Evaluation value of neutrophil, monocyte and lymphocyte for the prognosis of different grade glioma

Objective To evaluate the prognostic value of neutrophil-lymphocyte radio (NLR), monocyte-tolymphocyte ratio (MLR) for the prognosis of different grades glioma. Methods We enrolled 635 glioma patients who received surgery from January 2010 to March 2018 in the Neurosurgery Department, the Third Affiliated Hospital of Harbin Medical University, with 291 low-grade gliomas and 344 high-grade gliomas, and collected their clinical records and follow-up data. The optimal cut-off values of NLR and MLR for the prognosis of gliomas was determined by R software. The patients were divided into high-value groups and low-value groups according to the cut-off values. Kaplan-Meier survival analysis, univariate and multivariate Cox regression analysis were used to evaluate the effect of preoperative peripheral blood NLR and MLR on the prognosis of patients with different grade gliomas. Results The preoperative NLR and MLR levels were statistical different between low-grade and high-grade gliomas. The best cut-off points for the effects of NLR and MLR on the prognosis of glioma were 1.83 and 0.16, respectively. In low-grade and high-grade gliomas, the median survival of patients with NLR <1.83 was greater than that of NLR ≥ 1.83, and the median survival of patients with MLR <0.16 was greater than that of MLR ≥ 0.16. In low-grade gliomas, NLR and MLR were prognostic risk factors, and NLR was an independent risk factor of glioma prognosis [OR=1.92(1.14~3.23), P<0.05]. In high-grade gliomas, only NLR was independent risk factor of glioma prognosis [OR=1.42(1.05~1.93), P<0.05]. Conclusion Preoperative blood NLR and MLR can be used as clinical evaluation indicators for low-grade glioma prognosis, and only NLR was the clinical evaluation indicator for high-grade glioma prognosis. NLR was more effective prognostic indicator for glioma patients than MLR. Key words: Glioma; Neutrophil-lymphocyte ratio; Monocyte-lymphocyte ratio; Prognosis