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NLR (Neutrophil-to-Lymphocyte Ratio)

⚠️ Update approaching🔬 Evidence: LimitedInternal Medicine
Diğer adları: Neutrophil lymphocyte ratio, Neutrophil-to-lymphocyte ratio
⚠️

Discuss your test results with your doctor. This page is for informational purposes only and does not provide a diagnosis.

⚡ Key Facts

• A ratio calculated by dividing neutrophil count by lymphocyte count • Reflects the balance between innate and adaptive immunity • No internationally standardized threshold exists • Used as a supplementary inflammation and prognosis marker

🧪 What Does This Test Measure?

The NLR (neutrophil-to-lymphocyte ratio) is calculated by dividing neutrophil count by lymphocyte count, reflecting the balance between innate and adaptive immunity.

📋 Why Is It Ordered?

Used for inflammation severity assessment, infection monitoring, oncology prognosis, and cardiovascular risk evaluation as a supplementary marker.

🔧 Preparation

NLR is not a separate test — it is calculated from the CBC differential. No special preparation beyond CBC requirements.

📊 Reference Ranges

No internationally standardized threshold. Commonly cited approximate values: Normal: 1–3 Elevated: >3 (may indicate inflammation or stress) High: >6 (significant inflammatory or stress response)

⬆️ High Values

Elevated NLR may be associated with infection, inflammation, physiological stress, surgery, and certain oncological conditions.

⬇️ Low Values

Low NLR is generally not considered clinically significant. It may reflect neutropenia or relative lymphocytosis.

⚙️ What Can Affect Results?

Corticosteroids, infection, stress, age, exercise, smoking, and individual variation in neutrophil/lymphocyte counts may affect NLR.

🔬 Evidence Summary

Limited evidence: 3 reviews and 1 observational study.

📚 Most Important Studies on This Topic

1

Ratio of neutrophil to lymphocyte counts--rapid and simple parameter of systemic inflammation and stress in critically ill

Observational· Bratislavske Lekarske Listy · 2001 · PMID: 11723675

2

Neutrophil-to-lymphocyte ratio, past, present and future perspectives

Review· Bratislavske Lekarske Listy · 2021 · PMID: 34161115

3

Zahorec index or Neutrophil-to-lymphocyte ratio, valid biomarker of inflammation and immune response to infection, cancer and surgery

Review· Bratislavske Lekarske Listy · 2024 · PMID: 38219059

✅ Key Takeaways

💡

What you learned: NLR is a supplementary inflammation marker. It has no standardized threshold and should be interpreted alongside clinical context.

⛔

NLR alone cannot diagnose any condition. It is a supplementary marker interpreted alongside clinical findings.

🔬 Sources Used on This Page

4 sources · Most recent publication: 2024
📖
Review
Comprehensive topic evaluation
3
sources
👁
Observational
Observational and cohort studies
1
source
Overall assessment: Evidence level for this topic is limited. This page is supported by 3 reviews, 1 observational study.

📝 Questions to Ask Your Doctor

Be prepared for your appointment. Add questions to your list.

📋 References

[PMID: 38219059] Zahorec index or Neutrophil-to-lymphocyte ratio, valid biomarker of inflammation and immune response to infection, cancer and surgery. Bratislavske Lekarske Listy, 2024.
[PMID: 34161115] Neutrophil-to-lymphocyte ratio, past, present and future perspectives. Bratislavske Lekarske Listy, 2021.
[PMID: 11723675] Ratio of neutrophil to lymphocyte counts--rapid and simple parameter of systemic inflammation and stress in critically ill. Bratislavske Lekarske Listy, 2001.
[PMID: 9971870] Acute-phase proteins and other systemic responses to inflammation. New England Journal of Medicine, 1999.
Last reviewed: 4/2/2026
Next review: 4/2/2027

🔗 Related Topics

🧪 Nötrofil (NLR'nin payı)🧪 Lenfosit (NLR'nin paydası)🧪 Lökosit / WBC (total beyaz küre)🧪 CRP (C-reaktif protein)🧪 Prokalsitonin (bakteriyel enfeksiyon belirteci)
⚖️ This page does not replace medical advice. Make treatment decisions with your doctor.
Content is based on scientific studies indexed in PubMed and current clinical guidelines.