Zhang Xu, Li Can, Xiao Lifei, Gao Caibin, Zhao Wei, Yang Maolin, Sun Tao, Wang Feng
Department of Neurosurgery, General Hospital of Ningxia Medical University, Yinchuan 750000, People's Republic of China.
Ningxia Key Laboratory of Cerebrocranial Disease, Incubation Base of National Key Laboratory, Ningxia Medical University, Yinchuan 750000, People's Republic of China.
Cancer Manag Res. 2020 Jul 14;12:5793-5802. doi: 10.2147/CMAR.S260695. eCollection 2020.
Eosinophils are proven to play a role in the prognosis of some malignant-tumors. The prognostic value of eosinophils in glioma patients is, however, scarcely reported. The authors of this article have designed a novel prognostic indicator based on eosinophils and the neutrophil-to-lymphocyte ratio (NLR), named ENS, to predict the survival of patients with glioma.
A retrospective study was conducted on 217 glioma patients. The cut-off values for eosinophil, NLR, and other clinical variables were determined by the receiver operating characteristic (ROC) curve analysis. Patients with both low eosinophil count (<0.08 ×10/L) and high NLR (≥1.70) were given a score of 2. Those with one or neither got a score of 1 or 0, respectively. The nomogram was based on ENS and several other clinical variables, its performance was determined by the concordance index (c-index).
Our results showed that ENS is an independent prognostic indicator for overall survival (OS). The three-year OS rates for low-grade glioma patients (LGGs) were 84.0%, 69.0%, and 46.4% for ENS=0, ENS=1, and ENS=2, respectively (=0.014). The three-year OS incidence for LGGs stratified into eosinophils count ≥0.08×109/L and<0.08×109/L subgroups were 88.1% and 80.0%, respectively (=0.043). ENS was positively correlated with glioma grade (r=0.311, <0.001). The c-index for OS prognosis was 0.80 using this nomogram in LGGs.
Preoperative ENS can predict OS to some extent for LGGs and can increase prognostic accuracy for individual OS in LGGs postoperatively when incorporating other clinical variables compose a nomogram.
嗜酸性粒细胞已被证明在某些恶性肿瘤的预后中发挥作用。然而，嗜酸性粒细胞在胶质瘤患者中的预后价值鲜有报道。本文作者基于嗜酸性粒细胞和中性粒细胞与淋巴细胞比值（NLR）设计了一种新的预后指标，称为ENS，以预测胶质瘤患者的生存期。
对217例胶质瘤患者进行回顾性研究。通过受试者工作特征（ROC）曲线分析确定嗜酸性粒细胞、NLR和其他临床变量的临界值。嗜酸性粒细胞计数低（<0.08×10⁹/L）且NLR高（≥1.70）的患者得分为2分。只有其中一项或两项均无的患者分别得1分或0分。该列线图基于ENS和其他几个临床变量，其性能由一致性指数（c指数）确定。
我们的结果表明，ENS是总生存期（OS）的独立预后指标。低级别胶质瘤患者（LGGs）的三年总生存率，ENS = 0时为84.0%，ENS = 1时为69.0%，ENS = 2时为46.4%（P = 0.014）。LGGs按嗜酸性粒细胞计数≥0.08×10⁹/L和<0.08×10⁹/L分层的三年总生存发生率分别为88.1%和80.0%（P = 0.043）。ENS与胶质瘤分级呈正相关（r = 0.311，P < 0.001）。在LGGs中使用该列线图进行OS预后的c指数为0.80。
术前ENS在一定程度上可以预测LGGs的OS，并且在结合其他临床变量组成列线图时，可以提高LGGs术后个体OS的预后准确性。
