Search Results (102)

Background: Systemic inflammation is an essential factor in the formation of the tumor microenvironment and has an impact on patient response to immune checkpoint inhibitors. Although there is a growing interest in biomarkers of inflammation, there is a gap in understanding their predictive value for response to nivolumab in clinical practice. The objective of this research was to design and assess a multi-algorithmic machine learning (ML) model based on regular systemic inflammation measurements to forecast the response of treatment to nivolumab. Methods: An analysis of a retrospective real-world cohort of 177 nivolumab-treated patients was performed. Baseline inflammatory biomarkers, such as neutrophils, lymphocytes, platelets, CRP, LDH, albumin, and derived indices (NLR, PLR, SII), were derived. After preprocessing, 5 ML models (Logistic Regression, Random Forest, Gradient Boosting, Support Vector Machine, and Neural Network) were trained and tested on a 70/30 stratified split. Accuracy, AUC, precision, recall, F1-score, and Brier score were used to evaluate predictive performance. The interpretability of the model was analyzed based on feature-importance ranking and SHAP. Results: Gradient Boosting performed best in terms of discriminative (AUC = 0.816), whereas Support Vector Machine performed best on overall predictive profile (accuracy = 0.833; F1 = 0.909; recall = 1.00; and Brier Score = 0.134) performance. CRP and LDH became the most common predictors of all models, and then neutrophils and platelets. SHAP analysis has verified that high CRP and LDH were strong predictors that forced the prediction to non-response, whereas higher lymphocyte levels were weak predictors that increased the response probability prediction. Conclusions: Machine learning models based on common inflammatory systemic markers give useful predictive information about nivolumab response. Their discriminative ability is moderate, but the high performance of SVM and Gradient Boosting pays attention to the opportunities of inflammation-based ML tools in making personalized decisions regarding immunotherapy. A combination of clinical, radiomic, and molecular biomarkers in the future can increase predictive capabilities and clinical use. Full article

Introduction: Rheumatoid arthritis (RA) is associated with increased cardiovascular morbidity and mortality. Left ventricular diastolic dysfunction (LVDD) represents an early sign of cardiac involvement in RA. Objectives: This study aimed to evaluate the incidence of LVDD and the association of the neutrophil-to-lymphocyte ratio (NLR) and circulating FGF21 levels with chosen LVDD echocardiographic parameters, as well as to assess their diagnostic utility for LVDD in a cohort of patients with RA. Patients and Methods: A total of 51 RA patients (46 females, 5 males; average age 48.8 ± 8.2 years; median disease duration of 12 years) were enrolled. NLR and serum FGF21 levels were analysed for association with echocardiographic parameters of LVDD using univariate regression models. The diagnostic performance of these markers was evaluated by receiver operating characteristic (ROC) analysis. Results: LVDD was diagnosed in 10 patients (19.6%). The NLR was associated negatively with E velocity (β = −4.99, p = 0.02), E/A ratio (β = −0.16, p = 0.004), lateral and medial e′ velocities (β = −1.05, p = 0.038 and β = −0.97, p = 0.013, respectively), and positively with left atrial diameter (β = 2.08, p = 0.006). Serum FGF21 levels were negatively associated with the E/A ratio (β = −0.0005, p = 0.009) and lateral e′ velocity (β = −0.003, p = 0.04). ROC analysis demonstrated a greater diagnostic value for NLR (Youden index 0.30, cut-off point 2.26, sensitivity 50%, specificity 80%, and area under curve [AUC] 0.58) compared to FGF21 (Youden index 0.30, cut-off value 852.85 pg/mL, 100% specificity, 30% sensitivity, and AUC 0.48). Conclusions: NLR and FGF21 are associated with the echocardiographic parameters of the left ventricular diastolic dysfunction prior to the fulfilment of LVDD diagnostic criteria. RA patients with elevated NLR and FGF21 serum levels should be considered for LVDD screening. Full article

Background: Anal squamous cell carcinoma (ASCC) is a rare malignancy primarily treated with chemoradiotherapy (CRT). This study evaluated outcomes and the prognostic value of simple hematologic indices in patients receiving modern image-guided CRT. Methods: Fifty-five patients with non-metastatic ASCC treated between 2017 and 2025 were retrospectively analyzed. Survival was estimated by Kaplan–Meier methods, and prognostic factors were assessed by log-rank testing and Cox regression. Baseline neutrophil-to-lymphocyte (NLR) and platelet-to-lymphocyte (PLR) ratios were analyzed individually and in combination with nodal status. Results: At a median follow-up of 53.1 months, overall survival reached 90% at 5 years, whereas disease-free survival declined to 51%. Nodal positivity showed a non-significant trend toward poorer DFS. Baseline PLR ≥ 150 was significantly associated with inferior DFS in univariable analysis (HR 5.28, 95% CI 1.12–24.97, p = 0.036), while NLR ≥ 3 showed a borderline effect (p = 0.108). In multivariable models, PLR retained borderline prognostic relevance (p = 0.083), whereas Kaplan–Meier curves indicated non-significant trends (p = 0.129 and 0.055). Integrated models combining nodal status with PLR ± NLR improved risk discrimination: Model A (N + PLR ≥ 150 ± NLR ≥ 3) showed a trend (p = 0.059), and Model B (N + PLR ≥ 150) reached significance (p = 0.021; C-index ≈ 0.68–0.69). Conclusions: Modern CRT achieved excellent OS with acceptable toxicity, though early recurrences limited DFS. Integrating hematologic indices with nodal status provides a pragmatic, cost-effective approach for individualized risk assessment and follow-up in ASCC. Full article

The spirochete Borrelia is responsible for Lyme disease, a multisystemic infection and growing public health concern. This study aimed to evaluate host response dynamics to Borrelia bavariensis by analyzing hematological parameters as potential immuno-inflammatory markers in a murine model. Forty C3He/HeNCrl mice were inoculated intradermally with B. bavariensis (5 × 10⁵ spirochetes/100 µL/mouse) and monitored for 90 days. Samples were collected at defined intervals for microbiological examination, hematology, and qPCR. Microbiological and qPCR testing revealed infection between days 7–21; results were negative on days 28–42. At later stages (days 60 and 90), Borrelia was only detectable by qPCR, highlighting differences in diagnostic sensitivity. Hematological analysis showed that the neutrophil-to-lymphocyte ratio (NLR) and systemic immuno-inflammatory index (SII) peaked on day 7 (p < 0.0001), followed by gradual normalization until day 35. These markers reflected the intensity of the inflammatory response and defined three distinct phases of host reaction. Overall, results demonstrate the complexity of immune responses in B. bavariensis infection and underscore the value of monitoring hematological indices for understanding host–pathogen interactions. This approach supports the potential use of simple blood markers in diagnostic strategies with translational relevance for clinical practice. Full article

Introduction: The neutrophil–lymphocyte ratio (NLR) has proven to be an inexpensive and easily available inflammatory marker for cardiovascular disease. The aim of the present study is to evaluate a possible association between preoperative NLR value and endovascular aneurysm repair (EVAR) outcomes. Methods: A multicentric retrospective study of patients undergoing EVAR in elective setting between 2015 and 2023 was performed. Preoperative NLR was calculated by dividing the absolute neutrophil count by the absolute lymphocyte count, and a cut-off of 5 was used as threshold for the analysis. Primary outcomes (technical success, endograft occlusion, AAA-related reintervention, endoleaks, and mortality rates) were compared between the NLR < 5 and the NLR > 5 group. Kaplan–Meier survival analysis was employed to assess overall survival and the incidence of long-term complications. Results: The study initially considered 1360 patients. Eventually, 823 patients were included in the study, of whom 129 (15.7%) with NLR > 5. The latter group presented a higher AAA diameter (59.1 mm vs. 55, mm; p = 0.004). Technical success was obtained in 98,9% of all enrolled patients. NLR values were significantly associated with ASA class (p = 0.014), involvement of the iliac arteries (p = 0.023), duration of ICU stays (p < 0.001), and overall length of hospitalization (<0.001). At Kaplan–Meier analysis, patient with NLR > 5 showed a significant lower survival rates (p = 0.006), while no significant differences were found in terms of endograft occlusion (p = 0.45), AAA-related reintervention (p = 0.63), and endoleaks (p = 0.49). Conclusions: This study highlights the association between the NLR value and an elevated risk of long-term mortality, highlighting its role as an indicator of the patient’s overall clinical condition rather than immediate surgical outcomes. Focusing on this selected group of patients can improve postoperative care and reduce long-term complications. Full article

The aim of this study was to assess whether baseline the neutrophil-to-lymphocyte ratio (NLR), the platelet-to-lymphocyte ratio (PLR), the systemic immune-inflammation index (SII), and C-reactive protein (CRP) could predict postoperative outcomes in systemically healthy patients receiving dental implants. A retrospective analysis of 116 systemically healthy adults receiving dental implants was conducted. To minimise confounding, individuals over 50 years old, smokers, and those with systemic diseases, stage III/IV periodontitis, or current medication use were excluded. Periodontal status was classified as clinically healthy or stable. Baseline CRP and complete blood count-derived indices (NLR, PLR, SII) were recorded preoperatively. The primary outcome was osseointegration (proper versus impaired). Implant success was 95.7% (n = 111), with early implant failure occurring in 4.3% (n = 5). Females exhibited higher PLR values than males (p = 0.041), and SII was higher in periodontally stable patients compared to clinically healthy ones (p = 0.036). In systemically healthy patients, routine preoperative screening based on NLR, PLR, and CRP did not improve prediction of early implant failure, whereas SII demonstrated good, statistically significant discrimination (p = 0.015). These findings emphasise the need for further research to clarify the predictive value of blood inflammatory biomarkers. Full article

Background/Objectives: MOC31 immunostain identifies carcinoma cells and is often used in effusion fluid cytology. This systematic review and meta-analysis aim to detail the diagnostic performance of MOC31 with subgroup analysis for different types of carcinomas. Methods: A literature search from five databases was performed. Relevant studies were reviewed for the calculation of pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and area under the curve of hierarchical summary receiver operating characteristics (AUC-HSROC). Risk of bias, heterogeneity, and publication bias were assessed by the QUADAS-2, I2 index, and Deeks’ funnel plot. Results: In total, 25 studies (10 retrospective cohorts, 10 case–control studies, and 5 case series) were included. The pooled sensitivity, specificity, NLR, PLR, and DOR were 0.926 (0.827–0.971), 0.932 (0.883–0.961), 0.079 (0.005–0.152), 13.610 (5.327–21.892), and 172.475 (83.150–428.100), respectively. The AUC-HSROC was 0.975, indicating excellent performance. Further analysis for adenocarcinomas, mesotheliomas, and benign/reactive mesothelial cells showed sensitivity for adenocarcinomas at 0.962 (0.948–0.975) and specificity for mesotheliomas and mesothelial cells at 0.934 (0.900–0.967) and 0.997 (0.994–1.000). Sensitivity in all four primary site subgroups (female genital, gastrointestinal/hepatobiliary, lung and breast) of adenocarcinoma were high (>0.910). Heterogeneity was observed, and meta-regression identified a trend for the year of publication. No evidence of publication bias was observed. Conclusions: Evidence shows that MOC31 could be a robust immunocytochemical marker for identifying and excluding metastatic carcinoma, with excellent diagnostic performance across types of adenocarcinomas. However, evidence is mainly from retrospective studies, highlighting the need for high-quality evidence to further establish MOC31diagnostic utility. Full article

Leaf rust, a devastating fungal disease caused by Puccinia triticina (Pt), severely impacts wheat quality and yield. Identifying genetic loci for wheat leaf rust resistance, developing molecular markers, and breeding resistant varieties is the most environmentally friendly and economical strategy for disease control. This study utilized a recombinant inbred line (RIL) population of Doumai and Shi4185, combined with the wheat 90 K single nucleotide polymorphisms (SNPs) chip data and maximum disease severity (MDS) of leaf rust from four environments, to identify adult plant resistance (APR) loci through linkage mapping. Additionally, kompetitive allele-specific PCR (KASP) markers suitable for breeding were developed, and genetic effects were validated in a natural population. In this study, 5 quantitative trait loci (QTL) on chromosomes 1B (2), 2A and 7B (2) were identified through inclusive composite interval mapping, and named as QLr.lfnu-1BL1, QLr.lfnu-1BL2, QLr.lfnu-2AL, QLr.lfnu-7BL1 and QLr.lfnu-7BL2, respectively, explaining 4.54–8.91% of the phenotypic variances. The resistance alleles of QLr.lfnu-1BL1 and QLr.lfnu-1BL2 originated from Doumai, while the resistance alleles of QLr.lfnu-2AL, QLr.lfnu-7BL1 and QLr.lfnu-7BL2 came from Shi4185. Among these, QLr.lfnu-1BL2, QLr.lfnu-7BL1 and QLr.lfnu-7BL2 overlapped with previously reported loci, whereas QLr.lfnu-1BL1 and QLr.lfnu-2AL are likely to be novel. Two KASP markers, QLr.lfnu-2AL and QLr.lfnu-7BL, were significantly associated with leaf rust resistance in a diverse panel of 150 wheat varieties mainly from China. Totally, 34 potential candidate genes encoded the NLR proteins, receptor-like kinases, signaling kinases and transcription factors were selected as candidate genes for the resistance loci. These findings will provide stable QTL, available breeding KASP markers and candidate genes, and will accelerate the progresses of wheat leaf rust resistance improvement through marker-assisted selection breeding. Full article

Background/Objectives: Intravesical Bacillus Calmette–Guérin (BCG) is the standard adjuvant treatment for high-risk non-muscle-invasive bladder cancer (NMIBC), but treatment-related urinary toxicity may compromise quality of life (QoL) and adherence. The neutrophil-to-lymphocyte ratio (NLR), a marker of systemic inflammation, has been linked to oncologic outcomes in bladder cancer, but its association with urinary symptom burden during BCG therapy remains unclear. We aimed to assess whether baseline NLR is associated with early deterioration in urinary symptoms and urinary QoL following BCG induction. Methods: This prospective study included male patients with NMIBC treated with intravesical BCG. Baseline demographics, comorbidities, laboratory parameters, and urinary symptoms were recorded. Patients were stratified into two groups according to baseline NLR (<3 vs. ≥3). Urinary outcomes were assessed at baseline and 8 weeks using the International Prostate Symptom Score (IPSS) and the IPSS-related QoL item. Univariable and multivariable linear regression analyses were performed. Results: A total of 96 patients were analyzed. Median baseline NLR was 2.6 (IQR: 2.1–3.8). Patients with NLR ≥ 3 (n = 34) and NLR < 3 (n = 62) had comparable baseline characteristics and urinary scores. At 8 weeks, patients with NLR ≥ 3 experienced a greater worsening of urinary symptoms (median IPSS 24 vs. 21, p = 0.02; median change +5 vs. +2, p = 0.01) and QoL (median 5 vs. 4, p = 0.03). Univariable regression confirmed the association of NLR ≥ 3 with worse QoL (β = +0.74; p = 0.003) and higher IPSS (β = +2.20; p = 0.021). Modeled as a continuous variable, each one-unit increase in NLR corresponded to a +0.20 worsening in QoL (p = 0.008). In the multivariable analyses adjusted for baseline IPSS and concomitant CIS, NLR remained independently associated with QoL decline. Conclusions: Baseline NLR was independently associated with worsening urinary symptoms and QoL during BCG induction in NMIBC patients. NLR may represent a simple and accessible biomarker for early risk stratification during BCG induction, warranting validation in larger, longer-term prospective trials. Full article

Background: Inflammatory biomarkers such as the platelet-to-lymphocyte ratio (PLR) and neutrophil-to-lymphocyte ratio (NLR) have been increasingly investigated as prognostic indicators in pancreatic cancer. However, their role in patients receiving high-dose neoadjuvant stereotactic body radiotherapy (SBRT) remains unclear. Methods: Thirty-three patients with borderline resectable (BRPC) or locally advanced pancreatic cancer (LAPC) prospectively included from June 2017 to December 2022 in a multicenter academic SBRT escalated-dose study of neoadjuvant chemotherapy followed by escalated-dose SBRT (50–55 Gy in 5 fractions) were scored according to PLR/NLR expression, before SBRT. Patients were stratified according to the median value for each marker. The primary endpoint was freedom from local progression as the first site of failure (FFLP-FF). Secondary endpoints included cancer-specific survival (CSS) and overall survival (OS). Follow-up was conducted prior to the closing date of 18 July 2025. Results: After a mean follow-up of 24 months (range 6–71 months), the two-year FFLP-FF rate for the entire cohort was 80.2%. High PLR prior to SBRT was significantly associated with lower FFLP-FF (p = 0.038). Similarly, elevated NLR was associated with reduced FFLP-FF (p = 0.014). Patients with both high PLR and high NLR showed the poorest FFLP-FF outcomes (p = 0.001). High pre-SBRT PLR was also correlated with reduced CSS (p = 0.019) and OS (p = 0.018). Conclusions: Pre-treatment inflammatory biomarkers, particularly PLR and NLR, may serve as valuable predictors of local control and survival in patients with borderline or locally advanced pancreatic cancer undergoing escalated high-dose SBRT. Their combination may help identify subgroups with a worse prognosis who may benefit from tailored treatment strategies. Full article

Background/Objectives: Romania remains a tuberculosis (TB) hotspot in the European Union, yet host-derived factors of poor outcomes are poorly characterised. We quantified circulating pro-inflammatory cytokines and examined their interplay with behavioural risk factors, the nutritional status, and the clinical course in adults hospitalised with pulmonary TB. We analysed 80 adults with microbiologically confirmed pulmonary TB and 40 respiratory symptom controls; four TB patients (5%) died during hospitalisation, all within 10 days of admission. Methods: A retrospective analytical case–control study was conducted at the Constanța regional TB referral centre (October 2020—October 2023). Patients with smear- or culture-confirmed TB were frequency-matched by sex, 10-year age band, and BMI class to culture-negative respiratory controls at a 2:1 ratio. The patients’ serum interferon-γ (IFN-γ), interleukin-1α (IL-1α), interleukin-1β (IL-1β), and tumour-necrosis-factor-α (TNF-α) were quantified within 24 h of admission; the neutrophil/lymphocyte ratio (NLR) was extracted from full blood counts. Independent predictors of in-hospital mortality were identified by multivariable logistic regression; factors associated with the length of stay (LOS) were modelled with quasi-Poisson regression. Results: The median TNF-α (24.1 pg mL⁻¹ vs. 16.2 pg mL⁻¹; p = 0.009) and IL-1β (5.34 pg mL⁻¹ vs. 3.67 pg mL⁻¹; p = 0.008) were significantly higher in the TB cases than in controls. TNF-α was strongly correlated with IL-1β (ρ = 0.80; p < 0.001), while NLR showed weak concordance with multiplex cytokine patterns. Among the patients with TB, four early deaths (5%) exhibited a tripling of TNF-α (71.4 pg mL⁻¹) and a doubling of NLR (7.8) compared with the survivors. Each 10 pg mL⁻¹ rise in TNF-α independently increased the odds of in-hospital death by 1.8-fold (95% CI 1.1–3.0; p = 0.02). The LOS (median 29 days) was unrelated to the smoking, alcohol, or comorbidity load, but varied across BMI strata: underweight, 27 days; normal weight, 30 days; overweight, 23 days (Kruskal–Wallis p = 0.03). In a multivariable analysis, under-nutrition (BMI < 18.5 kg m⁻²) prolonged the LOS by 19% (IRR 1.19; 95% CI 1.05–1.34; p = 0.004) independently of the disease severity. Conclusions: A hyper-TNF-α/IL-1β systemic signature correlates with early mortality in Romanian pulmonary TB, while under-nutrition is the dominant modifiable determinant of prolonged hospitalisation. Admission algorithms that pair rapid TNF-α testing with systematic nutritional assessment could enable targeted host-directed therapy trials and optimise bed utilisation in high-burden settings. Full article

Background/Objectives: Given the increasing interest in the predictive role of inflammation in oncology, we aimed to assess the association between inflammatory factors (IFs) and the histopathological characteristics of bladder cancer (BC). Our objective was to correlate some of these IFs with BC progression and recurrence, identifying possible new diagnostic tools. Methods: We retrospectively analyzed 285 patients (79.8% male, 20.4% female; median age 73) who underwent transurethral resection of the bladder (TURB) between January 2016 and January 2022. The preoperative neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammation index (SII), pan-immune-inflammation value (PIV), systemic inflammation response index (SIRI), and standard clinical variables were collected one month before TURB and evaluated as predictors of recurrence and progression. Patients were stratified using the Youden Index and ROC analysis. Cox regression models were applied to identify independent predictors. Results: High-grade tumors were present in 74.6% of cases, and 34% were recurrent. Carcinoma in situ was found in 5%. After 72 months, 53% underwent radical cystectomy, and 13.7% died within 5 years. The optimal cutoffs were PLR 139, SIRI 1.12, PIV 248.49, NLR 2, SII 327. Smoking, primary MIBC, age, and lymph node status were significantly associated with recurrence. Elevated PLR correlated with recurrence and T2 progression (p = 0.004). Higher SIRI, PIV, and PLR levels were significantly associated with lymphovascular invasion and nodal metastasis (p < 0.05). PLR was linked to recurrence in tumors ≥ 3 cm post-BCG (p = 0.004); high SIRI predicted recurrence within 48 months (p = 0.05). Conclusions: High PLR and SIRI levels were associated with recurrence. Our findings support the emerging role of IFs in predicting BC outcomes and suggest their potential inclusion in future prognostic models. Full article

Peanut rust, caused by Puccinia arachidis Speg., is one of the most significant leaf diseases globally, and has a severe impact on peanut yield and quality. The development of disease-resistant varieties is recognized as an effective strategy to mitigate the damage caused by peanut rust. However, the research foundation for understanding peanut rust remains relatively limited. In this study, we identified significant single nucleotide polymorphisms (SNPs) associated with peanut rust resistance using a natural population consisting of 353 peanut germplasm accessions. These accessions were analyzed based on resequencing data and rust disease phenotypes across one laboratory test and three field trials. A total of 18 significant SNPs were identified on chromosomes A05 (5 SNPs), A08 (7 SNPs), and A12 (6 SNPs). Notably, three SNPs—Arahy.05_93085395, Arahy.05_93114354, and Arahy.12_4097252—were consistently detected across multiple environments. Within their confidence intervals, 48 genes were annotated, including 9 NLR domain-containing genes functionally related to plant disease resistance, which may serve as candidate genes for peanut rust resistance. This study provides insights into the regulatory mechanisms underlying peanut rust resistance. Full article

Objective: The neutrophil–lymphocyte ratio (NLR) is an inexpensive and easily available inflammatory marker for cardiovascular disease. The aim of the present study is to evaluate a possible association between preoperative NLR value and popliteal artery aneurysm (PAA) repair outcomes. Methods: A single-center retrospective study on all patients, who underwent urgent or elective PAA repair from June 2010 to October 2022, was performed. Study outcomes were immediate technical success, 30-day and mid-term primary patency, reintervention, limb salvage, and mortality rates. The NLR was calculated by dividing the absolute neutrophil count by the absolute lymphocyte count, and, according to the literature, a cut-off of five has been considered as a possible threshold for the analysis. Results: Eighty-two patients (80 male) with a total of 97 popliteal artery aneurysms were enrolled in this study. The mean preoperative NLR was 2.9 ± 2.4. In 10 (10.3%) PAAs, the NRL was >5 (High-NLR group), and, in the remaining 87 (89.7%), the NLR was <5 (Low-NLR group). The preoperative NLR for urgent procedures was higher than elective cases (4.37 vs. 2.30; p < 0.001). However, no significant differences were found as far as immediate 24 h technical success (p = 0.48) and 30-day primary patency (p = 39). At mean follow-up, the primary patency rate was significantly higher in the Low-NLR group (p = 0.0044), without statistical differences for re-operation (p = 0.27), limb salvage (p = 0.09), and mortality rates (p = 0.51). The Kaplan–Mayer analysis showed a significant difference in freedom from major amputation in patients with an NLR > 5 compared to the ones with an NLR < 5 (p = 0.038), without any differences in terms of survival, primary patency, and the need for reintervention rates. The multivariable Cox regression analysis identified the NLR value as an independent predictor of better outcomes regarding freedom from the amputation rate (p = 0.25). Conclusions: Our experience indicates that a preoperative NLR value > 5 can identify high-risk patients affected by a PAA and may negatively influence the surgery’s long-term outcomes. Therefore, this selected group of patients could need a more tailored approach and closer monitoring over time. Full article

Background and Objectives: This study aimed to evaluate the prognostic significance of the pre-treatment albumin-to-alkaline phosphatase ratio (AAPR) in early-stage colorectal cancer patients and to compare it with the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) within the same patient cohort. Materials and Methods: This retrospective study included 540 patients who were followed up after a diagnosis of early-stage colorectal cancer and whose albumin (ALB), alkaline phosphatase (ALP), neutrophil, platelet, and lymphocyte values were measured before treatment. Results: In the receiver operating characteristic (ROC) curve analysis for overall survival (OS), the AAPR index Area Under Curve (AUC):0.560, (p = 0.018), NLR index (p = 0.079), and PLR index (p = 0.692) were evaluated. In the ROC analysis for OS, a cut-off value of the AAPR index of ≤0.423 was found. In the AAPR-low group, the relapse and death rates were higher than in the AAPR-high group (p = 0.004 and p = 0.001, respectively). As the AAPR index decreased, the NLR and PLR indexes increased (p = 0.027 and p = 0.003, respectively). Median disease-free survival (DFS) was worse in the AAPR-low group (128 versus 156) months (p = 0.015). The AAPR index significantly affected OS with hazard ratio (HR):0.42 (95%CI, 0.18–0.97) (p = 0.044). At 5 years, 68% of the patients in the AAPR-low group and 79% of the patients in the AAPR-high group were alive (p = 0.005). In a multivariate analysis, low AAPR, patient age at diagnosis, TNM stage, and recurrence status were independent factors affecting OS (p = 0.022, p < 0.001, p = 0.002, and p < 0.001, respectively). Conclusions: In early-stage colorectal cancer patients, the OS was worse in the AAPR-low group than in the AAPR-high group. The AAPR index demonstrated significant prognostic value for OS compared to the NLR and PLR in the same patient cohort. Full article