Pre-treatment neutrophils count as a prognostic marker to predict chemotherapeutic response and survival outcomes in glioma: a single-center analysis of 288 cases

Am J Transl Res. 2020 Jan 15;12(1):90-104. eCollection 2020.

Abstract

Background: Glioma is the most common and deadliest malignant primary intracranial brain tumor in adults. It remains unclear whether the pre-treatment peripheral blood test parameters might serve as biomarkers for treatment outcome. The purpose of the current study was to investigate the predictive and prognostic value of pre-treatment peripheral blood test parameters in glioma.

Methods: In total, 288 glioma patients with complete results of pre-operation peripheral blood test, clinical information and tumor transcriptome data from Chinese Glioma Genome Atlas (CGGA project) were enrolled in our study. Receiver operating characteristic (ROC) curve, Kaplan-Meier analysis and Cox proportional hazards models were performed to evaluate the diagnostic and prognostic value of pre-treatment peripheral blood test parameters in glioma patients.

Results: The white blood cells (WBC) and neutrophils (NEU) counts and neutrophil to lymphocyte ratio (NLR) were positively correlated with tumor grade. IDH mutation and 1p/19q codeletion occurred frequently in patients with higher NEU counts and NLR. We also found that glioma patients with higher NEU or NLR were more likely to have a significantly decreased overall survival. Meanwhile, NEU count was a prognostic marker for TMZ standard treatment GBM patients or IDH wild-type GBM patients. Further biological and functional analysis revealed that NEU count was positively associated with cell cycle and DNA duplication.

Conclusion: Our study was first to highlight the clinical significance of NEU count in GBM clinical treatment, which should be fully valued for clinical prediction and precise management.

Keywords: GBM; Glioma; diagnostic marker; neutrophils; prognostic marker.