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Predicting Individual Prognosis and Grade of Patients with Glioma Based on Preoperative Eosinophil and Neutrophil-to-Lymphocyte Ratio

Authors Zhang X, Li C, Xiao L, Gao C, Zhao W, Yang M, Sun T, Wang F

Received 30 April 2020

Accepted for publication 1 July 2020

Published 14 July 2020 Volume 2020:12 Pages 5793—5802


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 3

Editor who approved publication: Dr Seema Singh

Xu Zhang,1,2 Can Li,1,2 Lifei Xiao,1,2 Caibin Gao,1,2 Wei Zhao,1,2 Maolin Yang,1,2 Tao Sun,1,2 Feng Wang1,2

1Department of Neurosurgery, General Hospital of Ningxia Medical University, Yinchuan 750000, People’s Republic of China; 2Ningxia Key Laboratory of Cerebrocranial Disease, Incubation Base of National Key Laboratory, Ningxia Medical University, Yinchuan 750000, People’s Republic of China

Correspondence: Tao Sun; Feng Wang Tel +86 13895670991

Purpose: Eosinophils are proven to play a role in the prognosis of some malignant-tumors. The prognostic value of eosinophils in glioma patients is, however, scarcely reported. The authors of this article have designed a novel prognostic indicator based on eosinophils and the neutrophil-to-lymphocyte ratio (NLR), named ENS, to predict the survival of patients with glioma.
Methods: A retrospective study was conducted on 217 glioma patients. The cut-off values for eosinophil, NLR, and other clinical variables were determined by the receiver operating characteristic (ROC) curve analysis. Patients with both low eosinophil count (< 0.08 × 109/L) and high NLR (≥ 1.70) were given a score of 2. Those with one or neither got a score of 1 or 0, respectively. The nomogram was based on ENS and several other clinical variables, its performance was determined by the concordance index (c-index).
Results: Our results showed that ENS is an independent prognostic indicator for overall survival (OS). The three-year OS rates for low-grade glioma patients (LGGs) were 84.0%, 69.0%, and 46.4% for ENS=0, ENS=1, and ENS=2, respectively (P=0.014). The three-year OS incidence for LGGs stratified into eosinophils count ≥ 0.08× 109/L and< 0.08× 109/L subgroups were 88.1% and 80.0%, respectively (P=0.043). ENS was positively correlated with glioma grade (r=0.311, P< 0.001). The c-index for OS prognosis was 0.80 using this nomogram in LGGs.
Conclusion: Preoperative ENS can predict OS to some extent for LGGs and can increase prognostic accuracy for individual OS in LGGs postoperatively when incorporating other clinical variables compose a nomogram.

Keywords: low-grade glioma, eosinophil, neutrophil-to-lymphocyte ratio, nomogram, prognosis

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