A Multielement Prognostic Nomogram Based on a Peripheral Blood Test, Conventional MRI and Clinical Factors for Glioblastoma

Abstract

BackgroundGlioblastoma (GBM) is one of the most malignant types of tumors in the central nervous system, and the 5-year survival remains low. Several studies have shown that preoperative peripheral blood tests and preoperative conventional Magnetic Resonance Imaging (MRI) examinations affect the prognosis of GBM patients. Therefore, it is necessary to construct a risk score based on a preoperative peripheral blood test and conventional MRI and develop a multielement prognostic nomogram for GBM.MethodsThis study retrospectively analyzed 131 GBM patients. Determination of the association between peripheral blood test variables and conventional MRI variables and prognosis was performed by univariate Cox regression. The nomogram model, which was internally validated using a cohort of 56 GBM patients, was constructed by multivariate Cox regression. RNA sequencing data from Gene Expression Omnibus (GEO) and Chinese Glioma Genome Atlas (CGGA datasets were used to determine peripheral blood test-related genes based on GBM prognosis.ResultsThe constructed risk score included the neutrophil/lymphocyte ratio (NLR), lymphocyte/monocyte ratio (LMR), albumin/fibrinogen (AFR), platelet/lymphocyte ratio (PLR), and center point–to-ventricle distance (CPVD). A final nomogram was developed using factors associated with prognosis, including age, sex, the extent of tumor resection, IDH mutation status, radiotherapy status, chemotherapy status, and risk. The Area Under Curve (AUC) values of the receiver operating characteristic curve (ROC) curve were 0.876 (12-month ROC), 0.834 (24-month ROC) and 0.803 (36-month ROC) in the training set and 0.906 (12-month ROC), 0.800 (18-month ROC) and 0.776 (24-month ROC) in the validation set. In addition, vascular endothelial growth factor A (VEGFA) was closely associated with NLR and LMR and identified as the most central negative gene related to the immune microenvironment and influencing immune activities.ConclusionThe risk score was established as an independent predictor of GBM prognosis, and the nomogram model exhibit appropriate predictive power. In addition, VEGFA is the key peripheral blood test-related gene that is significantly associated with poor prognosis.

Identification of immune-associated genes in diagnosing osteoarthritis with metabolic syndrome by integrated bioinformatics analysis and machine learning

“…We were able to approximate the odds of developing OA in MetS patients by simply testing the peripheral blood of MetS patients with known expression of core genes, given that the MetS samples used in this study were all from peripheral blood. Because of its simplicity and effectiveness, peripheral blood testing is used in the diagnosis of many diseases ( 33 , 34 ). Following that, we will develop a more refined model that can accurately reflect gene expression and assign it a numerical value to make it more accurate for diagnosis ( 35 ).…”

Advancements in Image-Based Models for High-Grade Gliomas Might Be Accelerated

“…131 GB patients. [112] Basal ganglia iron levels as a biomarker in glioma prognosis and treatment. 59 patients with brain lesions.…”

“…Rao and colleagues proposed calculating a risk score based on the results of a preoperative peripheral blood test and conventional MRI, then developing a prognostic nomogram for HGG (Figure 12F-K) (Table 2). VEGFA was the most important gene related to peripheral blood tests significantly associated with an unfavorable prognosis and the nomogram contributed to the prognostic classification of the patient [112].…”

“…The same QSM image with the regions of interest (ROI) outlined. An enlargement of the left basal ganglia shows the labeled ROIs for the caudate nucleus, putamen, and globus pallidus (after[110,112,113] with permission).…”

The role of angiogenic growth factors in the immune microenvironment of glioma

“…More and more emphasis on the function of VEGF of its immune effect has been shown. VEGFA was considered as a core negative gene affecting immune activity in the GBM microenvironment ( 37 ). VEGFRs are expressed both on the surface of immune cells and vascular endothelial cells.…”