An evaluation of the neutrophil-to-lymphocyte ratio as a prognostic and predictive marker in thromboangiitis obliterans

Aim: The aim of this study was to investigate whether the neutrophil/lymphocyte ratio is an independent predictor of poor prognosis, mortality, co-morbidities, critical limb ischmemia, amputation, or a potential prognostic biomarker predicting pathological and survival outcomes in thromboangiitis obliterans. We also investigated whether there was any relation between an increased neutrophil/lymphocyte ratio in patients with Buerger’s disease and amputation, the ultimate outcome of poor prognosis.Material and Methods: The hospital records of patients treated, followed-up and diagnosed with thromboangiitis obliterans were analyzed retrospectively. Surgical procedures performed and medical treatments applied were recorded from patients’ clinical data. Extremities exposed to the disease during its course were identified. Amputations were recorded as minor and major. Neutrophil and lymphocyte values were recorded from peripheral blood samples at time of first presentation to hospital, with the neutrophil/ lymphocyte ratio being calculated from these. One hundred ten subjects were finally enrolled as the patient group (TAO; n=110). A control group (n=49) was established consisting of smoker volunteers with no health problems. Statistical changes in neutrophil/lymphocyte ratio values between the groups were investigated.Results: No statistically significant difference was observed between the two groups’ basic characteristics. In terms of neutrophil/ lymphocyte ratio values, a statistically significant increase was observed in the patient group compared to the control group. We observed no statistical correlation between amputations and neutrophil/lymphocyte ratio values.Conclusions: We think that the neutrophil / lymphocyte ratio, obtained easily and cheaply from routine peripheral blood samples, may be of clinical benefit in thromboangiitis obliterans.

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Miao Y, Yan Q, Li S, Li B, Feng Y. Neutrophil to lymphocyte ratio and platelet to lymphocyte ratio are predictive of chemotherapeutic response and prognosis in epithelial ovarian cancer patients treated with platinum-based chemotherapy. Cancer Biomark 2016;17(1):33-40.
Yodying H, Matsuda A, Miyashita M, Matsumoto S, Sakurazawa N, Yamada M, et al. Prognostic significance of neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio in oncologic outcomes of esophageal cancer: A systematic review and meta-analysis. Ann Surg Oncol 2016;23(2):646-54.
Zou ZY, Liu HL, Ning N, Li SY, Du XH, Li R. Clinical significance of pre-operative neutrophil lymphocyte ratio and platelet lymphocyte ratio as prognostic factors for patients with colorectal cancer. Oncol Lett 2016;11(3):2241-8.
Zadora P, Dabrowski W, Czarko K, Smolen A, KotlinskaHasiec E, Wiorkowski K, et al. Preoperative neutrophillymphocyte count ratio helps predict the grade of glial tumor-a pilot study. Neurol Neurochir Pol 2015;49(1):41-4.
Wang X, Zhang G, Jiang X, Zhu H, Lu Z, Xu L. Neutrophil to lymphocyte ratio in relation to risk of all-cause mortality and cardiovascular events among patients undergoing angiography or cardiac revascularization: a meta-analysis of observational studies. Atherosclerosis 2014;234(1):206-13.
Arbel Y, Finkelstein A, Halkin A, Birati EY, Revivo M, Zuzut M, et al. Neutrophil / lymphocyte ratio is related to the severity of coronary artery disease and clinical outcome in patients undergoing angiography. Atherosclerosis 2012;225(2):456-60.
Yüksel İÖ, Köklü E, Arslan Ş, Çağırcı G, Göksu EÖ, Koç P, et al. Association of neutrophil/lymphocyte ratio with plaque morphology in patients with asymptomatic intermediate carotid artery stenosis. Korean Circ J 2016;46(5):699-705.
Kordzadeh A, Malietzis G, Browne T, Prionidis I, Pavayiotopoulos YP. Neutrophil to lymphocyte ratio (NLR) of five predicts 30-day morbidity in ruptured abdominal aortic aneurysms (rAAA): a retrospective cohort study. Int J Surg 2015;15:45-8.
Li H, Zhao D, Diao M, Yang C, Zhang Y, Lv Y, et al. Hyperbaric oxygen treatments attenuate the neutrophil-to-lymphocyte ratio in patients with ıdiopathic sudden sensorineural hearing loss. Otolaryngol Head Neck Surg 2015;153(4):606-12.
Gezer C, Ekin A, Ertas IE, Ozeren M, Solmaz U, Mat E, et al. High first-trimester neutrophil-to-lymphocyte and plateletto-lymphocyte ratios are indicators for early diagnosis of preeclampsia. Ginekol Pol 2016;87(6):431-5.
Chan C, Puckridge P, Ullah S, Delaney C, Spark JI. Neutrophil-lymphocyte ratio as a prognostic marker of outcome in infrapopliteal percutaneous interventions for critical limb ischemia. J Vasc Surg 2014;60(3):661-8.
Dimmick SJ, Goh AC, Cauzza E, Steinbach LS, Baumgartner I, Stauffer E, et al. Imaging appearances of Buerger’s disease complications in the upper and lower limbs. Clin Radiol 2012;67(12):1207-11.
Belaj K, Pichler M, Hackl G, Rief P, Eller P, Hafner F, et al. Association of the derived neutrophil-lymphocyte ratio with critical limb ischemia. Angiology 2016;67(4):350-4.
Erturk M, Cakmak HA, Surgit O, Celik O, Aksu HU, Akgul O, et al. Predictive value of elevated neutrophil to lymphocyte ratio for long-term cardiovascular mortality in peripheral arterial occlusive disease. J Cardiol 2014;64(4):371-6.
Maruyama Y, Inoue K, Mori K, Gorai K, Shimamoto R, Onitsuka T, et al. Neutrophil-lymphocyte ratio and platelet-lymphocyte ratio as predictors of wound healing failure in head and neck reconstruction. Acta Otolaryngol 2017;137(1):106-10.
Arkkila PE. Thromboangiitis obliterans (Buerger’s disease). Orphanet J Rare Dis 2006;1:14.
Hemsinli D, Kaplan ST, Kaplan S, Yildirim F. Hyperbaric oxygen therapy in the treatment of fontaine stage IV thromboangiitis obliterans. Int J Low Extrem Wounds 2016;15(4):336-70.
Zheng JF, Chen YM, Chen DY, Lin CH, Chen HH. The incidence and prevalence of thromboangiitis obliterans in Taiwan: A nationwide, population-based analysis of data collected from 2002 to 2011. Clinics (Sao Paulo) 2016;71(7):399-403.
Guidelli GM, Bardelli M, Fioravanti A Selvi E. Nailfold capillaroscopy in Buerger’s disease: A useful tool? Eur J Rheumatol 2014;1(2):81-3.
Piazza G, Creager MA. Thromboangiitis Obliterans. Circulation 2010;121(6):1858-61.
Rivera-Chavarría IJ, Brenes-Gutiérrez JD. Thromboangiitis obliterans (Buerger’s disease). Ann Med Surg (Lond) 2016;7:79-82.