A Novel Scoring System Based on Peripheral Blood Test in Predicting Grade and Prognosis of Patients with Glioma

Yiyang Wu; Zimu Song; Kuisheng Sun; Shikuo Rong; Peng Gao; Feng Wang; Tao Sun

doi:10.2147/OTT.S236598

A Novel Scoring System Based on Peripheral Blood Test in Predicting Grade and Prognosis of Patients with Glioma

Onco Targets Ther. 2019 Dec 24:12:11413-11423. doi: 10.2147/OTT.S236598. eCollection 2019.

Authors

Yiyang Wu^#¹, Zimu Song^#¹, Kuisheng Sun², Shikuo Rong², Peng Gao¹, Feng Wang^{1

2}, Tao Sun^{1

2}

Affiliations

¹ Department of Neurosurgery, General Hospital of Ningxia Medical University, Yinchuan, People's Republic of China.
² Ningxia Key Laboratory of Cerebrocranial Diseases, Incubation Base of National Key Laboratory, Ningxia Medical University, Yinchuan, People's Republic of China.

^# Contributed equally.

Abstract

Purpose: To explore the value of F-NLR-AGR score based on preoperative fibrinogen, neutrophil to lymphocyte ratio (NLR), and albumin to globulin ratio (AGR) in predicting the prognosis in patients with glioma.

Patients and methods: 203 glioma patients were retrospectively analyzed. Receiver-operating characteristic (ROC) curve analysis was used to determine the optimal cut-off values for NLR, AGR, and fibrinogen. According to these cut-off values, patients with high NLR (>1.90), low AGR (<1.54), and elevated fibrinogen (>2.61 g/L) were defined as a score of 3, if none of the patients' three parameters met these standards they were given a score of 0, if any two or one parameter met these standards they were scored as 2 or 1, respectively. The correlation between F-NLR-AGR score and glioma grade was also evaluated.

Results: The three-year overall survival (OS) rate and the mean overall survival in patients with F-NLR-AGR=3 were lower than those of patients with F-NLR-AGR = 2, 1 or 0 [17.6% vs 35.2%, 66.9% or 83.7% (26.0 vs 39.0, 64.0 or 81.0 months), P<0.001]. Multivariate analysis revealed that age (HR=2.071; 95% CI=1.195-3.588; P=0.009), WHO grade (P<0.001), and F-NLR-AGR score (P<0.001) were independent prognostic factors for OS. Spearman's rank correlation analysis revealed that F-NLR-AGR score was positively correlated with glioma grade (r=0.278, P<0.01).

Conclusion: Preoperative F-NLR-AGR score was correlated with glioma grading, high F-NLR-AGR score was an independent predictor of poor prognosis in glioma. Therefore, the scoring system may be applied in clinical practice to identify high-risk patients.

Keywords: AGR; NLR; albumin to globulin ratio; fibrinogen; glioma; neutrophil to lymphocyte ratio; prognosis.