Search Results (508)

Background/Objectives: Psoriasis is a chronic immune-mediated inflammatory disease associated with systemic inflammation and comorbidities such as cardiovascular disease and metabolic syndrome. Blood-derived inflammatory indices like neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammation index (SII), systemic inflammation response index (SIRI), and pan-immune-inflammation value (PIV) have been proposed as biomarkers of systemic inflammation and disease severity. This retrospective and prospective observational study aimed to evaluate the long-term effects of guselkumab, an IL-23 inhibitor, on these indices in moderate-to-severe psoriasis. Methods: We analyzed 208 patients with moderate-to-severe psoriasis treated with guselkumab, with hematologic evaluations available for 208 patients at baseline, 208 at week 52, 129 at week 104, and 94 at week 156. Systemic inflammatory indices were calculated from routine annual blood tests. Patients were stratified by obesity, cardiovascular comorbidities, treatment response, and prior biologic therapy. Longitudinal changes were assessed using Friedman tests with Wilcoxon post hoc comparisons, and correlations between PASI and inflammatory indices were evaluated using Spearman’s coefficients. Results: SIRI and PLR showed significant reductions at week 156 (p = 0.038 and p = 0.018, respectively), while MLR also decreased over time without reaching consistent significance. NLR and PIV showed minimal or inconsistent changes. Obese patients and those with cardiovascular disease had higher baseline SII and SIRI and less pronounced improvements. No significant differences were observed between super responders and others. Correlation between baseline PASI and most inflammatory markers was weak, except for a weak but significant correlation with PIV (ρ = 0.119, p = 0.049). Conclusions: Guselkumab treatment is associated with long-term reduction in systemic inflammatory indices, particularly SIRI. The weak correlation of these markers with skin severity highlights a dissociation between cutaneous and systemic inflammation. SIRI and SII may serve as useful biomarkers to monitor systemic inflammation and guide comprehensive management in psoriasis patients. Full article

Background/Objectives: Alopecia areata is an autoimmune disorder characterized by nonscarring hair loss and systemic immune dysregulation. Hematological indices such as neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), mean platelet volume (MPV), systemic immune-inflammation index (SII), erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) have been associated with inflammatory activity in dermatologic diseases. This study aimed to compare systemic inflammatory markers among patients with severe and mild alopecia areata and healthy controls, and to explore longitudinal changes in these markers in patients with severe disease who achieved clinical improvement following Janus kinase (JAK) inhibitor therapy. Methods: This retrospective cohort study included 129 participants: 43 patients with severe alopecia areata (SALT ≥ 50) treated with JAK inhibitors who achieved documented clinical improvement, 43 patients with mild disease (SALT ≤ 20), and 43 age- and sex-matched healthy controls. Hematological inflammatory markers, including red cell distribution width (RDW), MPV, MLR, NLR, PLR, SII, ESR, and CRP, were compared across groups. In patients with severe disease, longitudinal changes were assessed at baseline, three months after treatment initiation, and at the time of documented clinical improvement. Results: MLR, NLR, PLR, SII, and ESR levels were significantly higher in the severe group compared with mild cases and controls, while RDW, MPV, and CRP showed no significant differences. Among patients with severe alopecia areata who achieved clinical improvement following JAK inhibitor therapy, NLR and SII decreased significantly over time. MLR, PLR, and CRP also showed reductions during follow-up, while ESR and RDW remained unchanged. Conclusions: Systemic inflammatory markers are elevated in severe alopecia areata compared with mild disease and healthy controls. In patients who achieved clinical improvement with JAK inhibitor therapy, several inflammatory indices demonstrated longitudinal changes. These findings are exploratory and suggest an association between systemic inflammation, disease severity, and clinical improvement rather than definitive predictive biomarkers. Full article

Background: Acute appendicitis, a frequent pediatric surgical emergency, requires distinguishing simple from complicated cases for treatment decisions. Current tools, such as clinical scores and ultrasound, are sometimes ineffective. This study evaluates the biomarkers: neutrophils to lymphocytes ratio (NLR), monocytes to lymphocytes ratio (MLR), platelet-to-lymphocyte ratio (PLR), neutrophils to monocytes ratio (NMR), neutrophils to platelet ratio (NPR), pan-immune-inflammation value (PIV) ratio, and C-Reactive Protein (CRP) to lymphocytes ratio (CLR) for differentiation between simple and complicated appendicitis. Methods: A retrospective study of 878 pediatric patients (<18 years) who underwent appendectomy (2018–2024) at a tertiary medical center, with appendicitis classified as simple (SA, n = 696) or complicated (CA, n = 182) using intraoperative findings. Biomarkers were calculated from preoperative blood counts and CRP. Diagnostic accuracy was assessed using Mann–Whitney U tests, ROC curves, and logarithmic regression. Results: Patients with CA had higher neutrophils counts (13.61 ± 4.92 vs. 11.39 ± 4.29 K/μL), monocytes counts (1.23 ± 1.41 vs. 0.95 ± 0.48 K/μL), platelet counts (294.31 ± 72.73 vs. 270.15 ± 72.08 K/μL), CRP levels (88.55 ± 97.75 vs. 27.15 ± 44.74 mg/L), and elevated biomarker ratios as compared to those with SA: NLR (≥10.15, OR = 2.45), MLR (≥0.645, OR = 2.78), PLR (≥224.38, OR = 2.502), NMR (≥6.38, OR = 2.34), NPR (≥0.0405, OR = 1.876), PIV (≥2433.85, OR = 3.348), and CLR (≥11.77, OR = 5.935), all at p < 0.01. CLR demonstrated the highest accuracy (AUC = 0.772, sensitivity 78%, specificity 62.6%), outperforming established biomarkers, followed by PIV (AUC = 0.679). NPR was the least effective marker (AUC = 0.569). Conclusions: CLR, a promising biomarker, can aid in distinguishing complicated from simple appendicitis in children, and may offer accessible tools for resource-limited settings. Full article

Background/Objectives: Immunotherapy has improved outcomes for selected patients with advanced non-small-cell lung cancer (NSCLC), yet the predictive value of individual biomarkers such as PD-L1 remains limited. Systemic inflammatory indices derived from routine blood tests may complement molecular and immunohistochemical features, offering a broader view of host–tumor immunobiology. Methods: We conducted a retrospective study of 298 patients with stage IIIB–IV NSCLC treated with immune checkpoint inhibitors (ICIs) at a tertiary oncology center between 2022 and 2024. Baseline neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), and systemic immune–inflammation index (SII) were collected alongside PD-L1 expression and molecular alterations (EGFR, KRAS, ALK, TP53). Patients were stratified into inflammatory–molecular clusters integrating these parameters. Associations with objective response rate (ORR), progression-free survival (PFS), and overall survival (OS) were evaluated using Kaplan–Meier and multivariate Cox analyses. Results: Four distinct inflammatory–molecular clusters demonstrated significantly different outcomes (p < 0.001). Patients with low NLR and high PD-L1 expression (Cluster A) showed the highest ORR (41%), longest median PFS (13.0 months), and OS (22.5 months). The EGFR/ALK-driven, inflammation-dominant cluster (Cluster C) exhibited poor response (ORR 7%) and shortest survival (PFS 4.3 months). High NLR (HR 2.12), PD-L1 < 1% (HR 1.91), and EGFR mutation (HR 2.36) independently predicted shorter PFS. A combined model incorporating NLR, PD-L1, and molecular status outperformed individual biomarkers (AUC 0.82). Conclusions: Integrating systemic inflammatory indices with PD-L1 expression and molecular alterations identifies clinically meaningful NSCLC subgroups with distinct immunotherapy outcomes. This multidimensional approach improves prediction of ICI response and may enhance real-world patient stratification, particularly in settings with limited access to extended molecular profiling. Full article

Background and Objectives: HER2-positive metastatic colorectal cancer (mCRC) represents a biologically distinct and clinically aggressive subtype associated with poor response to standard first-line chemotherapy. Reliable, low-cost prognostic biomarkers are urgently needed to identify early non-responders and guide treatment decisions. This real-world cohort study evaluated the prognostic value of carcinoembryonic antigen (CEA) kinetics and systemic inflammatory markers (SIMs) in HER2-positive mCRC treated with first-line chemotherapy. Materials and Methods: We retrospectively analyzed 98 patients with HER2-positive mCRC treated between 2015 and 2024. Serial CEA values were measured at baseline, after three cycles (week 6), and at radiologic progression. Early CEA change was categorized as ≥50% decline, 10–49% decline, or any increase. Baseline SIMs—including neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), and systemic immune-inflammation index (SII)—were calculated from pretreatment blood counts. Progression-free survival (PFS) was analyzed using Kaplan–Meier and Cox regression models. Results: Among patients with evaluable CEA kinetics (n = 60), early CEA increase occurred in 30% of patients (n = 18) and was strongly associated with inferior PFS (HR 2.84; 95% CI 1.81–4.44; p < 0.001). ROC analysis identified a ≥38% CEA reduction as the optimal predictor of radiologic response (AUC 0.79). High baseline NLR (≥3) and high SII (≥900) were also significantly associated with shorter PFS (median PFS: 5.2 vs. 9.1 months for NLR; 4.7 vs. 10.3 months for SII; both p < 0.01). In multivariate analysis, early CEA increase, high NLR, and high SII remained independent predictors of poor PFS. Conclusions: CEA dynamics and inflammation-based biomarkers provide robust, complementary prognostic information in HER2-positive mCRC. Early CEA increase is the strongest independent predictor of poor outcome, while high baseline NLR and SII further refine risk stratification. These inexpensive and widely accessible biomarkers may help identify early non-responders, optimize monitoring strategies, and support timely therapeutic adjustments in routine clinical practice. Full article

Background and Objectives: Mean platelet volume (MPV) is a routinely available blood marker that measures platelet size and activation, and it has been evaluated as a potential marker for thyroid malignancies. Platelets participate in tumor genesis through angiogenesis, immune evasion, and metastasis, making them plausible adjuncts for cancer risk evaluation. The objective is to systematically evaluate the role of MPV in thyroid cancers, with the main focus on diagnostic accuracy, prognostic value, and limitations, focusing on papillary thyroid carcinoma (PTC). Materials and Methods: A systematic search of PubMed was conducted from January 2015 to September 2025. Only free full-text studies on human subjects were included. Eligible studies included case–control, cohort, or observational designs reporting MPV or platelet indices in thyroid cancer compared with benign nodules or healthy controls. Data on diagnostic performance, associations with tumor stage, lymph node involvement, and recurrence were extracted and synthesized narratively. No formal risk-of-bias or study quality assessment tool was applied. The literature search was restricted to studies with freely available full-text articles, which may have introduced access-based selection bias. Results: Eleven studies met the inclusion criteria. Most of them reported high MPV values in papillary thyroid carcinoma (PTC), with limited evidence regarding other thyroid cancer subtypes. High values of MPC were reported in the majority of studies in PTC compared to benign nodules or healthy controls. The diagnostic performance of MPV alone was poor, but integration with inflammatory ratios such as the neutrophil-to-lymphocyte ratio (NLR) or platelet-to-lymphocyte ratio (PLR), and with ultrasound systems (TI-RADS), improved accuracy. Regarding prognostic utility, some studies linked higher MPV with lymph node involvement or recurrence risk, while others did not find significant data. Thyroid function, autoimmune thyroid disease, and methodological variability in MPV measurement limited comparability across studies. Conclusions: MPV is a low-cost adjunct biomarker, especially when combined with other hematologic and imaging markers. However, MPV should not be used as a stand-alone diagnostic or prognostic tool. Larger, prospective studies are mandatory to clarify its clinical role. Full article

Introduction: Prompt diagnosis and differentiation between non-muscle-invasive bladder cancer (NMIBC) and muscle-invasive bladder cancer (MIBC) are essential in the treatment of bladder cancer. Inflammation-based biomarkers have recently emerged as potential tools for improving cancer diagnostics and prognostication. This study aims to evaluate the potential value of the Systemic Inflammation Index (SII), Systemic Inflammation Response Index (SIRI), Pan-immune Inflammation Value (PIV), and Platelet-to-Lymphocyte Ratio (PLR) as predictors of muscle-invasive disease. Materials and methods: Analyzed data included 310 bladder tumors. The SII, SIRI, PIV, and PLR were calculated from pre-TURBT complete blood-count results. Differences in inflammatory markers between pathological stages (pTa–pT4) were examined using ANOVA with Tukey’s post hoc testing. Optimal cutoff values for distinguishing NMIBC from MIBC were identified using ROC curve analysis and Youden’s J statistic. Logistic regression models incorporating age, sex, the number of recurrences, and each inflammatory index were developed to evaluate their predictive performance in patients treated with curative intent. Results: All investigated inflammation indices significantly differed across tumor stages (p < 0.001), with lower values observed in pTa tumors compared with muscle-invasive disease. Determined cutoff values for muscle-invasive disease were 865.63 for SII, 2.02 for SIRI, 579.28 for PIV, and 166.35 for PLR. Logistic regression models demonstrated promising diagnostic performance, achieving AUC values of 0.812 (SII), 0.816 (SIRI), 0.821 (PIV), and 0.795 (PLR); sensitivity and specificity were 76% and 75% for SII, 79% and 77% for SIRI, 80% and 72% for PIV, and 88% and 59% for PLR. Discussion: The presented results indicate that inflammation-based indices vary meaningfully between bladder cancer stages and may be utilized in early identification of muscle-invasive disease. As inexpensive and widely available biomarkers, they offer potential value in the evaluation of suspected MIBC before the final pathology report and could enhance the diagnostic process. Full article

Objective: This study aimed to evaluate blood count-derived inflammatory indices—the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), and the systemic immune-inflammation index (SII)—in patients with fibromyalgia and to explore their association with disease activity and pain severity. Methods: A cross-sectional study was conducted with 85 fibromyalgia patients and 84 age- and sex-matched healthy controls. Demographic, clinical, and laboratory data were recorded. Inflammatory indices were calculated from blood counts. Disease activity and functional status were assessed with the Fibromyalgia Impact Questionnaire (FIQ), Health Assessment Questionnaire (HAQ), and pain severity with the Visual Analog Scale (VAS). Results: Compared to controls, the fibromyalgia group had significantly higher BMI, PLR, MLR, and NLR (all p < 0.05), and lower lymphocyte levels. PLR and MLR moderately discriminated fibromyalgia (AUC = 0.623 and 0.661, respectively), suggesting limited diagnostic utility when used alone. MLR and BMI were independently associated with fibromyalgia in multivariate analysis. Disease duration showed significant positive correlations with PLR (r = 0.167), MLR (r = 0.228), FIQ (r = 0.773), HAQ (r = 0.589), and VAS at rest and movement (r = 0.584 and r = 0.601; all p < 0.05). PLR, MLR, and NLR were also positively correlated with VAS scores, while SII showed no significant associations. FIQ was strongly correlated with pain severity and HAQ with VAS during movement. Conclusions: Blood count-derived indices, particularly PLR and MLR, are elevated in fibromyalgia and are associated with disease duration, severity, and pain. Although PLR and MLR were higher in fibromyalgia patients, their discriminatory ability was limited and should be interpreted cautiously, indicating that their diagnostic specificity is low, as these ratios primarily reflect nonspecific inflammatory processes. Full article

Objectives: Lung cancer remains as the most common cause of cancer-related death. The possible relationships between inflammatory markers and lung cancer prognosis have yet to be clarified. In this study, we aimed to assess and compare various inflammatory markers and prognostic tests for their role in predicting mortality in patients with lung cancer who were admitted to the intensive care unit. Methods: A total of 229 patients diagnosed with small cell or non-small cell lung cancer who attended follow-up after treatment were included. The predictive performance of neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), systemic immune-inflammation index (SII), modified Glasgow prognostic score (mGPS), Prognostic nutritional index (PNI), APACHE II score, and MPM II-Admission (Mortality Probability Models II-0) were assessed in terms of mortality status. We also performed multivariable logistic regression to determine whether any of these parameters were independently associated with mortality. Results: We included 229 patients into our study; the mean age was 66.17 ± 11.89 years. Among these, 135 (58.95%) patients died and 94 (41.05%) patients were discharged. When we evaluated the performance of the prognostic scores in predicting mortality, we found mGPS, MPM II-Admission, and APACHE II scores had the highest sensitivity, and MPM II-Admission, PNI, and APACHE II scores had the highest specificity. Multivariable regression revealed that PNI was the only inflammation-related parameter that was independently associated with mortality. Conclusions: PNI, APACHE-II, and MPM II-Admission may be used as easily accessible tests for mortality estimation in lung cancer patients admitted to the ICU. Full article

Background/Objectives: Acute appendicitis (AA) is among the most common surgical emergencies. Differentiating between complicated (CAA) and uncomplicated (UAA) forms is essential for selecting the appropriate management—operative or non-operative—and for optimizing patient prioritization and outcomes. This study aimed to evaluate the diagnostic performance of emerging inflammatory indices in distinguishing these forms of AA. Methods: A total of 514 adult patients with surgically confirmed AA were retrospectively analyzed. Six immune-inflammatory indices—neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), systemic immune-inflammation index (SII), systemic inflammation response index (SIRI), and pan-immune-inflammation value (PIV)—were calculated and compared with intraoperative and histopathological findings. Postoperative outcomes, including length of hospital stay (LOS) and hospitalization costs, were also evaluated. Results: All six indices were significantly higher in intraoperatively identified complicated cases (p < 0.0001). In histopathological analysis, five indices (NLR, MLR, SII, SIRI, and PIV) remained significantly elevated in patients with wall necrosis or perforation (p = 0.000–0.019), while PLR did not reach statistical significance. The indices showed fair diagnostic accuracy (AUC = 0.664–0.719, p < 0.0001). NLR and MLR were independent risk factors for CAA (p = 0.006 and p = 0.016), and MLR was also independently associated with complicated histopathological findings (p = 0.036). PIV independently predicted both increased LOS and higher hospitalization costs (p = 0.001 for each). Conclusions: These easily calculable inflammatory markers can serve as useful adjuncts for preoperative stratification of AA, supporting timely decision-making and contributing to more cost-effective emergency surgical care. Full article

Background/Objectives: Metabolic comorbidities and systemic inflammation are implicated in colon carcinogenesis, yet their relationship with acute obstructive presentation and early in-hospital course remains unclear. This study evaluated whether age, metabolic multimorbidity, and inflammatory–metabolic biomarkers are associated with obstruction severity and length of stay in a surgical colon cancer cohort. Methods: We analyzed 677 consecutive adults undergoing surgery for histologically confirmed colon cancer. Acute presentation was categorized as no obstruction, subocclusive syndrome, or frank obstruction. Predictors included age, comorbidity count (multimorbidity defined as ≥2), diabetes, hypertension, and preoperative biomarkers (C-reactive protein (CRP), lipids, glucose; neutrophil-to-lymphocyte ratio (NLR)/platelet-to-lymphocyte ratio (PLR)/C-reactive protein-to-albumin ratio (CAR)where available). Multivariable logistic and ordinal regression assessed obstructive presentation; linear regression assessed length of stay. Results: Subocclusion or obstruction occurred in 34.8% of patients. In multivariable logistic regression, age was independently associated with obstructive presentation (odds ratio (OR) 1.016 per year; 95% confidence interval (CI) 1.001–1.032), while comorbidity count and CRP were not. In an ordinal model, age increased the odds of more severe presentation (OR 1.018 per year), whereas diabetes was inversely associated (OR 0.573). Length of stay was independently associated only with presentation severity (β = −0.959 days per category). Correlations between inflammatory indices and length of stay were negligible. Conclusions: In this hospital-based surgical cohort, age showed a modest association with obstructive presentation, while metabolic multimorbidity and routine inflammatory markers provided limited discrimination for obstruction or early in-hospital resource use. Full article

Background/Objectives: Preeclampsia can be divided into two groups (with and without severe features) based symptom severity. We aimed to distinguish these two entities with the aid of fibrinogen to albumin ratio (FAR), uric to acid albumin ratio (UAR) and LDH to albumin ratio (LAR). Methods: This retrospective study was conducted in Istanbul Basaksehir Cam and Sakura City Hospital between 2020 and 2023. Seventy-three patients with preeclampsia were included in this study which were categorized into two groups according to disease severity: 40 patients with preeclampsia without severe features and 33 patients with severe features. Additionally, 30 healthy pregnant women were included as a control group. Neutrophil–lymphocyte ratio (NLR), monocyte–lymphocyte ratio (MLR), platelet–lymphocyte ratio (PLR), mean platelet volume (MPV), red cell distribution width (RDW), mean platelet volume (MPV), Uric acid, LDH, AST, ALT, fibrinogen, albumin, FAR, UAR and LAR were compared among the groups. Results: FAR was significantly higher in preeclampsia patients with and without severe features compared to control group (Odds ratio 8.32 for ≥0.139 vs. <0.139, p < 0.001). There was no significant difference in FAR levels between preeclampsia patients according to disease severity. UAR and LAR were significantly different between preeclampsia patients with and without severe features and the control group (p < 0.001). Receiver operating characteristics (ROC) curves for UAR showed that a cut-off value of 1.727 had a sensitivity of 73% and a specificity of 68% in discriminating between preeclampsia with and without severe features (Odds ratio 5.53 for ≥1.727 vs. <1.727). ROC curves for LAR showed that a cut-off value of 79.09 had a sensitivity of 85% and a specificity of 73% in discriminating between preeclampsia with and without severe features (Odds ratio 14.76 for ≥79.09 vs. <79.09). Conclusions: UAR and LAR appear to be better markers than FAR for identifying preeclamptic patients who require delivery due to severe features. They are easily accessible and promising biomarkers, and to our knowledge, this is the first study to evaluate LAR in this context. Further studies are needed to validate their diagnostic accuracy and compare their performance with established biomarkers. Full article

Background: As demonstrated by the PACIFIC trial, biomarker-driven patient selection is crucial. While treatment based on programmed death ligand-1 (PD-L1) and mutational status have become routine, tests for biomarkers available from pretherapeutic blood samples are currently a topic of scientific interest. Methods: This analysis was conducted on patients from the ALLSTAR RWD study, which is a nationwide, prospective registry for inoperable non-small cell lung cancer (NSCLC) stage III. Patients were amenable if they had a full routine pre-treatment blood sample, from which the following biomarkers were extracted: neutrophil-to-lymphocyte ratio (NLR), derived neutrophil-to-lymphocyte ratio (dNLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), derived monocyte-to-lymphocyte ratio (dMLR) and lactate dehydrogenase (LDH) levels. The intention was to find a cutoff for each of these biomarkers to predict locoregional control (LRC), progression-free survival (PFS) and overall survival (OS). Results: MLR and dMLR demonstrated their predictive potential with cutoff values of 0.665 and 0.945, respectively. Stratifying the whole cohort by means of these cutoffs demonstrated significantly better locoregional control for patients below the threshold, both in the whole cohort (N = 175; 55.7% vs. 75.5%; p-value = 0.018) and in the Durvalumab subgroup (N = 106; 57.5% vs. 77.3%; p-value = 0.030). Similar findings were observed for PFS in the whole cohort (N = 175; 20.5% vs. 56.1%; p-value p < 0.001) and in the Durvalumab subgroup (N = 106; 31.2% vs. 64.6%, p-value < 0.001). dMLR could also significantly predict PFS (N = 173; 17.4% vs. 56.3%; p-value < 0.001), which was corroborated in the Durvalumab subgroup (N = 108; 23.1% vs. 64.1%; p-value = 0.003). Conclusions: This explorative analysis demonstrates the predictive potential of MLR and dMLR for LRC and PFS. These blood biomarkers can be readily integrated into clinical routines since they are easily available. Full article

Background: Lung cancer (LC) is a complex-to-treat disease and remains the leading cause of cancer-related mortality. Methods: Our aim was to investigate the prognostic role of neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), and monocyte to lymphocyte ratio (MLR) in patients with LC. In this retrospective study, examining the period between 1 June 2020 and 31 May 2024, we recorded consecutive patients who presented to the Department of Respiratory Medicine, University Hospital of Patras, Patras, Greece, and received a first diagnosis of LC. The primary outcome was mortality risk analysis based on NLR, PLR, and MLR at diagnosis. Secondary outcomes included associations of tumor, node, metastasis (TNM) staging, and smoking with NLR, PLR, and MLR at diagnosis. Results: We identified 353 patients with a first diagnosis of LC. The mean age ± SD at the time of diagnosis was 68.1 ± 9.1 years. Most patients were male (77.9%, n = 275) and current or ex-smokers (58.1%, n = 205, and 39.1%, n = 138, respectively). Histological diagnosis was non-small-cell lung cancer (NSCLC), small-cell lung cancer (SCLC), and not otherwise specified (NOS) in 67.1% (n = 237), 29.8% (n = 105), and 3.1% (n = 11) of patients, respectively. Adenocarcinoma NSCLC was more common (40.2%, n = 142) compared to squamous NSCLC (25.5%, n = 90). In 12.9% of patients, we identified EGFR, KRAS, ALK, or BRAF molecular driver mutations, while PD-L1 expression was positive in 20.7% of patients. The majority of enrolled patients presented with advanced stage IV LC at diagnosis (63.2%, n = 223). Kaplan–Meier curves showed that patients with higher than the median NLR and PLR at diagnosis were associated with significantly higher mortality risk compared to those with lower than the median [HR: 0.58, (95% CI: 0.42 to 0.81) p = 0.0009 and HR: 0.71, (95% CI: 0.53 to 0.95) p = 0.02, respectively], while no differences in mortality risk were observed between patients with higher versus lower than the median MLR [HR: 0.84, (95% CI: 0.63 to 1.12) p = 0.22]. With regard to secondary outcomes, no associations between higher versus lower than the median NLR, PLR, or MLR values and TNM staging [4.0 (95% CI: 4.0–4.0) vs. 4.0 (95% CI: 4.0–4.0), p = 0.95, 4.0 (95% CI: 4.0–4.0) vs. 4.0 (95% CI: 4.0–4.0), p = 0.09, 4.0 (95% CI: 4.0–4.0) vs. 4.0 (95% CI: 4.0–4.0), p = 0.4, respectively], as well as smoking status [70 (95% CI: 60–80) vs. 80 (95% CI: 60–80), p = 0.10, 70 (95% CI: 60–80) vs. 80 (95% CI: 60–80), p = 0.46, 80 (95% CI: 60–80) vs. 70 (95% CI: 60–80), p = 0.96, respectively] were reported. Conclusions: NLR and PLR could serve as reliable and clinician-friendly prognosticators of clinical outcomes in patients with LC. Further validation cohorts are sorely needed to prove this notion. Full article

Diabetic macular edema (DME) is a leading cause of vision loss in patients with diabetes. While VEGF-driven vascular permeability is central to its pathogenesis, inflammation plays a complementary and pivotal role in disease progression, morphological heterogeneity, and treatment response. Readily available blood cell-derived inflammatory indices, such as the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammation index (SII), monocyte-to-high-density lipoprotein cholesterol ratio (MHR), monocyte-to-lymphocyte ratio (MLR), platelet-to-neutrophil ratio (PNR), and pan-immune-inflammation value (PIV), as well as platelet measures (MPV, PDW), have been investigated as low-cost markers of systemic inflammation in DME. Specifically, comparative studies have reported that an NLR ≥ 2.26 can effectively distinguish DME from non-DME with 85% sensitivity and 74% specificity. Elevated NLR is more associated with serous retinal detachment. Moreover, a baseline NLR ≤ 2.32 has been linked to a better anatomical response to treatment. This narrative review summarizes the evidence regarding these biomarkers’ diagnostic and prognostic utility and highlights their associations with OCT morphotypes and anti-VEGF responsiveness. We propose that multi-marker panels integrated with OCT features may enhance risk stratification and help personalize therapy, but emphasize that prospective, multi-center validation and harmonized thresholds are required before routine clinical application. Full article