Bratisl Lek Listy. 2024;125(2):75-83. doi: 10.4149/BLL_2024_012.
For many years, the physicians are searching for easily measurable marker of immune response to the stress and inflammation. More than, 20 years ago Zahorec (2001) proposed neutrophil-to-lymphocyte ratio (NLR) as an easy available and valid biomarker of inflammation, stress, and activation of immune system.
In this narrative review we focused on the utility of neutrophil-to-lymphocyte ratio (Zahorec's index) in clinical practice of general medicine (inflammation and infection), intensive medicine (sepsis), oncology (prediction of prognosis in cancer of solid organs), surgery and perioperative medicine (diagnosis of complications, and prediction of clinical outcome).
We provide many evidences of clinical research which confirm that Neutrophil-to-lymphocyte ratio is a very sensitive marker of inflammation, stress reliable and valid parameter in everyday clinical practice. NLR (Zahorec index) is an effective tool for diagnosis of infection and severity of disease of variable etiologies. NLR reflect the grade of inflammation in cancer disease, which has a significant impact on the prognosis of cancer patients. Zahorec index should be used routinely in emergency medicine, surgery and perioperative medicine as a marker of the severity of affliction, infection, and complications in general. NLR may help physicians in decision making process for early diagnosis and therapy. NLR should be investigated frequently in acute states (sepsis, shock, peritonitis, stroke, trauma) on a daily basis, in subacute states few times per week (during hospital stay), and few times per year in chronic disease (cancer, diabetes mellitus, ischemic heart disease, psychiatry disorders). NLR has a deep biological sense connecting together function of three suprasystems: immune, endocrinne and autonomous nervous system (Tab. 2, Fig. 3, Ref. 86).
多年来，医生一直在寻找一种可衡量的免疫反应标志物，以反映机体对应激和炎症的反应。20 多年前，Zahorec（2001 年）提出中性粒细胞与淋巴细胞比值（NLR）可作为一种简单、可用且有效的炎症、应激和免疫系统激活的生物标志物。
在这篇叙述性综述中，我们重点介绍了中性粒细胞与淋巴细胞比值（Zahorec 指数）在普通医学（炎症和感染）、重症监护医学（脓毒症）、肿瘤学（实体器官癌预后预测）、外科学和围手术期医学（并发症诊断和临床结局预测）中的临床应用。
我们提供了许多临床研究证据，证实中性粒细胞与淋巴细胞比值是一种非常敏感的炎症标志物，是日常临床实践中一种可靠且有效的参数。NLR（Zahorec 指数）是一种用于诊断感染和各种病因疾病严重程度的有效工具。NLR 反映了癌症疾病的炎症程度，对癌症患者的预后有重要影响。Zahorec 指数应常规用于急诊医学、外科学和围手术期医学，作为疾病严重程度、感染和并发症的标志物。NLR 可帮助医生在早期诊断和治疗方面做出决策。NLR 应在急性状态（脓毒症、休克、腹膜炎、中风、创伤）中每天频繁检查，在亚急性状态中每周数次（住院期间），在慢性疾病（癌症、糖尿病、缺血性心脏病、精神障碍）中每年数次检查。NLR 具有深刻的生物学意义，它将三个超系统（免疫、内分泌和自主神经系统）的功能联系在一起（表 2，图 3，参考文献 86）。
