A prospective comparative clinical study of peripheral blood counts and indices in patients with primary brain tumors

Subeikshanan, Venkatesan; Dutt, Akshat; Basu, Debdatta; Tejus, MN; Maurya, V. P.; Vs, Madhugiri

doi:10.4103/0022-3859.180551

Cited by 19 publications

(13 citation statements)

References 12 publications

(14 reference statements)

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“…As corticosteroids consumption increase neutrophil and decrease lymphocyte counts, it may heavily influence NLR. A recent change or tapering schedule in steroid dosage administration was previously related with significant white blood cells variations [21] . In the context of brain tumors, CD4 lymphopenia was associated with worse prognosis [10] .…”

Section: Discussionmentioning

confidence: 99%

Neutrophilia as a biomarker for overall survival in newly diagnosed high-grade glioma patients undergoing chemoradiation

Schernberg

Nivet

Dhermain

et al. 2018

Clinical and Translational Radiation Oncology

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Section: Discussionmentioning

confidence: 99%

Neutrophilia as a biomarker for overall survival in newly diagnosed high-grade glioma patients undergoing chemoradiation

Schernberg

Nivet

Dhermain

et al. 2018

Clinical and Translational Radiation Oncology

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“…For a variety of tumours peripheral blood measurement of neutrophils, monocytes or the NLCR can provide correlation with prognosis or predict response to treatment [ 7 , 12 , 15 ]. Recent publications have suggested that a systemic response can even be measured when tumours are confined to immune-privileged sites such as the brain and can be correlated with the presence of malignant histological types and prognosis [ 5 , 17 , 19 ]. It would therefore follow that measurement of the systemic immune response should provide similar insights regarding paediatric intracranial tumours, albeit with a different spectrum of histological subtypes.…”

Section: Discussionmentioning

confidence: 99%

“…Peripheral blood counts in patients with brain tumours are not normal when compared to healthy controls [ 17 ]. This is unusual, as the brain is traditionally considered an immune-privileged site and central nervous system inflammation/infection can often manifest with little systemically measurable response [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

Pre-operative neutrophil count and neutrophil-lymphocyte count ratio (NLCR) in predicting the histological grade of paediatric brain tumours: a preliminary study

et al. 2017

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IntroductionThe neutrophil-lymphocyte count ratio (NLCR) is an established prognostic marker for renal, lung and colorectal carcinomas and has been suggested to be predictive of histological grade and outcome in adult intracranial tumours. The purpose of this study was to determine whether a correlation of the pre-operative neutrophil count (NC) and NLCR with the final histological grade exists in paediatric intracranial tumours.MethodsA retrospective analysis was undertaken at a single centre. Patients less than 18 years old at the time of surgery who underwent tumour-related procedures from 2006 to 2015 were included. Patients with recurrent tumours, previous bone marrow transplant and metastases were excluded. Pre-operative full blood counts (FBC), collected before the diagnosis of intracranial pathology and before administration of steroids, were matched with histological diagnosis for each patient. Post-operative FBC was also recorded, together with survival data where applicable.ResultsA total of 116 patients (74 male, 42 female; mean age, 8 ± 0.9 years) with a diagnosis of primary intracranial tumours had pre-operative FBC that could be matched to final histological grade. Pre-operative NC and NLCR were higher with increasing grade of tumour: grade 1 (NC 4.29 109/l, NLCR 2.26), grade 2 (NC 4.59 109/l, NLCR 2.38), grade 3 (NC 5.67 109/l, NLCR 2.72) and grade 4 (NC 6.59 109/l, NLCR 3.31). Patients with WHO grade 1 and 2 tumours pooled together had a lower NC (4.37 95% CI ± 0.67 109/l) compared to WHO grade 3 and 4 patients (6.41 95% CI ± 0.99 109/l, p = 0.0013). The NLCR was lower in grade 1 and 2 tumours (2.29 ± 0.59) (compared to grade 3 and 4 tumours; 3.20 ± 0.76) but this did not reach significance (p = 0.069). The subgroup of patients with pilocytic astrocytoma had a significantly lower NC when compared to patients with high-grade tumours (p = 0.005). Medulloblastoma and supratentorial PNET subgroups had significantly higher NC compared to the low-grade group (p = 0.033, p = 0.002). Post-operative NC was significantly higher in the high-grade tumours (p = 0.034), but no difference was observed for NLCR (p = 0.28).ConclusionsNo evidence exists to support the correlation of pre-operative NC or NLCR to histological diagnosis in paediatric intracranial tumours. Our results indicate that a higher pre-operative NC/NLCR correlates with a higher histological grade of tumour. This suggests that immunological mechanisms may be involved in the pathogenesis of paediatric brain tumours, and a further prospective study is required to substantiate and expand these findings.

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“…2 Among the various inflammatory markers, neutrophil-to-lymphocyte ratio (NLR) is one of the readily available markers and has been proved to be a prognostic marker to predict the survival in high-grade glioma and metastases. 9 10 11 12 13 14 15 16 17 18 19 20 21…”

Section: Introductionmentioning

confidence: 99%

Neutrophil-to-Lymphocyte Ratio: Can It Be Used as an Adjunct Tool to Predict Histopathological Grade of Brain Tumor?

Ashwath

Aggarwal

Praneeth

et al. 2019

JNRP

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Background Since histopathology is available only after surgery, clinical condition and radiological characters of the tumor are important factors on which a clinician counsels the patient of brain tumor to take a decision regarding the management. Neutrophil lymphocyte ratio (NLR), a marker of inflammation can be used as a prognostic marker to predict the survival in high-grade gliomas and metastases. We evaluated the utility of NLR as an adjunct tool in predicting the histopathological grade of brain tumors. Materials and Methods One hundred sixteen patients with a diagnosis of brain tumors planned for surgical excision or biopsy were enrolled in the study. NLR was estimated in the preoperative blood sample. Patients were grouped into low- and highgrade brain tumors and their mean NLRs were analyzed. Similar evaluation was carried out between the intra- and extra-axial tumors. Results Mean age of the study group was 40.14 years with 61 males. Seventy-eight patients had low-grade tumor and 38 patients had high-grade tumor. Sixty patients had extra-axial tumors and 56 patients had intra-axial tumors. The mean NLR of low-grade tumors was 1.68 ± 0.53 and that of high-grade tumors was 3.12 ± 0.74. NLR > 2.4 can be used to identify high-grade brain tumors with a sensitivity of 80%, specificity of 92%, positive predictive value of 82.1%, negative predictive value of 91%, an excellent impact with likelihood ratio (+) of 10.1, and an odds ratio of 54.1. The mean NLR of extra-axial tumors was 1.68 + 0.62 and that of intra-axial tumors was 2.64 ± 0.91. These observations were statistically significant with p -value < 0.05. Conclusions NLR is an easily available and inexpensive marker of systemic inflammation, which varies across different histopathological grades of brain tumors. Mean NLR is higher in high-grade tumors and also intra-axial tumors with a cutoff value of NLR > 2.4 and > 2.0, respectively.

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A prospective comparative clinical study of peripheral blood counts and indices in patients with primary brain tumors

Cited by 19 publications

References 12 publications

Neutrophilia as a biomarker for overall survival in newly diagnosed high-grade glioma patients undergoing chemoradiation

Neutrophilia as a biomarker for overall survival in newly diagnosed high-grade glioma patients undergoing chemoradiation

Pre-operative neutrophil count and neutrophil-lymphocyte count ratio (NLCR) in predicting the histological grade of paediatric brain tumours: a preliminary study

Neutrophil-to-Lymphocyte Ratio: Can It Be Used as an Adjunct Tool to Predict Histopathological Grade of Brain Tumor?

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