Prognostic Values of Combined Ratios of White Blood Cells in Glioblastoma: A Retrospective Study

Abstract

In some malignant tumours, the changes in neutrophil counts in relation to other blood cells are connected with unfavourable prognosis. Nevertheless, the prognostic value of the combinations of the haematological components in glioblastoma (GBM) remains under dispute. The clinical significance of the neutrophil-to-lymphocyte ratio (NLR), systemic immune inflammation index (SII), and systemic inflammation response index (SIRI) was investigated in our study. We retrospectively studied 358 patients (males n = 195; females n = 163) aged 59.9 ± 13.5 yrs with newly diagnosed glioma and admitted to the Neurosurgery Centre. Routine blood tests and clinical characteristics were recorded within the first hour of hospital admission. The inflammatory variables: NLR, SII and SIRI exceeded the reference values and were significantly elevated in Grade 3 and Grade 4 tumour. The Cox model analysis showed that the age ≥ 63 years, NLR ≥ 4.56 × 103/µL, SII ≥ 2003 × 103/µL and SIRI ≥ 3.03 × 103/µL significantly increased the risk of death in Grade 4 tumour patients. In the inflammatory variables, NLR demonstrated the highest impact on the survival time (HR 1.56; 95% CI 1.145–2.127; p = 0.005). In the first Polish study including GBM patients, the age in relation to simple parameters derived from complete blood cell count were found to have prognostic implications in the survival rate.

Prognostic role of the pretreatment systemic immune-inflammation index in patients with glioma: A meta-analysis

“…To be specific, articles enrolled in this meta-analysis were published between 2019 and 2022 and were all in English ( 15 – 22 ). A total of four studies were performed in China ( 15 , 16 , 19 , 22 ), two studies were carried out in Turkey ( 17 , 18 ), and one each in Italy ( 21 ) and Poland ( 20 ), respectively. A sample size of 77 to 358 was obtained, with 168 representing the median.…”

“…All studies were of retrospective design. A total of six studies included patients with GBM ( 16 – 18 , 20 – 22 ), one study recruited patients with glioma grade III–IV ( 15 ), and one study enrolled patients with medulloblastoma (MB) ( 19 ). The SII was characterized by a median value of 914.5, with the cut-off value ranging from 324.38 to 2,300.…”

“…A receiver operating characteristic (ROC) curve analysis was conducted to determine the threshold of seven articles (16)(17)(18)(19)(20)(21)(22), and there was one article (15) using X-tile software. All eight studies analyzed the prognostic role of the SII for OS (15-22), and three studies reported the association between SII and PFS (17, 18,22).…”

“…SII has also been investigated in numerous studies to be the prognosis prediction biomarker for glioma cases; however, results have been inconsistent ( 15 – 22 ). For example, some researchers reported elevated SII as the important biomarker to predict the prognosis of glioma cases ( 17 , 19 , 20 ), whereas some other scholars found no evident relation of SII with glioma prognosis ( 18 ). These conflicting results confuse the application of SII in the clinical management of patients with glioma.…”

Predictive Value of Inflammatory and Nutritional Indexes in the Pathology of Bladder Cancer Patients Treated with Radical Cystectomy

“…In a large number of cancers, it has been shown that biomarkers of the inflammatory response can predict the prognosis and outcomes of these patients [ 16 , 17 , 18 , 19 ]. In recent years, the focus of numerous studies with oncology patients has been markers that can be calculated from blood count parameters such as the neutrophil-to-lymphocyte ratio (NLR) [ 20 , 21 ], the derived neutrophil-to-lymphocyte ratio (dNLR), the systemic immuno-inflammatory index (SII), and the systemic inflammatory response index (SIRI) [ 19 , 22 , 23 ].…”