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Pre-treatment neutrophil-to-lymphocyte ratio is associated with neutrophil and T-cell infiltration and predicts clinical outcome in patients with glioblastoma.

Han S, Liu Y, Li Q, Li Z, Hou H, Wu A - BMC Cancer (2015)

Bottom Line: Markers of systemic inflammation are correlated with patient survival in various cancers.Despite the correlation between NLR and PLR (R = 0.509, P < 0.001), NLR was superior to PLR as a prognostic factor.Pre-treatment NLR is of prognostic significance independent of MGMT status and is superior to PLR as a prognostic factor.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurosurgery, The First Hospital of China Medical University, Nanjing Street 155, Heping District, Shenyang, 110001, China. hansheng2001_x@aliyun.com.

ABSTRACT

Background: Markers of systemic inflammation are correlated with patient survival in various cancers. The prognostic value of neutrophil-to-lymphocyte ratio (NLR) was compared with that of platelet-to-lymphocyte ratio (PLR) in patients with glioblastoma. The association of NLR with neutrophil and T- cell infiltration was also explored.

Methods: A total of 152 patients with glioblastoma were retrospectively analyzed. Clinical information was obtained from electronic medical records. Kaplan-Meier analysis and the Cox proportional hazards models were used to examine the survival function of pre-treatment NLR and PLR in these glioblastoma patients. Neutrophil and CD3(+) T-cell infiltration was assessed by immunohistochemical staining of tissue microarray cores from glioblastomas.

Results: Pre-treatment NLR levels were significantly correlated with overall survival (OS) in glioblastoma patients (multivariate hazard ratio =1.050; 95% confidence interval, 1.003-1.100; P = 0.037). Despite the correlation between NLR and PLR (R = 0.509, P < 0.001), NLR was superior to PLR as a prognostic factor. High pre-treatment NLR (≥4 versus < 4) was significantly associated with high neutrophil infiltration and low CD3(+) T-cell infiltration into tumors, and predicted poor OS (mean, 10.6 vs. 17.9 months, P < 0.001).

Conclusions: Pre-treatment NLR is of prognostic significance independent of MGMT status and is superior to PLR as a prognostic factor. Our results demonstrate a correlation between elevated peripheral blood NLR levels and increased tumor neutrophil infiltration/decreased CD3(+) T-cell infiltration.

No MeSH data available.


Related in: MedlinePlus

Correlation between pre-treatment NLR and other clinical factors in glioblastoma patients. a Stratified analysis of pre-treatment NLR level and overall mortality. Hazard ratios and 95 % confidence intervals in various strata are shown. b Relationship between pre-treatment NLR and postoperative NLR. c Relationship between pre-treatment PLR and postoperative PLR. NLR and PLR were assessed as continuous variables
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Fig2: Correlation between pre-treatment NLR and other clinical factors in glioblastoma patients. a Stratified analysis of pre-treatment NLR level and overall mortality. Hazard ratios and 95 % confidence intervals in various strata are shown. b Relationship between pre-treatment NLR and postoperative NLR. c Relationship between pre-treatment PLR and postoperative PLR. NLR and PLR were assessed as continuous variables

Mentions: Multivariate analysis showed that KPS and MGMT promoter methylation were also independently associated with OS in glioblastoma (Table 2). In keeping with prior literature and prognostic nomograms [27], variables including age (≤60 vs. >60) and KPS (≤70 vs. 80–100) were also analyzed as categorical variables. As shown in Tables 1 and 3, similar results were obtained. We further examined the influence of pre-treatment NLR on OS across strata of other potential predictors, including age, KPS, degree of resection, and MGMT promoter methylation status. Pre-treatment NLR was an independent prognostic factor in all the subgroups (Fig. 2a).Table 3


Pre-treatment neutrophil-to-lymphocyte ratio is associated with neutrophil and T-cell infiltration and predicts clinical outcome in patients with glioblastoma.

Han S, Liu Y, Li Q, Li Z, Hou H, Wu A - BMC Cancer (2015)

Correlation between pre-treatment NLR and other clinical factors in glioblastoma patients. a Stratified analysis of pre-treatment NLR level and overall mortality. Hazard ratios and 95 % confidence intervals in various strata are shown. b Relationship between pre-treatment NLR and postoperative NLR. c Relationship between pre-treatment PLR and postoperative PLR. NLR and PLR were assessed as continuous variables
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4559944&req=5

Fig2: Correlation between pre-treatment NLR and other clinical factors in glioblastoma patients. a Stratified analysis of pre-treatment NLR level and overall mortality. Hazard ratios and 95 % confidence intervals in various strata are shown. b Relationship between pre-treatment NLR and postoperative NLR. c Relationship between pre-treatment PLR and postoperative PLR. NLR and PLR were assessed as continuous variables
Mentions: Multivariate analysis showed that KPS and MGMT promoter methylation were also independently associated with OS in glioblastoma (Table 2). In keeping with prior literature and prognostic nomograms [27], variables including age (≤60 vs. >60) and KPS (≤70 vs. 80–100) were also analyzed as categorical variables. As shown in Tables 1 and 3, similar results were obtained. We further examined the influence of pre-treatment NLR on OS across strata of other potential predictors, including age, KPS, degree of resection, and MGMT promoter methylation status. Pre-treatment NLR was an independent prognostic factor in all the subgroups (Fig. 2a).Table 3

Bottom Line: Markers of systemic inflammation are correlated with patient survival in various cancers.Despite the correlation between NLR and PLR (R = 0.509, P < 0.001), NLR was superior to PLR as a prognostic factor.Pre-treatment NLR is of prognostic significance independent of MGMT status and is superior to PLR as a prognostic factor.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurosurgery, The First Hospital of China Medical University, Nanjing Street 155, Heping District, Shenyang, 110001, China. hansheng2001_x@aliyun.com.

ABSTRACT

Background: Markers of systemic inflammation are correlated with patient survival in various cancers. The prognostic value of neutrophil-to-lymphocyte ratio (NLR) was compared with that of platelet-to-lymphocyte ratio (PLR) in patients with glioblastoma. The association of NLR with neutrophil and T- cell infiltration was also explored.

Methods: A total of 152 patients with glioblastoma were retrospectively analyzed. Clinical information was obtained from electronic medical records. Kaplan-Meier analysis and the Cox proportional hazards models were used to examine the survival function of pre-treatment NLR and PLR in these glioblastoma patients. Neutrophil and CD3(+) T-cell infiltration was assessed by immunohistochemical staining of tissue microarray cores from glioblastomas.

Results: Pre-treatment NLR levels were significantly correlated with overall survival (OS) in glioblastoma patients (multivariate hazard ratio =1.050; 95% confidence interval, 1.003-1.100; P = 0.037). Despite the correlation between NLR and PLR (R = 0.509, P < 0.001), NLR was superior to PLR as a prognostic factor. High pre-treatment NLR (≥4 versus < 4) was significantly associated with high neutrophil infiltration and low CD3(+) T-cell infiltration into tumors, and predicted poor OS (mean, 10.6 vs. 17.9 months, P < 0.001).

Conclusions: Pre-treatment NLR is of prognostic significance independent of MGMT status and is superior to PLR as a prognostic factor. Our results demonstrate a correlation between elevated peripheral blood NLR levels and increased tumor neutrophil infiltration/decreased CD3(+) T-cell infiltration.

No MeSH data available.


Related in: MedlinePlus