Department of Neurosurgery, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany.
Division of Clinical Neuro-Oncology, Department of Neurology, University Hospital Bonn, Bonn, Germany.
J Neurooncol. 2021 Sep;154(2):229-235. doi: 10.1007/s11060-021-03817-4. Epub 2021 Aug 4.
The conception of individual patient-adjusted treatment strategies is constantly emerging in the field of neuro-oncology. Systemic laboratory markers may allow insights into individual needs and estimated treatment benefit at an earliest possible stage. Therefore, the present study was aimed at analyzing the prognostic significance of preoperative routine laboratory values in patients with newly-diagnosed glioblastoma.
Between 2014 and 2019, 257 patients were surgically treated for newly-diagnosed glioblastoma at the Neuro-Oncology Center of the University Hospital Bonn. Preoperative routine laboratory values including red blood cell distribution width (RDW) and platelet count were reviewed. RDW to platelet count ratio (RPR) was calculated and correlated to overall survival (OS) rates.
Median preoperative RPR was 0.053 (IQR 0.044-0.062). The receiver operating characteristic (ROC) curve indicated an optimal cut-off value for RPR to be 0.05 (AUC 0.62; p = 0.002, 95% CI 0.544-0.685). 101 patients (39%) presented with a preoperative RPR < 0.05, whereas 156 patients (61%) had a RPR ≥ 0.05. Patients with preoperative RPR < 0.05 exhibited a median OS of 20 months (95% CI 17.9-22.1), which was significantly higher compared to a median OS of 13 months (95% CI 10.9-15.1) in patients with preoperative RPR ≥ 0.05 (p < 0.001).
The present study suggests the RPR to constitute a novel prognostic inflammatory marker for glioblastoma patients in the course of preoperative routine laboratory examinations and might contribute to a personalized medicine approach.
在神经肿瘤学领域，个体化患者治疗策略的概念不断涌现。系统的实验室标志物可能使我们能够在最早阶段洞察个体需求和估计的治疗获益。因此，本研究旨在分析新诊断为胶质母细胞瘤患者术前常规实验室值的预后意义。
2014 年至 2019 年，在波恩大学医院神经肿瘤学中心对 257 例新诊断为胶质母细胞瘤的患者进行了手术治疗。回顾了术前常规实验室值，包括红细胞分布宽度（RDW）和血小板计数。计算了 RDW 与血小板计数的比值（RPR），并与总生存率（OS）相关联。
中位术前 RPR 为 0.053（IQR 0.044-0.062）。接收者操作特征（ROC）曲线表明 RPR 的最佳截断值为 0.05（AUC 0.62；p=0.002，95%CI 0.544-0.685）。101 例（39%）患者术前 RPR<0.05，而 156 例（61%）患者 RPR≥0.05。术前 RPR<0.05 的患者中位 OS 为 20 个月（95%CI 17.9-22.1），明显高于术前 RPR≥0.05 的患者中位 OS 13 个月（95%CI 10.9-15.1）（p<0.001）。
本研究表明 RPR 可作为胶质母细胞瘤患者术前常规实验室检查中的一种新的预后炎症标志物，并可能有助于个性化医疗方法。
