Can preoperative neutrophil to lymphocyte, lymphocyte to monocyte, or platelet to lymphocyte ratios differentiate glioblastoma from brain metastasis?

Abstract

This retrospective analysis of patients aims to show the blood levels of preoperative inflammatory markers in patients with glioblastoma and brain metastasis and to provide the diagnostic accuracy of the neutrophil–lymphocyte (NLR), lymphocyte–monocyte (LMR), and platelet–lymphocyte (PLR) ratios between the 2 groups of patients. The retrospective reviews of the neutrophil, lymphocyte, monocyte, and platelet counts were analyzed in 80 patients with newly diagnosed glioblastoma and 70 patients with brain metastasis. The NLR, LMR, and PLR were calculated in each group. The differences in all the parameters were compared between the 2 groups. Although the neutrophil, monocyte, and platelet counts were higher and the lymphocyte count was lower in patients with metastasis, the difference was not significant. A significantly higher PLR (P = .004) and a lower LMR (P = .01) were found in patients with brain metastasis. Although both PLR and LMR had diagnostic accuracy in differentiating glioblastoma from brain metastasis, LMR showed the highest diagnostic accuracy. NLR showed no diagnostic accuracy. Systemic inflammation is more severe in glioblastoma than in brain metastasis, and LMR is more sensitive and/or specific than PLR in differentiating glioblastoma from brain metastasis. Therefore, LMR (less likely PLR) can be used as an index for differentiating between glioblastoma and brain metastasis before surgery.

Diagnostic and prognostic value of preoperative systemic inflammatory markers in anaplastic thyroid cancer

“…Although the exact association between circulating white cell indices and peritumoral immune reaction remains largely unclear, SIMs could reflect the balance between innate and adaptive immune responses to some extent 37 . Previous works have identified the diagnostic value of SIMs in several solid tumors, while rarely focused on thyroid cancers 38‐40 . Although the comprehensive index such as NPLR and NMLR have been reported to predict the prognosis of patients with cancer, few studies concern NMPLR 24,41,42 .…”

Blood-Based Biomarkers for Glioma in the Context of Gliomagenesis: A Systematic Review

“…Total monocyte counts could not be correlated to prognosis (62,71,227,231). Monocytes were found to not be different in glioblastoma patients as compared to patients with brain metastases (207) and increased in glioma patients compared to epilepsy (54), meningioma (54,55), or acoustic neuroma (54).…”

“…Moreover, glioma patients had higher neutrophils compared to patients with a meningioma (54,161), neuromas (54) or epilepsy (54,206). It was also found that there was no difference between glioma or glioblastoma patients and meningioma patients (55,206), between glioma or glioblastoma and metastases (206,207) and grade III and grade IV glioma patients (227) in terms of neutrophil counts. Multiple studies reported that neutrophil counts had no prognostic value in glioma patients (62,70,71,198,204,205,230,234), however, other studies found a negative correlation of neutrophil counts with survival in glioma (201,227,231,247) with HRs around 1.6 (227,231).…”

“…Furthermore, there is overwhelming evidence that platelet counts are not correlated with patient prognosis in glioma patients (62,70,71,93,(198)(199)(200)(201)(202)(203)(204)(205). Moreover, platelet counts are not different in glioma patients as compared to other intracranial pathologies such as epilepsy and non-glial brain tumors (54,206,207). Aside platelet counts, researchers, amongst us, have noted that platelets may have altered protein content (208) and RNA content, due to sequestration of tumorderived RNAs.…”

“…Also, many studies reported that total lymphocyte numbers were not correlated with survival in glioma patients (62,70,71,74,198,201,202,204,205,227,(230)(231)(232)(233) though two studies reported that increased numbers of total lymphocytes were associated with prolonged survival (234,235). Furthermore, total lymphocytes were not changed in glioma patients as compared to patients with brain metastases (206,207), but it remains unclear whether total lymphocytes are changed in glioma patients as compared to meningioma (54,55,206) and epilepsy patients (54,206). However, lymphocytes were also not correlated to tumor grade in two other studies (58,196) or with IDH-1/2 mutation status (201,236).…”