Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai, China; Shanghai Key Laboratory of Brain Function Restoration and Neural Regeneration, Shanghai, China; State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, School of Basic Medical Sciences and Institutes of Brain Science, Fudan University, Shanghai, China.
Department of Neurosurgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China.
J Clin Neurosci. 2022 Feb;96:180-186. doi: 10.1016/j.jocn.2021.10.006. Epub 2021 Nov 18.
The inflammatory response is closely related to cancer progression and prognosis. The aim of this study was to determine the prognostic value of preoperative inflammatory markers among different molecular subtypes of lower-grade glioma (LGG).
We performed a retrospective analysis of 214 patients with LGG from 2001 to 2013, evaluating the effect of the neutrophil/lymphocyte ratio (NLR), lymphocyte/monocyte ratio (LMR), platelet/lymphocyte ratio (PLR) and derived NLR (dNLR) on prognosis among different molecular subtypes. Isocitrate dehydrogenase (IDH) and telomerase reverse transcriptase (TERT) promotor mutations were detected by gene sequencing, and Chromosome arms 1p and 19q (1p/19q) codeletion was estimated via fluorescence in situ hybridization.
Survival analysis showed that a high NLR, low LMR, and high dNLR were associated with poor prognosis, while the PLR had no prognostic significance. The subsequent molecular subtype analysis indicated that a high NLR and dNLR predicted worse survival in the IDH mutation only group, a high NLR and PLR predicted worse survival in the IDH and TERT promoter mutation group, and a high PLR was associated with shorter survival in the triple-positive group. Furthermore, univariate and multivariate Cox regression analysis suggested that the dNLR was an independent prognostic factor for LGG. Finally, the prognostic nomogram was developed by integrating the inflammatory marker dNLR and independent clinical risk factors.
The results of this study indicated that a high dNLR was an independent risk factor for overall survival rates in patients with LGG, which may increase prognostic accuracy and improve patient outcomes.
炎症反应与癌症的进展和预后密切相关。本研究旨在确定术前炎症标志物在不同低级别胶质瘤（LGG）分子亚型中的预后价值。
我们对 2001 年至 2013 年间的 214 例 LGG 患者进行了回顾性分析，评估中性粒细胞/淋巴细胞比值（NLR）、淋巴细胞/单核细胞比值（LMR）、血小板/淋巴细胞比值（PLR）和衍生 NLR（dNLR）对不同分子亚型预后的影响。通过基因测序检测异柠檬酸脱氢酶（IDH）和端粒酶逆转录酶（TERT）启动子突变，通过荧光原位杂交估计染色体臂 1p 和 19q（1p/19q）缺失。
生存分析表明，高 NLR、低 LMR 和高 dNLR 与预后不良相关，而 PLR 无预后意义。随后的分子亚型分析表明，在 IDH 突变组中，高 NLR 和 dNLR 预测生存率较差，在 IDH 和 TERT 启动子突变组中，高 NLR 和 PLR 预测生存率较差，在三阳性组中，高 PLR 与较短的生存率相关。此外，单因素和多因素 Cox 回归分析表明，dNLR 是 LGG 的独立预后因素。最后，通过整合炎症标志物 dNLR 和独立临床危险因素，开发了预后列线图。
本研究结果表明，高 dNLR 是 LGG 患者总生存率的独立危险因素，可能提高预后准确性并改善患者结局。
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