Based on clinical Ki-67 expression and serum infiltrating lymphocytes related nomogram for predicting the diagnosis of glioma-grading

Abstract

BackgroundCompelling evidence indicates that elevated peripheral serum lymphocytes are associated with a favorable prognosis in various cancers. However, the association between serum lymphocytes and glioma is contradictory. In this study, a nomogram was established to predict the diagnosis of glioma-grading through Ki-67 expression and serum lymphocytes.MethodsWe performed a retrospective analysis of 239 patients diagnosed with LGG and 178 patients with HGG. Immunohistochemistry was used to determine the Ki-67 expression. Following multivariate logistic regression analysis, a nomogram was established and used to identify the most related factors associated with HGG. The consistency index (C-index), decision curve analysis (DCA), and a calibration curve were used to validate the model.ResultsThe number of LGG patients with more IDH1/2 mutations and 1p19q co-deletion was greater than that of HGG patients. The multivariate logistic analysis identified Ki-67 expression, serum lymphocyte count, and serum albumin (ALU) as independent risk factors associated with HGG, and these factors were included in a nomogram in the training cohort. In the validation cohort, the nomogram demonstrated good calibration and high consistency (C-index = 0.794). The Spearman correlation analysis revealed a significant association between HGG and serum lymphocyte count (r = −0.238, P <0.001), ALU (r = −0.232, P <0.001), and Ki-67 expression (r = 0.457, P <0.001). Furthermore, the Ki-67 expression was negatively correlated with the serum lymphocyte count (r = −0.244, P <0.05). LGG patients had lower Ki-67 expression and higher serum lymphocytes compared with HGG patients, and a combination of these two variables was significantly higher in HGG patients.ConclusionThe constructed nomogram is capable of predicting the diagnosis of glioma-grade. A decrease in the level of serum lymphocyte count and increased Ki-67 expression in HGG patients indicate that their immunological function is diminished and the tumor is more aggressive.

Simultaneous quantification of perfusion, permeability, and leakage effects in brain gliomas using dynamic spin-and-gradient-echo echoplanar imaging MRI

“…Higher TRATE values in IDH wt gliomas (i.e., glioblastomas, as per 2021 WHO classification [ 1 ]) are consistent with their established higher cell density and proliferation rate, compared to lower grades [ 56 ]. As for Ki67 expression, while it does not directly represent cell density nor cell size, it is a biomarker of active cell proliferation [ 46 , 47 ], and it is reasonable to speculate that gliomas with higher proliferation rate may also have higher cellularity as a result. Finally, lower TRATE values in gliomas exposed to treatment can be explained with the notion that the enhancing regions in recurrent (R) gliomas are possibly characterized by a lower cellularity overall, due to a combination of malignant cells and treatment effects, including hyaline vasculopathy, reactive gliosis, and radiation necrosis, which were documented in histopathological reports in 50% of R-gliomas in our cohort.…”

“…Group differences were assessed with Mann-Whitney U tests. Ki67 expression was binarized as ≤ 10% or > 10% as validated in previous studies [ 46 , 47 ]. The significant p -value threshold was set to p < 0.05.…”

Predicting IDH mutation status as well as Ki-67 and p53 expression in high-grade gliomas using amide proton transfer-weighted and arterial spin labeling MRI

“…Ki-67 is one of the best markers of cellular proliferation in human neoplasms 24,25 . Additionally, Ki-67 is typically related to heterogeneity with respect to cell proliferation and microvascular hyperplasia 6 .…”