Alonzo-García CJ, García-Jiménez ES, Martínez-Villaseñor E, Flores-Mendoza JF, Zaragoza-Scherman F, Briones-Govea D, López-Cota GA, Rivera-Espíritu HJ, Schmidt-Ramírez A, Velarde-Ruiz VJA

Language: Spanish
References: 12
Page: 84-88
PDF size: 554.67 Kb.

ABSTRACT

Introduction. Cirrhosis of the liver (CL) creates an immunocompromise causing deregulation of macrophages and monocytes. The lymphocyte-monocyte (LMI), and neutrophil-lymphocyte (NLI) indexes have been described as indicators of systemic inflammatory response and mortality. Thus, defining the objective of determining the capacity of LMI and NLI to predict mortality and infection on patients with decompensated CL.
Material and Methods. 194 patients with decompensated CL from June 2016 to June 2018 in our center were included. As cut-off points for LMI ‹2.1, and NLI 1.9, 4 and 6.8 as risk markers of mortality and infection.
Results. 71 patients died (43 with LMI ‹2.1 and 18 with LMI ›2.1; 56 with NLI 1.9, 5 with NLI ‹1.9; 45 with NLI 4. 16 with NLI ‹4; 39 with NLI 6.8 and 22 with LNI ‹6.8), and 133 patients survived (83 with LMI ‹2.1 and 50 with LMI ›2.1; 128 with NLI 1.9, 5 with NLI ‹1.9; 93 with NLI 4, 40 with NLI ‹4; 67 with NLI 6.8), 66 with NLI‹6.8. There was no difference in the number of outcomes according to the LMI nor the NLI.
Discussion. The LMI and NLI have been described as in association to mortality and infection on patients with CL. In our study, it was determined that there is no association to mortality.

REFERENCES

1. Shah VH, Kamath PS. Portal Hypertension and Gastrointestinal Bleeding. En: Feldman M, Friedman L, Brandt L, editores. Sleisenger And Fordtran's Gastrointestinal And Liver Disease: Pathophysiology, Diagnosis and Management : vol.1. 9ª Ed. E.U.A: Saunders Elsevier, 2010: 1489- 1516.

2. 2.Tsochatzis EA, Bosch J, Burroughs AK. Liver cirrhosis. Lancet 2014; 383: 1749–61

3. 3.European Association for the Study of the Liver. EASL Clinical Practice Guidelines for the management of patients with decompensated cirrhosis. 2018; 1-55.

4. 4.Cai YJ, Dong JJ, Dong JZ, Chen Y, Lin Z, Song M, et al. A nomogram for predicting prognostic value of inflammatory responsebio markersin decompensated cirrhotic patients without acute-onchronic liver failure. Aliment Pharmacol Ther, 2017: 1-14.

5. 5.Philips CA, Sarin SK. Sepsis in cirrhosis: emerging conceptsin pathogenesis, diagnosis and management. Hepatol Int, 2016: 1-12.

6. 6.Porrata LF, Inwards DJ, Ansell SM, Micallef IN, Johnston PB, Hogan WJ, et al. Day 100 peripheral blood absolute lymphocyte/ monocyte ratio and survival in classical Hodgkin's lymphoma postautologous peripheral blood hematopoietic stem cell transplantation. Bone Marrow Res 2013.

7. 7.Li ZM, Huang JJ, Xia Y, Sun J, Huang Y, Wang Y, et al. Blood lymphocyte–tomonocyte ratio identifies high-risk patients in diffuse large B-cell lymphoma treated with R-CHOP. PLoS One 2012.

8. 8.Li J, Jiang R, Liu WS, Liu Q, Xu M, Feng QS, et al. A large cohort study reveals the association of elevated peripheral blood lymphocyte–tomonocyte ratio with favorable prognosis in nasophar- yngeal carcinoma. PLoS One 2013.

9. Freeman RB Jr, Wiesner RH, Harper A, McDiarmid SV, Lake J, Edwards E, et al. The new liver allocation system : movingtowardevidence-based transplantation policy. Liver Transpl 2002; 8:851–858

10. 10.Zhu S, Waili Y, Qi XT, Chen YM, Lou Y. Lymphocyte–monocyte ratio at admission predicts possible outcomes in patients with acute-on-chronic liver failure. European Journal of Gastroenterology & Hepatology 2016, 00: 1-5

11. 11.Zhang J, Feng G, Zhao Y, Zhang J, Feng L, Yang J. Association between lymphocyte-to-monocyte ratio (LMR) and the mortality of HBV- related liver cirrhosis: a retrospective cohort study. BMJ Open 2015; 5

12. 12.Rice J, Dodge J, Bambha K, Bajaj JS, Rajender Reddy K, Gralla J, et al. Neutrophil-to-Lymphocyte Ratio Associates Independently With Mortality in Hospitalized Patients With Cirrhosis. Clinical Gastroenterol Hepatol. 2018.