hearing thresholds of affected ear and timing of steroid treatment were significantly associated with hearing prognosis in diabetic patients with SSNHL. Conclusions: Diabetic patients with SSNHL tended to have increased NLR, LMR, and PLR, which are reported to be associated with microvascular angiopathy. Simultaneous ITD injections to improve hearing recovery in diabetic patients with SSNHL seems unnecessary.

• Asian Pacific Journal of Cancer Prevention
• /
• v.14 no.3
• /
• pp.2101-2105
• /
• 2013

Background: Long-term survival is a problem with locally advanced and metastatic renal cell carcinomas. Sunitinib malate is an oral multitargeted tyrosine kinase inhibitor, but data on sunitinib use as a second line treatment in metastatic renal cell carcinoma (mRCC) are limited. Prognostic and predictive value of peripheral blood markers has been shown for many cancers. Materials and Methods: Efficacy and safety profiles of sunitinib after interferon alpha (IFN-${\alpha}$) were evaluated based on retrospective data for 23 patients with mRCC. Hematological parameters (neutrophils, lymphocytes, platelets, mean platelet volume, neutrophil/lymphocyte ratio, platelet/lymphocyte ratio) were recorded at the time of metastasis. It was evaluated whether hematological parameters were prognostic and predictive factors. Results: Median progression-free survival (PFS) time was 16.5 months (95%CI: 0-34.5). Median overall survival (OS) time was 25.7 months (95%CI: 10.8-40.0). Most common side effects were neutropenia (52.2%), stomatitis (26.1%) and hand-food syndrome (26.1%). PFS was found 3.13 vs 17.1 months in patients with neutrophil / lymphocyte ratio (NLR)>3 vs $NLR{\leq}3$ (p:0.012). Median OS was 6.96 vs 27.1 months in patients with NLR>3 vs $NLR{\leq}3$ (p:0.001).While 75% of patients who responded to sunitinib had $NLR{\leq}3$, in 72% of patients with no response to sunitinib NLR>3 was detected (p:0.036). The association between the Memorial Sloan-Kettering Cancer Center (MSKCC) criteria and NLR was statistically significant (p:0.022). Conclusions: Data on second line sunitinib treatment following cytokine in mRCC are limited. In our study, we observed second line sunitinib treatment following IFN-${\alpha}$ to be effective and tolerable. NLRappeared to have prognostic and predictive value.

• Biomedical Science Letters
• /
• v.28 no.2
• /
• pp.120-126
• /
• 2022

Natural products are important sources for drug development because they have a wide variety of useful biological properties. Angelica gigas Nakai (AGN) has been used as an herbal medicine. The present study was designed to evaluate the immune-enhancing effect of AGN in the cyclophosphamide (CP) induced immune-suppressed mice. As the result, we found that CP induced the reductions of body ratio, spleen weights, hematopoietic parameter and cytokine productions in mice. However, AGN recovered immunosuppression-mediated decreased body ratio, spleen and thymus weights as well as regulation of hematopoietic parameter including white blood cell, lymphocyte, and neutrophil. According to histological study, AGN regenerated on CP-mediated injured spleen. Moreover, AGN increased the CP-induced reduction of cytokine expression in spleen tissue. Collectively, the findings provide experimental evidence that AGN may be a candidate for health-improving herbs.

• Journal of Acupuncture Research
• /
• v.18 no.1
• /
• pp.157-169
• /
• 2001

Objective : The purpose of this study is to investigate the effects on WBC counts and each differential of neutrophils, lymphocytes, monocytes in whole blood sample of each experimental Aqua-acupuncture treated mice groups PCortex Ulmi Pumilae(CU), Ramulus Cinnamomum(RC), Radix Achyranthes(RA), Apitoxin(BV), Calculus Bovis Fel Ursi Moschus compound(BUM). Materials & Method : All the BALB/c mice used in this study were bred and maintained in our pathogen-free mouse facility and were 6 weeks of age at the start of the experiment. The experimental model of arthritis was induced by injecting 300${\mu}g$/kg LPS to all mice knee joint. The each of Aqua-acupuncture(Cortex Ulmi Pumilae, Ramulus Cinnamomum, Radix Achyranthes, Apitoxin, Calculus Bovis Fel Ursi Moschus compound) was injected into GB34(陽陵泉) of mice groups every other day for 6 times. And the WBC counts and each differential of neutrophils, lymphocytes, monocytes were measured at the 3rd, 7th and 14th day after LPS injection. Results : 1. The WBC counts were significantly decreased compared with the control(CON) group in every Aqua-acupuncture groups at all days. And at the 14th day, BV & BUM groups were more significantly decreased than RA group. 2. The Neutrophil's ratio was significantty increased compared with the CON group in CU & RC groups at the 3rd day and RC group was more significant than CU group. But at the 7th and 14th day, every Aqua-acupuncture groups were significantly increased compared with the CON group and at the 7th day, RC group was more significant than RA, BV & BUM groups and at the 14th day, RC, BV & BUM groups were more significant than RA group. 3. The Lymphocyte's ratio was significantly decreased compared with the CON group in RC group at the 3rd day. At the 7th day, CU, RC & BV groups were significantly decreased compared with the CON group. At the 14th day, every Aqua-acupuncture groups were significantly decreased compared with the CON group and RC group was more significant than RA group, 4. The Monocyte's ratio was significantly decreased compared with the CON group in every Aqua-acupuncture groups at the 7th day. At the 14th day, BV & BUM groups were significantly decreased compared with the CON group. Conclusion : According to the above results, it was concluded that CU & RC groups were more effective at the early period of this experiment, and at the latter period, BV & BUM groups were more effective than others. RA group was less effctive than others.

• The Journal of Korean Society for Radiation Therapy
• /
• v.13 no.1
• /
• pp.91-103
• /
• 2001

In those patients who underwent radiation therapy with 10 MV X-ray for bone marrow transfer, compared the effect of high dose irradiation on peripheral blood were investigated in randomly selecting 18 patients. thus, changes in the levels of peripheral blood (WBC, Seg. neutrophil, Lymphocyte, RBC, Hemoglobin, Hematocrit ratio, GOT, GPT) were observed for 25 days after irradiation with the peripheral blood levels before irradiation in these patients and in 32 controls. Among changes in peripheral blood, the level of WBC was $8.63\%$ after radiation therapy with as much decrease as $0.22{\times}103{\pm}0.19{\times}103/mm^3$ compared with $2.51{\times}103{\pm}1.29{\times}103/mm^3$ before radiation therapy, and was only $6.35\%$ of $7.17{\times}103/mm^3{\pm}1.46{\times}103/mm^3$ in the controls, showing statistical significance (P<0.01, r2=0.9151). In the morphologic test of WBC, the level of Seg. neutrophil was decreased as much as to $20.53\%$ with $14.17{\pm}21.60\%$ compared with $69.00{\pm}25.60\%$ before irradiation, and decreased down to $24.39\%$ compared with $58.09{\pm}7.62\%$ in the controls (P<0.05, r2=0.6316). The number of lymphocyte increased as much as 3.94 folds at $79.91{\pm}27.30\%$ compared with $20.29{\pm}21.15\%$ before irradiation and was 2.39 times higher than $33.46{\pm}6.79\%$ in the controls (P<0.05, r2=0.7337). Although the change in the number of RBC was little with $3.18{\times}106{\pm}0.41{\times}106/mm^3$ before irradiation and $4.66{\times}106{\pm}0.43{\times}106/mm^3$ in the controls, no statistical significance was present (P>0.05). In addition, The number of hemoglobin was low compared with before irradiation and with the controls, but none showed statistical significance (P>0.05). Similarly, although the hematocrit ratio was low compared with before irradiation and with the controls, no statistical significance was present (P>0.05). In the values of the histologic examinations GOT and GPT, there is statistical significance between those from with before irradiation and with the controls (P<0.05). Thus, among peripheral blood, the number of WBC decreased drastically for a certain period after total body irradiation with high dose radiation, and the levels of Seg. neutriphil and lymphocyte decreased significantly after irradiation in the lymphocyte morphologic test. The results of the present study suggest that the possibility of developing the first to determine initially those patients who might develop radiation acute impairment using the usual peripheral blood test of patients to be exposed to high dose irradiation.

• Tuberculosis and Respiratory Diseases
• /
• v.63 no.1
• /
• pp.17-23
• /
• 2007

Background: Many diagnostic approaches for defining the definitive cause of pleurisy should be included due to the large variety of diseases resulting in pleural effusion. Although ADA is a useful diagnostic tool for making a differential diagnosis of pleural effusion, particularly for tuberculous pleural effusion, a definitive diagnostic cut-off value remains problematic in Korea. It was hypothesized that ADA multiplied by the Lymphocyte/Neutrophil ratio(L/N ratio) might be more powerful for making a differential diagnosis of pleural effusion. Methods: One hundred and ninety patients, who underwent thoracentesis and treatment in Chung-Ang University Hospital from January, 2005 through to February 2006, were evaluated. The clinical characteristics, radiologic data and the examination of the pleural effusion were analyzed retrospectively. Results: 1. Among the 190 patients, 59 patients (31.1%) were diagnosed with tuberculous pleurisy, 45 patients(23.7%) with parapneumonic effusion, 42 patients(22.1%) with malignant effusions, 36 patients(18.9%) with transudate, and 8 patients(4.2%) with empyema. One hundred and twenty one patients were found to have an ADA activity of 1 to 39 IU/L(63.7%). Twenty-nine were found to have an ADA activity of 40 to 75 IU/L(15.3%) and 40 were found to have an ADA activity of 75 IU/L or greater(21.0%). 2. Among the patients with tuberculous pleurisy, 5(8%), 18(30%) and 36 patients(60%) had an ADA activity ranging from 1 to 39 IU/L, 40 to 75 IU/L, and 75 IU/L or greater, respectively. In those with an ADA activitiy 40 to 75 IU/L, 18 patients(62%) had tuberculous pleurisy, 9(31%) had parapneumonic effusion and empyema, and 1(3.4%) had a malignant effusion. 3. In those with an ADA activity of 40 to 75 IU/L, there was no significant difference between tuberculous pleurisy and non-tuberculous pleural effusion(tuberculous pleurisy : 61.3 ${\pm}$ 9.2 IU/L, non-tuberculous pleural effusion : 53.3${\pm}$10.5 IU/L). 4. The mean L/N ratio of those with tuberculous pleurisy was 39.1 ${\pm}$ 44.6, which was significantly higher than nontuberculous pleural effusion patients (p<0.05). The mean ADA x L/N ratio of the tuberculous pleurisy patients was 2,445.7 ${\pm}$ 2,818.5, which was significantly higher than the non-tuberculous pleural effusion patients (level p<0.05). 5. ROC analysis showed that the ADA x L/N ratio had a higher diagnostic value than the ADA alone in the group with an ADA between 40-75 IU/L. Conclusion: The ADA multiplied by the lymphocyte-to-neutrophil ratio might provide a more definitive diagnosis of tuberculous pleurisy.

• Asian Pacific Journal of Cancer Prevention
• /
• v.15 no.2
• /
• pp.945-950
• /
• 2014

Purpose: To explore the value of systemic inflammatory markers as independent prognostic factors and the extent these markers improve prognostic classification for patients with inoperable advanced or metastatic gastric cancer (GC) receiving palliative chemotherapy. Methods: We studied the prognostic value of systemic inflammatory factors such as circulating white blood cell count and its components as well as that combined to form inflammation-based prognostic scores (Glasgow Prognostic Score (GPS), Neutrophil-Lymphocyte Ratio (NLR), Platelet Lymphocyte Ratio (PLR), Prognostic Index (PI) and Prognostic Nutritional Index (PNI)) in 384 patients with inoperable advanced or metastatic gastric cancer (GC) receiving first-line chemotherapy. Univariate and multivariate analyses were performed to examine the impact of inflammatory markers on overall survival (OS). Results: Univariate analysis revealed that an elevated white blood cell, neutrophil and/or platelet count, a decreased lymphocyte count, a low serum albumin concentration, and high CRP concentration, as well as elevated NLR/PLR, GPS, PI, PNI were significant predictors of shorter OS. Multivariate analysis demonstrated that only elevated neutrophil count (HR 3.696, p=0.003) and higher GPS (HR 1.621, p=0.01) were independent predictors of poor OS. Conclusion: This study demonstrated elevated pretreatment neutrophil count and high GPS to be independent predictors of shorter OS in inoperable advanced or metastatic GC patients treated with first-line chemotherapy. Upon validation of these data in independent studies, stratification of patients using these markers in future clinical trials is recommended.

• Asian Pacific Journal of Cancer Prevention
• /
• v.14 no.6
• /
• pp.3881-3885
• /
• 2013

Objective: The objective of this study was to identify clinical predictive factors for tumor response after neoadjuvant chemoradiotherapy (nCRT) in locally advanced rectal cancer (LARC). Methods: All factors were evaluated in 88 patients with LARC treated with nCRT. After a long period of 4-8 weeks of chemoradiotherapy, 3 patients achieved clinical complete response (cCR) and thus aggressive surgery was avoided, and the remaining 85 patients underwent a curative-intent operation. The response to nCRT was evaluated by tumor regression grade (TRG) system. Results: There were 32 patients (36.4%) with good tumor regression (TRG 3-4) and 56 (63.6%) with poor tumor regression (TRG 0-2). Lymphocyte counts and ratios were higher in good response cases (P=0.01, 0.03, respectively) while neutrophil ratios and N/L ratios were higher in poor response cases (P=0.04, 0.02, respectively). High lymphocyte ratios before nCRT and good tumor regression (TRG3-4) were significantly associated with improved 5-year disease-free survival (P<0.05). Pretreatment nodal status was also significantly associated with 5-year disease-free survival and 5-year overall survival (P<0.05). Multivariate analysis confirmed that the pretreatment lymphocyte ratio and lymph nodal status were independent prognostic factors. Conclusion: Our study suggested that LARC patients with high lymphocyte ratios before nCRT would have good tumor response and high 5-year DFS and OS.