Clavreul Anne, Lemée Jean-Michel, Soulard Gwénaëlle, Rousseau Audrey, Menei Philippe
Université d'Angers, CHU d'Angers, CRCINA, F-49000 Angers, France.
Département de Neurochirurgie, CHU Angers, F-49933 Angers, France.
Cancers (Basel). 2021 Nov 18;13(22):5778. doi: 10.3390/cancers13225778.
The survival times of glioblastoma (GB) patients after the standard therapy including safe maximal resection followed by radiotherapy plus concomitant and adjuvant temozolomide are heterogeneous. In order to define a simple, reliable method for predicting whether patients with isocitrate dehydrogenase (IDH)-wildtype GB treated with the standard therapy will be short- or long-term survivors, we analyzed the correlation of preoperative blood counts and their combined forms with progression-free survival (PFS) and overall survival (OS) in these patients.
Eighty-five patients with primary IDH-wildtype GB treated with the standard therapy between 2012 and 2019 were analyzed retrospectively. Cox proportional hazards models and Kaplan-Meier analysis were used to investigate the survival function of preoperative hematological parameters.
Preoperative high neutrophil-to-lymphocyte ratio (NLR, >2.42), high platelet count (>236 × 10/L), and low red blood cell (RBC) count (≤4.59 × 10/L) were independent prognostic factors for poorer OS ( = 0.030, = 0.030, and = 0.004, respectively). Moreover, a high NLR was an independent prognostic factor for shorter PFS ( = 0.010). We also found that, like NLR, preoperative high derived NLR (dNLR, >1.89) was of poor prognostic value for both PFS ( = 0.002) and OS ( = 0.033). A significant correlation was observed between NLR and dNLR (r = 0.88, < 0.001), which had a similar prognostic power for OS (NLR: AUC = 0.58; 95% CI: [0.48; 0.68]; dNLR: AUC = 0.62; 95% CI: [0.51; 0.72]). Two scores, one based on preoperative platelet and RBC counts plus NLR and the other on preoperative platelet and RBC counts plus dNLR, were found to be independent prognostic factors for PFS ( = 0.006 and = 0.002, respectively) and OS ( < 0.001 for both scores).
Cheap, routinely ordered, preoperative assessments of blood markers, such as NLR, dNLR, RBC, and platelet counts, can predict the survival outcomes of patients with IDH-wildtype GB treated with the standard therapy.
胶质母细胞瘤（GB）患者在接受包括安全的最大程度切除，随后进行放疗以及同步和辅助替莫唑胺治疗的标准治疗后的生存时间存在异质性。为了确定一种简单、可靠的方法来预测接受标准治疗的异柠檬酸脱氢酶（IDH）野生型GB患者是短期还是长期幸存者，我们分析了这些患者术前血细胞计数及其组合形式与无进展生存期（PFS）和总生存期（OS）的相关性。
回顾性分析了2012年至2019年间85例接受标准治疗的原发性IDH野生型GB患者。采用Cox比例风险模型和Kaplan-Meier分析来研究术前血液学参数的生存功能。
术前高中性粒细胞与淋巴细胞比值（NLR，>2.42）、高血小板计数（>236×10⁹/L）和低红细胞（RBC）计数（≤4.59×10¹²/L）是OS较差的独立预后因素（分别为P = 0.030、P = 0.030和P = 0.004）。此外，高NLR是PFS较短的独立预后因素（P = 0.010）。我们还发现，与NLR一样，术前高衍生NLR（dNLR，>1.89）对PFS（P = 0.002）和OS（P = 0.033）均具有不良预后价值。观察到NLR与dNLR之间存在显著相关性（r = 0.88，P < 0.001），它们对OS具有相似的预后能力（NLR：AUC = 0.58；95%CI：[0.48；0.68]；dNLR：AUC = 0.62；95%CI：[0.51；0.72]）。发现两个评分，一个基于术前血小板和RBC计数加上NLR，另一个基于术前血小板和RBC计数加上dNLR，是PFS（分别为P = 0.006和P = 0.002）和OS（两个评分的P均<0.001）的独立预后因素。
廉价且常规进行的术前血液标志物评估，如NLR、dNLR、RBC和血小板计数，可以预测接受标准治疗的IDH野生型GB患者的生存结局。
