Preoperative inflammation markers and IDH mutation status predict glioblastoma patient survival

// Peng-Fei Wang 1,* , Hong-Wang Song 1,* , Hong-Qing Cai 2 , Ling-Wei Kong 1 , Kun Yao 3 , Tao Jiang 4,5 , Shou-Wei Li 1 and Chang-Xiang Yan 1 1 Department of Neurosurgery, Sanbo Brain Hospital, Capital Medical University, China 2 Department of Neurosurgery, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, China 3 Department of Pathology, Sanbo Brain Hospital, Capital Medical University, China 4 Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China 5 Beijing Neurosurgical Institute, Beijing, China * These authors have contributed equally to this work and are co-first authors Correspondence to: Chang-Xiang Yan, email: // Shou-Wei Li, email: // Keywords : glioblastomas, IDH-1 R132H mutation, neutrophil to lymphocyte ratio, platelet to lymphocyte ratio, lymphocyte to monocyte ratio Received : September 08, 2016 Accepted : January 24, 2017 Published : February 09, 2017 Abstract Recent studies suggest that inflammation response biomarkers are prognostic indicators of solid tumor outcomes. Here, we quantify the prognostic value of the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and lymphocyte-to-monocyte ratio (LMR) in glioblastomas (GBMs), taking into consideration the role of the isocitrate dehydrogenase (IDH) mutation status. We examined 141 primary glioblastomas (pGBMs) and 25 secondary glioblastomas (sGBMs). NLRs, PLRs, and LMRs were calculated before surgery. IDH mutations were detected immunohistochemically after tumor resection, and patients’ clinical outcomes were analyzed after classification into GBM, pGBM, and IDH-wild type glioblastoma (IDH-wt GBM) groups. To make comparisons, we set cutoffs for NLR, PLR and LMR of 4.0, 175.0, and 3.7, respectively. In a multivariate analysis, both NLR (HR=1.712, 95% CI 1.026-2.858, p=0.040) and PLR (HR=2.051, 95% CI 1.288-3.267, p=0.002) had independent prognostic value. While a low NLR was associated with a better prognosis only in the IDH-wt GBM group, PLR was predictive of patient survival in the GBM, pGBM, and IDH-wt GBM groups. By contrast, LMR exhibited no prognostic value for any of the 3 types of GBM.