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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 immune cell infiltration in glioblastomas. a Representative immunohistochemical images of neutrophil infiltration and CD3+ T-cell infiltration in glioblastoma patients with pre-treatment NLR ≥4 and NLR <4. b, c Pre-treatment NLR ≥4 (versus NLR <4) significantly correlated with high neutrophil infiltration (b) and low CD3+ T-cell infiltration (c). High neutrophil infiltration (number of neutrophils ≥10/200 × HPF) and low CD3+ T-cell infiltration (number of CD3+ T-cells <20/400 × HPF) were more frequent in patients with pre-treatment NLR ≥4 than in those with pre-treatment NLR < 4 (69.4 vs. 36.9 %, P < 0.001 and 59.2 vs. 38.8 %, P = 0.019, respectively). d-f Kaplan-Meier plots of overall survival, stratified by different levels of neutrophil infiltration (D and E) or CD3+ T-cell infiltration (f). Scale bars, 50 μm
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Fig4: Correlation between pre-treatment NLR and immune cell infiltration in glioblastomas. a Representative immunohistochemical images of neutrophil infiltration and CD3+ T-cell infiltration in glioblastoma patients with pre-treatment NLR ≥4 and NLR <4. b, c Pre-treatment NLR ≥4 (versus NLR <4) significantly correlated with high neutrophil infiltration (b) and low CD3+ T-cell infiltration (c). High neutrophil infiltration (number of neutrophils ≥10/200 × HPF) and low CD3+ T-cell infiltration (number of CD3+ T-cells <20/400 × HPF) were more frequent in patients with pre-treatment NLR ≥4 than in those with pre-treatment NLR < 4 (69.4 vs. 36.9 %, P < 0.001 and 59.2 vs. 38.8 %, P = 0.019, respectively). d-f Kaplan-Meier plots of overall survival, stratified by different levels of neutrophil infiltration (D and E) or CD3+ T-cell infiltration (f). Scale bars, 50 μm

Mentions: Tissue microarrays were used to assess neutrophil and T-cell infiltration using immunohistochemical staining in 152 glioblastomas. To evaluate the association between pre-treatment NLR and immune cell infiltration, we semi-quantified the infiltrating neutrophils and CD3+ T-cells. The level of neutrophil infiltration was significantly positively correlated with pre-treatment NLR level (NLR < 4 vs. NLR ≥ 4; P < 0.001), whereas CD3+ T-cell infiltration level was negatively correlated with pre-treatment NLR level (P = 0.006; Table 4). According to previous data and our results, a number of neutrophils ≥10/200 × HPF [8, 9] and a number of CD3+ T-cells ≥20/400 × HPF [7, 11] were used as cutoff points to define a high infiltration group and a low infiltration group. High neutrophil infiltration and low CD3+ T-cell infiltration were more frequent in patients with pre-treatment NLR ≥4 than in those with pre-treatment NLR < 4 (69.4 vs. 36.9 %, P < 0.001 and 59.2 vs. 38.8 %, P = 0.019, respectively (Fig. 4a-c).Table 4


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 immune cell infiltration in glioblastomas. a Representative immunohistochemical images of neutrophil infiltration and CD3+ T-cell infiltration in glioblastoma patients with pre-treatment NLR ≥4 and NLR <4. b, c Pre-treatment NLR ≥4 (versus NLR <4) significantly correlated with high neutrophil infiltration (b) and low CD3+ T-cell infiltration (c). High neutrophil infiltration (number of neutrophils ≥10/200 × HPF) and low CD3+ T-cell infiltration (number of CD3+ T-cells <20/400 × HPF) were more frequent in patients with pre-treatment NLR ≥4 than in those with pre-treatment NLR < 4 (69.4 vs. 36.9 %, P < 0.001 and 59.2 vs. 38.8 %, P = 0.019, respectively). d-f Kaplan-Meier plots of overall survival, stratified by different levels of neutrophil infiltration (D and E) or CD3+ T-cell infiltration (f). Scale bars, 50 μm
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

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

Fig4: Correlation between pre-treatment NLR and immune cell infiltration in glioblastomas. a Representative immunohistochemical images of neutrophil infiltration and CD3+ T-cell infiltration in glioblastoma patients with pre-treatment NLR ≥4 and NLR <4. b, c Pre-treatment NLR ≥4 (versus NLR <4) significantly correlated with high neutrophil infiltration (b) and low CD3+ T-cell infiltration (c). High neutrophil infiltration (number of neutrophils ≥10/200 × HPF) and low CD3+ T-cell infiltration (number of CD3+ T-cells <20/400 × HPF) were more frequent in patients with pre-treatment NLR ≥4 than in those with pre-treatment NLR < 4 (69.4 vs. 36.9 %, P < 0.001 and 59.2 vs. 38.8 %, P = 0.019, respectively). d-f Kaplan-Meier plots of overall survival, stratified by different levels of neutrophil infiltration (D and E) or CD3+ T-cell infiltration (f). Scale bars, 50 μm
Mentions: Tissue microarrays were used to assess neutrophil and T-cell infiltration using immunohistochemical staining in 152 glioblastomas. To evaluate the association between pre-treatment NLR and immune cell infiltration, we semi-quantified the infiltrating neutrophils and CD3+ T-cells. The level of neutrophil infiltration was significantly positively correlated with pre-treatment NLR level (NLR < 4 vs. NLR ≥ 4; P < 0.001), whereas CD3+ T-cell infiltration level was negatively correlated with pre-treatment NLR level (P = 0.006; Table 4). According to previous data and our results, a number of neutrophils ≥10/200 × HPF [8, 9] and a number of CD3+ T-cells ≥20/400 × HPF [7, 11] were used as cutoff points to define a high infiltration group and a low infiltration group. High neutrophil infiltration and low CD3+ T-cell infiltration were more frequent in patients with pre-treatment NLR ≥4 than in those with pre-treatment NLR < 4 (69.4 vs. 36.9 %, P < 0.001 and 59.2 vs. 38.8 %, P = 0.019, respectively (Fig. 4a-c).Table 4

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