Preoperative neutrophil–lymphocyte ratio correlated with glioma grading and glioblastoma survival

ABSTRACT

Background: Neutrophil–lymphocyte ratio (NLR) is a simple, low-cost and easily measured inflammation marker, corresponding with pathological tumor grading and clinical prognosis in various cancers.

Objectives: This study aimed to investigate the relationship between preoperative NLR and glioma grading and also the correlation between NLR and glioblastoma survival.

Methods: The preoperative NLR was analyzed retrospectively in 239 gliomas of different grades, and receiver operating characteristic (ROC) curve analysis was adopted to investigate the prediction of glioma grading. Univariate and multivariate analyses were performed to analyze the variables of overall survival (OS) of glioblastoma patients.

Results: There were significant differences in the preoperative NLR values among the four glioma groups, with the highest values observed in the glioblastoma group (p < 0.05). ROC curve analysis showed the NLR value of 2.36 was a cutoff point for predicting glioblastoma. The OS of patients with high NLR (≥ 4.0) was shorter compared with that with low NLR (< 4.0) (mean 11.23 vs. 18.56 months, p < 0.05). Univariate analysis and multivariate analysis indicated age≥ 60, NLR≥ 4.0, Karnofsky Performance Scores (KPS) ≤ 70, incomplete tumor resection, incomplete Stupp protocol accomplishment and the isocitrate dehydrogenase 1 (IDH1) wild-type as independent prognostic indicators for poor outcome (each p < 0.05).

Conclusion: The preoperative NLR was correlated with glioma grading, and the elevated NLR was an independent predictive factor for poor outcome of glioblastoma patients.

Abbreviation IDH1: Isocitrate dehydrogenase 1IL-8: Interleukin-8KPS: Karnofsky Performance ScoresNLR: Neutrophil–lymphocyte ratioOS: Overall survivalROC: Receiver operating characteristicSD: Standard deviationsWHO: World Health Organization

KEYWORDS:

• Glioma
• glioblastoma
• grading
• neutrophil–lymphocyte ratio
• survival

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This work was supported by grant from the National Natural Science Fund [81701201], the Renji Hospital Zhong Zi Research Program [RJZZ16-018] and the Renji Hospital Pei Yu Zi You Research Program [PYZY16-009].

Notes on contributors

Liemei Guo

Liemei Guo, M.D., Ph.D., male, 34 yrs, is focusing on the treatment and research of malignant brain tumors.