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Neutrophil-to-Lymphocyte Ratio and Its Changes are Related to Grade II–IV Glioma Recurrence

Authors Ma L, Li G, Wei M

Received 23 June 2020

Accepted for publication 8 September 2020

Published 30 September 2020 Volume 2020:12 Pages 9429—9434

DOI https://doi.org/10.2147/CMAR.S267523

Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 3

Editor who approved publication: Dr Antonella D'Anneo


Lianghua Ma,1 Guang Li,1 Minjie Wei2

1Department of Radiation Oncology, The First Affiliated Hospital of China Medical University, Shenyang 110001, People’s Republic of China; 2Department of Pharmacology, School of Pharmaceutical Science, China Medical University, Shenyang 110122, People’s Republic of China

Correspondence: Guang Li
Department of Radiation Oncology, The First Affiliated Hospital of China Medical University, Heping District, Shenyang 110001, Liaoning, People’s Republic of China
Email sy_liguang@163.com
Minjie Wei
Department of Pharmacology, School of Pharmaceutical Science, China Medical University, Shenyang North New Area, Shenyang 110122, Liaoning, People’s Republic of China
Email sy_weiminjie@163.com

Objective: To explore whether the neutrophil-to-lymphocyte ratio (NLR) and its changes are related to tumor recurrence in grade II–IV glioma patients.
Methods: One hundred patients who underwent two surgeries (first for diagnosis and the second for recurrence) were retrospectively analyzed. Complete blood count was obtained preoperatively before any treatment. Basic NLR (before the first surgery) and NLR changes were calculated. Tumor recurrence was evaluated by progression-free survival (PFS) using the Kaplan–Meier method. Univariate and multivariate Cox regression analyses were used to determine the potential prognostic factors for PFS.
Results: The PFS of patients with high basic NLR (≥ 4) (median 9 months) was shorter than that of patients with low basic NLR (< 4) (median 23 months) (P = 0.004). Univariate and multivariate analyses both showed that basic NLR (before the first surgery) (≥ 4 vs < 4) was an independent predictor of PFS (P = 0.011). The PFS is also varied with NLR changes before two surgeries (P < 0.05). The PFS of patients with two low NLR (< 4) at both initial surgical resection and section for tumor recurrence had the longest PSF. The patients with two high NLR (≥ 4) at both initial surgical resection and section for tumor recurrence had the shortest PSF. The patients with one high NLR (≥ 4) at initial surgical resection or section for tumor recurrence had an average PSF. Multivariate analysis showed that the change of NLR was of prognostic significance independent of glioma grade.
Conclusion: We showed both basic NLR and NLR changes could predict the recurrence of glioma, but the change of NLR is more accurate than that of basic NLR. The current research not only provides a simple and feasible method for clinical judgment of glioma recurrence but also provides a new idea for exploring the mechanism of glioma recurrence.

Keywords: neutrophil-to-lymphocyte ratio, glioma, prognosis, recurrence, PFS

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