Search Results (88)

Background/Objectives: Inflammation-based markers have emerged as potential prognostic tools in hepatocellular carcinoma (HCC), but comparative data with classical prognostic factors in untreated HCC are limited. This study aimed to evaluate and compare the prognostic performance of inflammatory and conventional markers using Harrell’s concordance index (C-index). Methods: This retrospective study included 250 patients with untreated HCC. Prognostic variables included age, BCLC stage, Child–Pugh classification, Milan criteria, MELD score, AFP, albumin, Charlson comorbidity index, and the inflammation-based markers neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), Systemic Inflammation Response Index (SIRI), and Systemic Immune-inflammation Index (SIII). Survival was analyzed using Cox regression. Predictive performance was assessed using the C-index, Akaike Information Criterion (AIC), and likelihood ratio tests. Results: Among the classical markers, BCLC showed the highest predictive performance (C-index: 0.717), while NLR ranked highest among the inflammatory markers (C-index: 0.640), above the MELD score and Milan criteria. In multivariate analysis, NLR ≥ 2.3 remained an independent predictor of overall survival (HR: 1.787; 95% CI: 1.264–2.527; p < 0.001), along with BCLC stage, albumin, Charlson index, and Milan criteria. Including NLR in the model modestly improved the C-index (from 0.781 to 0.794) but significantly improved model fit (Δ–2LL = 10.75; p = 0.001; lower AIC). Conclusions: NLR is an accessible, cost-effective, and independent prognostic marker for overall survival in untreated HCC. It shows discriminative power comparable to or greater than most conventional predictors and may complement classical stratification tools for HCC. Full article

Background/Objectives: Acute pancreatitis (AP) is a highly variable inflammatory condition that can lead to severe complications and high mortality, particularly in its severe forms. Early risk stratification is essential; however, the delayed availability of traditional scoring systems often limits its effectiveness. This study aimed to evaluate the clinical utility of systemic inflammation indices as early predictors of severity in patients with acute pancreatitis. Methods: A retrospective, observational study was conducted among patients diagnosed with acute pancreatitis, classified according to the revised Atlanta criteria. Upon admission, systemic inflammation indices were calculated from complete blood count parameters, including neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), systemic immune-inflammation index (SII), systemic inflammation response index (SIRI), and aggregate index of systemic inflammation (AISI). Severity was assessed using the APACHE II score. Statistical analysis involved Kruskal–Wallis tests, Dunn’s post hoc comparisons, ROC curve analysis, logistic regression for odds ratios (ORs), and Spearman correlations. Results: SII, NLR, MLR, SIRI, and AISI showed statistically significant associations with AP severity (p < 0.05). MLR and SIRI exhibited the highest predictive performance (AUC = 0.74). ORs for severe pancreatitis were: MLR = 19.10, SIRI = 7.50, NLR = 7.33, AISI = 5.12, and SII = 4.10. All four indices also demonstrated moderate positive correlations with APACHE II scores. Conclusions: Systemic inflammation indices are simple, cost-effective, and accessible tools that can aid in the early identification of patients at high risk for severe acute pancreatitis. Their integration into clinical practice may enhance early decision-making and improve patient outcomes. Full article

Background/Objectives: Non-pancreatic hyperlipasemia (NPHL) is associated with high in-hospital mortality, with sepsis being one of the most common etiologies. The prognostic value of hematological parameter-derived inflammatory scores has not been extensively studied in NPHL to date. Methods: The prognostic value of eight inflammatory scores for in-hospital mortality was assessed in a total of 545 NPHL patients from two hospitalized patient cohorts (COVID-19 [n = 144] and non-COVID-19 [n = 401], the latter stratified as bacterial sepsis [n = 111] and absence of systemic infection [n = 290]). We assessed the neutrophil-to-lymphocyte ratio (NLR), derived NLR (dNLR), neutrophil-to-lymphocyte and platelet ratio (N/(LP)), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), aggregate index of systemic inflammation (AISI), systemic inflammation index (SII), and systemic inflammation response index (SIRI), comparing their prognostic value among etiological groups. Results: Patients with bacterial sepsis were older, had more comorbidities, and experienced worse outcomes, including longer hospitalization (median: 15, 7, and 11 days; p < 0.001), higher ICU admission rates (75.7%, 33.8%, and 47.9%, p < 0.001), and increased mortality (45.0%, 13.8%, and 38.2%, p < 0.001), compared to those without systemic infection or with COVID-19-induced NPHL. Overall, NLR, dNLR, and N/(LP) were the most accurate predictors of in-hospital mortality at admission (AUROC: non-infection: 0.747; 0.737; 0.772; COVID-19: 0.810; 0.789; 0.773, respectively). The accuracy of NLR decreased in bacterial sepsis, and only N/(LP) and PLR remained associated with in-hospital mortality (AUROC: 0.653 and 0.616, respectively). Conclusions: The prognostic performance of hematological parameter-derived inflammatory scores in NPHL is etiology-dependent. NLR is the most accurate prognostic tool for mortality in the absence of bacterial sepsis, while N/(LP) is the best score in sepsis-induced NPHL. Full article

Background: Systemic inflammatory markers have emerged as accessible and reproducible tools for oncologic risk stratification, yet their prognostic value in rectal cancer remains incompletely defined, particularly in acute surgical settings. This study aimed to assess six inflammation-based indices—NLR, PLR, MLR, SII, SIRI, and AISI—in relation to tumor stage, recurrence, and outcomes among patients undergoing emergency versus elective resection for rectal cancer. Methods: We retrospectively evaluated 174 patients treated between 2018 and 2024. Pre-treatment blood counts were used to calculate inflammatory indices. Clinical and pathological parameters were correlated with biomarker levels using univariate and multivariate analyses. Results: Pre-treatment inflammation markers were significantly elevated in patients requiring emergency surgery (e.g., NLR: 3.34 vs. 2.4, p = 0.001; PLR: 204.1 vs. 137.8, p < 0.001; SII: 1008 vs. 693, p = 0.007), reflecting advanced tumor biology and immune activation. Notably, these patients also had higher rates of stage IV disease (p = 0.029) and permanent stoma (p = 0.002). Post-treatment, recurrence was paradoxically associated with significantly lower levels of SII (p = 0.021), AISI (p = 0.036), and PLR (p = 0.003), suggesting a potential role for immune exhaustion rather than hyperinflammation in early relapse. Conclusions: Inflammatory indices provide valuable insights into both tumor local invasion and host immune status in rectal cancer. Their integration into perioperative assessment could improve prognostication, particularly in emergency presentations. Post-treatment suppression of these markers may identify patients at high risk for recurrence despite initial curative intent. Full article

Background/Objectives: Anorexia nervosa (AN) is a chronic eating disorder with the highest mortality rate among psychiatric conditions. Malnutrition and starvation lead to long-term impairments in metabolic processes, hormonal regulation, and immune function, offering potential diagnostic and prognostic value. This study aimed to identify immune–metabolic–hormonal markers associated with treatment response and nutritional rehabilitation. Methods: Fifty hospitalized female patients with AN were included. Anthropometric measurements and venous blood samples were collected at admission and discharge, following partial nutritional recovery. Blood analyses included complete blood count, serum levels of total cholesterol, LDL and HDL, triglycerides, glucose, NT-pro-BNP, TSH, free thyroxine (fT4), sodium, chloride, potassium, calcium, iron, and vitamin D. Composite immune-inflammatory indices calculated were neutrophil-to-lymphocyte (NLR), monocyte-to-lymphocyte (MLR), platelet-to-lymphocyte (PLR); neutrophil-to-high-density lipoprotein (NHR), monocyte-to-high-density lipoprotein (MHR), platelet-to-high-density lipoprotein (PHR) and lymphocyte-to-high-density lipoprotein (LHR) ratios; systemic immune-inflammation (SII), and systemic inflammation response (SIRI) indexes. Results: Responders (R) and non-responders (NR) differed significantly at baseline in levels of sodium, chloride, fT4, monocyte count, MCV, NLR, MLR, SII, and SIRI (all: R < NR; p < 0.05). Predictive ability for treatment response was confirmed by AUC values (95%CI): sodium = 0.791 (0.622–0.960), chloride = 0.820 (0.690–0.950), fT4 = 0.781 (0.591–0.972), monocytes = 0.785 (0.643–0.927), MCV = 0.721 (0.549–0.892), NLR = 0.745 (0.578–0.913), MLR = 0.785 (0.643–0.927), SII = 0.736 (0.562–0.911), SIRI = 0.803 (0.671–0.935). The lower levels of inflammation and chloride are particularly predictive of better nutritional recovery, accounting for 26% of the variability in treatment response. Conclusions: The study demonstrated important insights into the hematological, metabolic, hormonal, and immune-inflammatory mechanisms associated with nutritional recovery in AN. Full article

Background/Objectives: Nonvalvular atrial fibrillation (NVAF) is a prevalent arrhythmia associated with elevated risks of stroke, systemic embolism, and mortality. Emerging evidence underscores the pivotal role of inflammation in NVAF pathogenesis. The CHA₂DS₂-VA score is currently the most powerful tool used in the management of patients with atrial fibrillation, and integrating novel inflammatory biomarkers—neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammation index (SII), and systemic inflammation response index (SIRI)—into this score may enhance prognostic accuracy and guide personalized therapy. Methods: In this observational case–control study, a cohort of 330 NVAF patients and 201 controls, inflammatory and biochemical parameters were measured and compared, we employed multivariate logistic regression and ROC analyses to validate the discriminative power of novel inflammatory indexes and novel CHA₂DS₂-VA score, setting a new benchmark for biomarker integration in NVAF management. Results: Inflammatory indexes (NLR, PLR, SII, SIRI) were significantly higher in NVAF patients compared to controls (p < 0.001). Multivariate analysis identified NLR (OR = 4.02), PLR (OR = 1.04), SII (OR = 1.01), and SIRI (OR = 1.87) as independent NVAF risk markers. The CHA₂DS₂-VA score showed the strongest association with NVAF (OR = 5.55), and an optimal cutoff of ≥2 yielded 88.18% sensitivity and 74.63% specificity. Conclusions: Inflammatory markers NLR, PLR, SII, and SIRI, when assessed alongside the CHA₂DS₂-VA score, offer significant and complementary prognostic insight for patients with NVAF. These findings support the integration of inflammatory indexes into routine clinical risk assessment models to enhance early identification of high-risk individuals and inform personalized therapeutic strategies. Moreover, our findings provide a rationale for developing composite risk scores in future studies that integrate inflammatory biomarkers with the CHA₂DS₂-VA score (e.g., a CHA₂DS₂-VA-Inflammation Score). Further large-scale, longitudinal studies are warranted to validate these results and explore the benefits of inflammation-targeted interventions. 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

Background: Coronary artery disease (CAD) is a leading global cause of mortality. The role of calcium (Ca), a key metabolic and structural element, in atherosclerosis and inflammation remains unclear. Ca influences immune cell function and is a component of atherosclerotic plaques. Hair analysis reflects long-term mineral exposure and may serve as a non-invasive biomarker. Objectives: This pilot study aimed to investigate the association between hair Ca levels and acute coronary syndrome (ACS), and to evaluate correlations with the Systemic Inflammatory Index (SII), Systemic Inflammatory Response Index (SIRI), and selected CAD risk factors. Methods: Ca levels were measured in hair samples from patients undergoing coronary angiography for suspected myocardial infarction. Associations with ACS diagnosis, Syntax score, SII, SIRI, and CVD risk factors were analyzed. Results: Serum calcium levels were not significantly associated with the presence of acute coronary syndrome (ACS) (p = 0.392) or with its clinical subtypes, including ST-elevation myocardial infarction (STEMI), non-ST-elevation myocardial infarction (NSTEMI), and unstable angina (UA) (p = 0.225). Diagnosis of ACS was linked to higher SII (p = 0.028) but not SIRI (p = 0.779). Ca levels correlated negatively with Syntax score (R = −0.19, p = 0.035) and SII (R = −0.22, p = 0.021) and positively with HDL-C (R = 0.18, p = 0.046). Conclusions: Hair calcium content may reflect subclinical inflammation and CAD severity. Although no direct link to ACS was observed, the associations with SII, HDL-C, and Syntax score suggest a potential diagnostic role which should be further explored in larger, well-controlled studies. Full article

Objective: This study aimed to investigate the prognostic value of two novel systemic inflammatory indices—the Aggregate Systemic Inflammation Index (AISI) and the Systemic Inflammatory Response Index (SIRI)—in predicting preterm delivery and associated neonatal outcomes. Methods: A retrospective, descriptive, cross-sectional study was conducted using the electronic health records of 1056 pregnant women admitted to a tertiary university hospital between 2020 and 2025. Pregnancies were classified into preterm (n = 528) and term (n = 528) groups. Demographic, obstetric, neonatal, and laboratory data were analyzed. Results: The AISI and SIRI values in the first trimester and at admission were significantly higher in the preterm delivery group than in the term delivery group (p < 0.001). Elevated AISI and SIRI levels correlated with lower 1st- and 5th-minute APGAR scores (p < 0.001) and higher neonatal intensive care unit (NICU) admission rates (35.8% vs. 4.5%; p < 0.001). The AISI cut-offs were 399.2 for preterm delivery (59.7% sensitivity, 59.8% specificity), 558.8 for NICU admission (79.3% sensitivity, 79.2% specificity), 694.0 for RDS (87.8% sensitivity, 87.8% specificity), 602.1 for sepsis (79.6% sensitivity, 79.2% specificity), and 753.8 for congenital pneumonia (81.6% sensitivity, 81.9% specificity). The SIRI cut-offs were 1.7 for preterm delivery (59.1% sensitivity, 58.9% specificity), 2.4 for NICU admission (81.7% sensitivity, 81.6% specificity), 3.1 for RDS (89.0% sensitivity, 89.5% specificity), 3.0 for sepsis (85.8% sensitivity, 85.7% specificity), and 3.4 for congenital pneumonia (85.7% sensitivity, 83.8% specificity). Conclusions: The AISI and SIRI showed significant predictive utility for neonatal morbidity in preterm delivery. The use of these markers in clinical practice may improve neonatal outcomes by enhancing the early diagnosis and management of high-risk pregnancies. Full article

Background and Objectives: Despite developments in cervical cancer (CC) treatment, an advanced stage is a poor prognostic factor. Cervical cancer is an immunogenic tumor in which viruses, like HPV, play a role in carcinogenesis. Therefore, systemic inflammatory markers (SIMs) may have prognostic value. Most studies on SIMs focus on the early stage by evaluating pretreatment levels. This study aims to evaluate the prognostic and predictive values of both pretreatment and post-treatment parameters at the advanced stage, as well as treatment efficacy after progression with first-line treatment. Materials and Methods: A total of 133 advanced-stage CC patients with progression on first-line platin–paclitaxel and bevacizumab were evaluated retrospectively. Demographic and histopathological characteristics were recorded along with treatment details. Pre-treatment baseline blood parameters and post-treatment follow-up values were recorded to calculate SIMs as the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammation index (SII), and systemic inflammatory response index (SIRI). Results: Median values for SIMs were accepted as cut-off values. Post-treatment values demonstrated stronger predictive power, with pre-treatment SIRI and NLR being significant only in univariate analysis, but not in multivariate analysis. High post-treatment SIRI (>2.1) was correlated with shorter overall survival (OS) and considered a poor prognostic factor. High post-treatment SIRI (>2.1), -SII (>746), and -PLR (>197) emerged as independent prognostic factors for progression-free survival (PFS). Their prognostic values were clearer in the whole population and the metachronous metastatic subgroup. Rechallenge of platinum-based chemotherapy was an option for those who had at least 6 months of PFS with first-line platinum-based chemotherapy. Bevacizumab addition to single-agent or combination regimens led to improved ORR as well. Conclusions: Post-treatment SIRI is a promising prognostic factor for OS, while post-treatment SIRI, SII, and PLR may serve as convenient SIMs for PFS. Platinum-based combination chemotherapy reinduction is a feasible second-line treatment strategy, especially with the addition of bevacizumab. Full article

Background: Myocardial infarction complicated by cardiogenic shock (MI-CS) remains a critical condition with high mortality rates, despite advances in treatment. Systemic inflammation plays a significant role in MI-CS progression; however, its dynamics across different stages of the Society for Cardiovascular Angiography and Interventions (SCAI) classification remain poorly understood. This study aimed to evaluate indices of systemic inflammation—neutrophil–lymphocyte ratio (NLR), platelet–lymphocyte ratio (PLR), systemic immune-inflammation index (SII), systemic inflammation response index (SIRI), and aggregate index of systemic inflammation (AISI)—in MI-CS patients, correlating them with SCAI stages and survival outcomes. Methods: A single-center retrospective study included 132 patients with MI-CS, categorized into SCAI stages A–E. All patients were assessed for demographic, clinical, and laboratory data, procedural and treatment characteristics, MI timing, and outcomes. Complete blood count test data were used to calculate inflammatory indices and evaluate types of immune reactions. Results: PLR, SII, and AISI peaked at SCAI stage C and declined significantly at stage E, suggesting suppressed inflammation in advanced shock. SIRI emerged as a key prognostic marker for stage C patients, with elevated levels associated with larger infarct size, higher heart rate, and predominant innate immune activation. Patients with SIRI ≥ 3.34 had significantly lower two-year survival (log-rank test, p = 0.006). Conclusions: Inflammation indices, particularly SIRI, provide valuable prognostic insights in MI-CS, reflecting disease severity and heterogeneity of immune response. The decline in inflammatory indices at SCAI stage E may indicate immune suppression in extreme MI-CS, underscoring the need for personalized therapeutic strategies. Full article

Objective: This study aimed to evaluate the prognostic utility of systemic inflammatory markers, such as the Systemic Immune-Inflammation Index (SII), Systemic Inflammatory Response Index (SIRI), Neutrophil–Lymphocyte Ratio (NLR), Monocyte–Lymphocyte Ratio (MLR), and Platelet–Lymphocyte Ratio (PLR), to identify patients at risk of developing surgically treated postpericardiotomy syndrome (PPS). Methods: A total of 150 patients were retrospectively analyzed. In total, 75 patients who developed postpericardiotomy syndrome requiring surgical drainage constituted the postpericardiotomy group, whereas 75 age- and surgically matched non-PPS patients served as the control group. Blood samples were collected at four time points: preoperative (T1), 24 h postoperative (T2), 7 days postoperative (T3), and 24 h before secondary intervention in the PPS group and the closest matched outpatient follow-up (T4) in the control group. Inflammatory marker values were compared within and between the groups at the four defined time points. Logistic regression and receiver operating characteristic (ROC) analyses were used to determine the diagnostic and predictive accuracy of each marker. Results: Significant increases in the SIRI, MLR, and CRP levels were observed in patients who developed PPS and required surgical intervention. MLR on postoperative day 7 had the highest sensitivity (84%) with a cut-off of 0.575, whereas SIRI demonstrated the highest specificity (81.3%) at a cut-off of 3.34. SII increased significantly only in the late stage, indicating disease progression. The NLR lacked predictive power across all time points. Conclusions: The SIRI and MLR are promising early-stage biomarkers for identifying patients at high risk of developing PPS. Their integration into routine postoperative follow-up could facilitate earlier diagnosis and reduce surgical burden. A multi-marker approach may enhance the diagnostic precision of PPS beyond that of traditional inflammatory measures. Full article

Background/Objectives: The early detection of high levels of CBC-derived inflammatory biomarkers and cellular lines, as well as their variations across different histological subtypes of lung cancer, may aid in the early identification of high-risk lung cancer patients and further guide their clinical approach. Methods: A retrospective descriptive study was conducted and included 202 patients diagnosed with lung carcinoma at the Clinical County Hospital Mureș. The main analyzed parameters were the histological subtype and the stage of the tumor at diagnosis, white blood cell counts, and platelet counts, as well as nine CBC-derived inflammatory indexes like neutrophil-to-lymphocyte ratio (NLR), derived neutrophil-to-lymphocyte ratio (d-NLR), monocyte-to-lymphocyte ratio (MLR), platelet-to-lymphocyte ratio (PLR), eosinophil-to-neutrophil ratio (ENR), eosinophil-to-monocyte ratio (EMR), systemic inflammatory index (SII), systemic inflammatory response index (SIRI), and aggregate index of systemic inflammation (AISI). The statistical analysis was performed using the MedCalc software, version 23.0.2. Logarithmic ANOVA was used to compare groups. Normality was tested using the Shapiro–Wilk test. The Chi-square test compared categorical variables, while the independent Mann-Whitney test was used for continuous variables. Results: The inflammatory response increased as disease severity progressed, with NSCLC-NOS being the histological subtype with the most numerous patients outside the normal ranges. Eosinophil count differed significantly across the histologic subtypes of NSCLC, with adenocarcinoma and adenosquamous patients exhibiting the highest values. In adenocarcinoma patients, we observed that NLR and MLR levels increased progressively as the tumor stage advanced. Based on severity, differences were observed across the histological subtypes of lung cancer in stage III patients for ENR, EMR, AISI, eosinophil count, and platelet count, as well as in stage IV patients for AISI, SIRI, and SII. Disease severity impacts the associated inflammatory response in all histologic subtypes of lung cancer to varying degrees. Conclusions: Histological subtype might have a decisive role in shaping the systemic inflammatory profile of lung cancer patients. CBC-derived indices serve as accessible, cost-effective biomarkers for early risk assessment, aiding in the prognosis evaluation and monitoring of therapeutic response. Future studies are needed to further evaluate the histology-specific inflammatory profiles as adjunctive tools in precision oncology. Full article

Background: Immune checkpoint inhibitors (ICIs) used for the treatment of advanced melanoma have yielded significant results, with long-term responses and improved survival rates, but not for all treated patients. Therefore, predictive biomarkers of response to ICI therapy have been intensively explored. Our study aimed to evaluate the dynamics of peripheral blood lymphocyte variation and their correlation with a set of related inflammatory factors in Nivolumab-treated advanced melanoma patients. Methods: The immunophenotypic assessment of peripheral blood immune cell subpopulations (CD3⁺, CD4⁺, and CD8⁺ T cells; CD19⁺ B cells; CD16⁺CD56⁺ NK cells; and CD4⁺/CD8⁺ ratio) was performed by the flow cytometry technique, concomitantly with a complete blood count; levels of S100, IL-6, and TNF-α proteins were quantified in serum by immunoassays, and lactate dehydrogenase (LDH) by a chemiluminescence assay. Results: Approximately 85% and 79% of patients recorded a trend of increasing levels of CD8⁺ lymphocytes and NK cells, respectively, during therapy. The percentage of NK cells negatively correlated with CD3⁺, CD4⁺, and CD19⁺ cells; the last three cell populations also established negative correlations with the inflammatory neutrophile/lymphocyte ratio (NLR). Furthermore, CD19⁺ cells were negatively correlated with the systemic inflammatory response index (SIRI) and systemic immune-inflammation index (SII). The evaluation of progression biomarkers showed that LDH levels directly correlated with IL-6 and S100 proteins, but no correlation was found with TNFα; IL-6 levels negatively correlated with percentages of CD3⁺, CD4⁺, and CD8⁺ lymphocytes. Conclusions: Variation in lymphocyte subpopulations during immunotherapy of advanced melanoma patients, associated with other cellular and/or molecular inflammatory markers, might provide insights about immune system response, but additional prospective studies are needed. Full article

Background: Transient tachypnea of the newborn (TTN) is traditionally viewed as a disorder of delayed lung fluid clearance, but emerging evidence suggests inflammatory involvement. Aim: This study investigated systemic inflammatory indices [(systemic immune-inflammation index (SII-i), systemic inflammation response index (SIR-i), neutrophil-to-lymphocyte ratio (NL-r), and platelet-to-lymphocyte ratio (PL-r)] and underlying mechanisms in TTN pathogenesis for the first time. Methods: This retrospective case–control study included 199 neonates (123 with TTN and 76 healthy controls) admitted between 2022 and 2025 to a tertiary care hospital. Complete blood count parameters were collected within the first two hours of life. Inflammatory indices were calculated and compared between groups. Subgroup analyses were conducted based on gestational age (late preterm vs. term) and mode of delivery (cesarean vs. vaginal). Results: Although not statistically significant, TTN infants showed a trend toward higher inflammatory indices with median NL-r (2.54 vs. 1.75, p = 0.197) and SII-i (729,307.83 vs. 373,593.50, p = 0.276). Term TTN infants had higher NL-r (3.08 vs. 2.04, p = 0.022) and SII-i (729,147.74 vs. 538,928.30, p = 0.133) than late preterm infants. SIR-i and NL-r values were higher in the full-term group than in the early-term and late-preterm groups (p = 0.014, p = 0.022, respectively). Cesarean births showed higher NL-r (3.20 vs. 2.33, p = 0.049) and SII-i (p = 0.040) than vaginal deliveries. Strong correlations existed between SII-I, NL-r (r = 0.886, p < 0.01), and SII-i, SIR-i (r = 0.817, p < 0.01). Conclusions: Elevated inflammatory indices in neonates with TTN, particularly in term infants and those delivered vaginally, suggest a supportive/potential role for systemic inflammation in TTN pathophysiology. These markers may serve as potential supplementary markers for risk stratification, though further prospective validation is required to confirm their clinical relevance. These findings suggest that the early assessment of systemic inflammatory indices may assist clinicians in identifying neonates at risk for TTN, thereby guiding initial respiratory support strategies. Full article