{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T13:34:34Z","timestamp":1774272874845,"version":"3.50.1"},"reference-count":27,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2023,11,29]],"date-time":"2023-11-29T00:00:00Z","timestamp":1701216000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81971338"],"award-info":[{"award-number":["81971338"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100007219","name":"Natural Science Foundation of Shanghai Municipality","doi-asserted-by":"publisher","award":["22ZR1449400"],"award-info":[{"award-number":["22ZR1449400"]}],"id":[{"id":"10.13039\/100007219","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100018625","name":"Science and Technology Innovation Plan Of Shanghai Science and Technology Commission","doi-asserted-by":"publisher","award":["21Y11907700"],"award-info":[{"award-number":["21Y11907700"]}],"id":[{"id":"10.13039\/501100018625","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Gynecology &amp; Obste"],"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To evaluate changes in the neutrophil\u2010to\u2010lymphocyte ratio (NLR) between day 4 and day 0 in ectopic pregnancy (EP) patients treated with single\u2010dose methotrexate (MTX) and investigate its predictive value for treatment outcome.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 406 EP patients receiving single\u2010dose MTX therapy at Shanghai First Maternity and Infant Hospital from January 10, 2013 to September 30, 2019 were studied. A multivariate model was constructed to predict treatment outcome.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among the 406 patients, 281 were treated successfully. Treatment success declined significantly when NLR decreased by less than 23% (74.8% vs 58.5%, <jats:italic>P<\/jats:italic>\u2009=\u20090.004). Multivariate regression analysis identified NLR reduction of less than 23% on day 4 (odds ratio [OR] 2.09, 95% confidence interval [CI] 1.27\u20133.44), a human chorionic gonadotropin (hCG) decrease of 15% or less (OR 3.17, 95% CI 1.62\u20136.34), and an hCG increase of more than 15% on day 4 (OR 5.47, 95% CI 3.05\u201310.22) as independent risk factors for single\u2010dose MTX treatment failure. The final predictive model had a sensitivity of 0.768 and a specificity of 0.569, using a cut\u2010off value of 3. The area under the receiver operating characteristic curve was 0.712. Patients with a predictive score of \u22653 were more likely to fail single\u2010dose MTX therapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The present study concluded that an NLR decrease of less than 23% on day 4, a plateau or increase in serum hCG on day 4, and an hCG value greater than 1000\u2009mIU\/mL on day 0 were predictors of single\u2010dose MTX treatment failure in EP patients.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ijgo.15248","type":"journal-article","created":{"date-parts":[[2023,11,30]],"date-time":"2023-11-30T04:24:14Z","timestamp":1701318254000},"page":"131-137","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Day 4 and day 0 neutrophil\u2010to\u2010lymphocyte ratios as predictors of treatment failure with single\u2010dose methotrexate for ectopic pregnancies"],"prefix":"10.1002","volume":"165","author":[{"given":"Rukeyemu","family":"Abuduxukuer","sequence":"first","affiliation":[{"name":"Department of Gynecology, School of Medicine, Shanghai First Maternity and Infant Hospital Tong Ji University  Shanghai P.R. 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