Evaluating the Diagnostic and Prognostic Value of Peripheral Immune Markers in Glioma Patients: A Prospective Multi-Institutional Cohort Study of 1282 Patients.

OBJECTIVE

Glioma is the most common primary brain tumor, with a specific immune microenvironment and aggressive nature. Novel systemic immune-inflammation indices (nSII) are the most comprehensive non-invasive biomarkers that represent patients' peripheral immune status, which are urgently needed to improve clinical management. However, the diagnostic and prognostic value of nSII in glioma remains unknown.

METHODS

From October 2006 to April 2022, 1282 patients with primary glioma were enrolled. The preoperative peripheral blood samples were collected. Correlations between novel systemic immune-inflammation indices (nSII) and glioma grades and subtypes were analyzed using ANOVA, test, and ordinal logistic regression. The Cox regression model, K-M survival analysis, etc. were used to study the relationship between nSII and patients' clinical outcomes.

RESULTS

With the higher clinical grade, the percentage of NK cells increases while Th lymphocytes and T lymphocytes decrease. The percentage of NK and Th cells was also correlated with glioma subtypes. In glioblastoma patients, the higher percentage of immunoglobulin light chains was associated with a favorable prognosis, whereas the higher percentage of B lymphocytes was associated with a poor prognosis. Our study showed high diagnostic potential, eg, combined model (C4 & NK & B cells) AUC 0.879 (grade I vs IV), combined model (Th & NK & T cells) AUC 0.845 (grade II vs IV), and combined model (C4 & NK & T cells) AUC 0.711 (grade III vs IV).

CONCLUSION

The nSII can serve as a robust non-invasive diagnostic and prognostic biomarker in glioma, thus promoting clinical management in screening, stratification, and treatment optimization. This study also provides a comprehensive perspective on glioma's systemic and intracranial immune landscape, paving the way for future translational applications.