Neutrophil-to-lymphocyte ratio at diagnosis as a biomarker for survival of amyotrophic lateral sclerosis

The neutrophil-to-lymphocyte ratio (NLR) has previously been reported to be associated with survival in ALS. To provide further information about the role of NLR as a biomarker in ALS, we performed a systematic review, analyzed data from our local cohort of ALS subjects and performed a meta-analysis. (1) The systematic review used established methods. (2) Using data from our cohort of subjects, we analyzed the association of NLR with survival. (3) Meta-analysis was performed using previous studies and our local data. (1) In the systematic review, higher NLR was associated with shorter survival in all studies. (2) In our subjects, survival was significantly shorter in patients in the highest NLR groups. (3) Meta-analysis showed subjects with highest NLR tertile or with NLR >3 had significantly shorter survival than other subjects. This study supports NLR as a biomarker in ALS; high NLR is associated with poor survival.中性粒细胞与淋巴细胞比值（neutrophil-to-lymphocyte ratio, NLR）此前已有研究报道其与肌萎缩侧索硬化症（Amyotrophic Lateral Sclerosis, ALS）的生存预后相关。为进一步明确NLR作为ALS生物标志物的作用，本研究开展了系统综述、分析了本中心ALS患者队列的临床数据，并完成了荟萃分析。(1) 本次系统综述采用了公认的标准化研究方法。(2) 基于本中心患者队列数据，本研究分析了NLR水平与患者生存预后的关联。(3) 本研究整合既往研究数据与本中心队列数据，开展了荟萃分析。系统综述结果显示，所有纳入研究均表明较高的NLR水平与更短的生存时长显著相关。(1) 在本中心患者队列中，NLR水平最高组的患者生存时长显著更短。(2) 荟萃分析结果显示，处于NLR最高三分位组或NLR＞3的受试者，其生存时长显著低于其他受试者。本研究支持NLR作为ALS的生物标志物，高水平NLR与不良生存预后相关。