Biom-42. Association of Neutrophil-Lymphocyte Ratio With Glioma Grading and Survival

Abstract

INTRODUCTION Gliomas are the most common primary central nervous system tumor. Inflammatory responses are thought to play an important role in cancer progression. Neutrophil-lymphocyte ratio (NLR) is a simple, low cost and easy to measure inflammation marker that has been shown to be a poor prognostic factor in many solid tumors. The preoperative NLR has been shown to be associated with histopathological grading of glioblastoma. This study aimed to find the association of NLR with glioma grading and overall survival in Indonesian patients. METHODS The patients were enrolled from Dr. Sardjito General Hospital, Yogyakarta Province, Indonesia. Neutrophil and lymphocyte counts were extracted from the complete blood count test before surgery. NLR was calculated as neutrophil count divided by lymphocyte count using standard units. Detailed demographic and clinical data were collected from medical records. RESULT A total of 79 patients were included in this study, consisting of 48 (60.8%) males and 31(39.2%) females. Most patients were diagnosed as WHO grade IV gliomas (43%), followed by grade II (26%), grade III (13%), and grade I (7.6%). In multivariate analysis, NLR ≥ 5.01 was significantly associated with high grade glioma (HR 5.50, 95%CI 1.96–15.44, p=0.001). We also found that patients with NLR ≥ 10.5 have significantly shorter median overall survival compared with patients with NLR < 10.5 (4.6 months and 27.2 months respectively, HR 2.13, 95%CI 1.03–4.40, p=0.041). Multivariate analysis using Cox Regression method showed that higher NLR (≥ 10.5) and IDH1 wild type were independent predictors for worse outcome. CONCLUSION In conclusion, NLR is associated with grading and overall survival of glioma patients in Indonesia.