The role of preoperative inflammatory markers in patients with central nervous system tumors, focus on glioma

Fan Chen; Min Chao; Tao Huang; Shaochun Guo; Yulong Zhai; Yuan Wang; Na Wang; Xuan Xie; Liang Wang; Peigang Ji

doi:10.3389/fonc.2022.1055783

The role of preoperative inflammatory markers in patients with central nervous system tumors, focus on glioma

Front Oncol. 2022 Nov 22:12:1055783. doi: 10.3389/fonc.2022.1055783. eCollection 2022.

Authors

Fan Chen¹, Min Chao¹, Tao Huang¹, Shaochun Guo¹, Yulong Zhai¹, Yuan Wang¹, Na Wang¹, Xuan Xie², Liang Wang¹, Peigang Ji¹

Affiliations

¹ Department of Neurosurgery, Tangdu Hospital of Fourth Military Medical University, Xi'an, China.
² Reproductive Medicine Center, Department of Gynecology & Obstetrics, Xijing Hospital of Fourth Military Medical University, Xi'an, China.

Abstract

Background: CNS tumors, particularly gliomas, are associated with a high rate of disability and lethality, and are typically diagnosed with histopathology and immunohistochemistry. Our research aims to develop a minimally invasive method for diagnosing, grading and molecular typing glioma.

Methods: We collected patients who underwent surgery for glioma, Trigeminal neuralgia/Hemifacial spasm, schwannoma, pituitary adenomas and meningioma at our hospital from June 2019 to June 2021. Preoperative WBCs, neutrophils, lymphocytes, monocytes, platelet counts and albumin levels were collected. Preoperative NLR, dNLR, PLR, LMR and PNI were calculated, and the correlation between them and glioma diagnosis as well as grading was analyzed. We also evaluated the diagnostic significance of NLR, dNLR, PLR, LMR, PNI and their combinations for gliomas, particularly GBM, as well as the diagnostic significance of IDH molecular typing of gliomas.

Results: There were 182 healthy samples and 3101 diseased samples in our study. Compared with other groups, glioma patients had significantly higher preoperative NLR, dNLR and PLR values, but lower LMR and PNI values. Further analysis showed that NLR, dNLR, and PLR were positively correlated with glioma grading, while LMR and PNI were negatively correlated with glioma grading. For the diagnosis of glioma, NLR showed a maximum AUC value of 0.8099 (0.7823-0.8374). For GBM, NLR showed a maximum AUC value of 0.9585 (0.9467-0.9703). In the combination, NLR+dNLR showed the highest AUC value of 0.8070(0.7849-0.8291). NLR showed significant statistical significance in all grades of glioma IDH molecular typing, while PLR did not show statistical significance.

Conclusions: NLR has the greatest value for the diagnosis, differential diagnosis, grading and molecular typing of gliomas. The NLR+dNLR combination also showed high sensitivity and specificity. We believe that inflammatory parameters may serve as economical and specific markers for glioma diagnosis, grading, molecular typing, and progression.

Keywords: IDH status; diagnosis; glioma; inflammatory markers; meningioma; molecular typing.