Introductions
Immuno-oncology is a rapidly developing field wherein tumor-immune system interactions can be harnessed for diagnostics. Herein, we set out to establish the role of the immune system response, as measured by preoperative neutrophil, platelet, and monocyte to lymphocyte ratios (NLR, PLR, and MLR) as prognostic markers for patient survival based on the newly defined criteria for glioblastoma (GBM).
Materials and methods
The study included patients diagnosed with GBM at a four-year interval. Exclusion criteria were patients subject to reoperation in the time period; tumors in more than one system; a history of hematological and autoimmune diseases; and cases with infectious or other inflammatory conditions. Data regarding patient demographics and preoperative blood counts were pulled from patient records and compared to postoperative survival.
Results
A total of 22 patients fit the established criteria, with a male to female ratio of 2.14:1, a mean age of 66.23 years, and a mean survival of 255.72 days (8.04 months, range 24-801 days). Eight patients had an elevation of NLR and five of PLR, with no statistical correlation to survival. Six patients had an increase in MLR with a statistically significant (p=0.0044) shorter postoperative survival. Synergic increases in NLR and PLR did not show significance, while synergic increases with MLR showed no added benefit.
Conclusion
Preoperative MLR, but not NLR or PLR, is a promising independent biomarker for patient survival in GBM. It is suggested that elevations in these ratios directly correlate to tumor biological potential.
Miscarriage due to fetal tumors is an extremely rare finding, with a varying incidence from 1.7 to 13.5 per 100,000 live births, with central nervous system tumors occupying a minority of these cases. Herein, we report the gross morphological and histological findings of a 17-gestational week spontaneous miscarriage in a 27 year old multi-gravida due to a fourth ventricle choroid plexus papilloma (CPP). The CPP was composed of a pronoun fibro-vascular stroma covered with a dense lining of tall cuboid sparsely ciliated single cell layer with rich in chromatin nuclei. The cytoplasm of the CPP covering cells was intensely colored when compared to the pale cytoplasm of the covering cells of the choroid plexus collected from the lateral ventricle, which also lacked in such pronoun fibrovascular stroma. The fourth ventricle was significantly dilated with parenchymal compression of nervous tissue towards the chondral fetal cranium.
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