Association of preoperative levels of selected blood inflammatory markers with prognosis in gliomas

Abstract

BackgroundRed cell distribution width (RDW), neutrophil–lymphocyte ratio (NLR), and platelet count (PLT) routinely tested as part of the complete blood count are indicative of systemic inflammation. The prognostic significance of NLR and PLT in cancer was demonstrated in many studies while the role of RDW has been hardly investigated. The present study aimed to assess the association of RDW, NLR, and PLT with survival and tumor grade in glioma patients.MethodsClinical data from 178 patients with primary gliomas treated in a single institution were retrospectively analyzed. Receiver operating characteristic curves for cutoff value determination, Kaplan–Meier survival analysis, various bivariate tests, and univariate and multivariate Cox regression analyses were performed.ResultsPatients with high RDW (≥13.95) and NLR (≥4) levels had worse overall survival (OS) (Wilcoxon test, P<0.026 and P<0.003, respectively) while the effect of thrombocytosis (≥400×109/L) on prognosis was not significant. Besides, a strong association between RDW and NLR was found (Spearman’s rho =0.230, P<0.02; χ2=8.887, P<0.03; Mann–Whitney U-test, P<0.017). Moreover, RDW and NLR were significantly associated with tumor grade. In univariate Cox analysis, elevated NLR (hazard ratio, HR 1.385; confidence interval, CI 1.020–1.881, P<0.037), older age (HR 0.452, CI 0.329–0.621, P<0), and higher tumor grade (HR 1.624, CI 1.187–2.223, P<0.002) were associated with poor outcomes. In the multivariate analysis, tumor grade, age, and Karnofsky performance score were identified as being independently prognostic for OS.ConclusionPreoperative NLR and RDW values can help to evaluate disease progression and outcomes in patients with gliomas, thereby contributing to patient follow-up optimization.

Peripheral blood test provides a practical method for glioma evaluation and prognosis prediction

“…Moreover, NLR was a prognostic marker in gliomas, which was consistent with findings in multiple other solid tumors . Using a cutoff NLR value of four, Raushan auezova et al reported on the associations of NLR with OS in 178 patients and Jing Zhang et al demonstrated that higher NLR was correlated with shorter OS. In our study, we found that the OS of patients in NLR >3.2 group was significantly shorter than in NLR <3.2 group.…”

Prognostic Significance of Preoperative Systemic Cellular Inflammatory Markers in Gliomas: A Systematic Review and Meta‐Analysis

“…suggested that PLR could be a diagnostic value in different metastasis from GBM. Preoperative RDW and PNI levels are also beneficial to evaluate glioma outcomes . Inversely, Diaz and his colleague have reported that pretreatment systemic inflammatory markers (NLR, MLR, and PLR) are not associated with improved OS in patients with GBM.…”

The blood peripheral content of the cells of innate and adaptive immunity in patients with brain tumors of various histogenesis

“…Абсолютное и относительное содержание клеток врожденного и приобретенного иммунитета в периферической крови уже используют для прогнозирования длительности периода ремиссии при некоторых онкологических заболеваниях, в част-ности, опухолях пищевода, яичников, желудка [8][9][10][11]. При глиобластомах при сотношении НГ/Лф больше 4 деятельность послеоперационной ремиссии превыша-ла 11 мес [12,13]. В то же время, содержание в крови клеток врожденного и приобретенного иммунитета при многих опухолях, в том числе опухолях мозга различного происхождения и степени анаплазии, недостаточно изучено, а прогностическая ценность предлагаемых показателей спорна [5,14,15].…”

“…Рост опухолей нейро-эктодермального и мезенхимального происхождения сопровождался изменением как количества, так и соотношения клеток врожденного и приобретенного иммунитета, что согласуется с данными об иммуно-супрессии Т-клеточного звена иммунитета, а также воспалительной реакциеи в опухолевом очаге [1][2][3][4]. В отличие от ряда других опухолей человека, в частнос-ти, яичников, легких, желудка [5,9,11,15], для которых показательным является изменение количества Тр, для опухолей головного мозга характерно соотношение НГ/Лф, соответствующее большей прогностической ценности и информативности при глиобластомах [12,13] колоректальном раке [14].…”