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. 2022 Nov 22:12:1055783.
doi: 10.3389/fonc.2022.1055783. eCollection 2022.

The role of preoperative inflammatory markers in patients with central nervous system tumors, focus on glioma

Fan Chen  1 , Min Chao  1 , Tao Huang  1 , Shaochun Guo  1 , Yulong Zhai  1 , Yuan Wang  1 , Na Wang  1 , Xuan Xie  2 , Liang Wang  1 , Peigang Ji  1
Affiliations

The role of preoperative inflammatory markers in patients with central nervous system tumors, focus on glioma

Fan Chen et al. Front Oncol. .

Abstract

Background: CNS tumors, particularly gliomas, are associated with a high rate of disability and lethality, and are typically diagnosed with histopathology and immunohistochemistry. Our research aims to develop a minimally invasive method for diagnosing, grading and molecular typing glioma.

Methods: We collected patients who underwent surgery for glioma, Trigeminal neuralgia/Hemifacial spasm, schwannoma, pituitary adenomas and meningioma at our hospital from June 2019 to June 2021. Preoperative WBCs, neutrophils, lymphocytes, monocytes, platelet counts and albumin levels were collected. Preoperative NLR, dNLR, PLR, LMR and PNI were calculated, and the correlation between them and glioma diagnosis as well as grading was analyzed. We also evaluated the diagnostic significance of NLR, dNLR, PLR, LMR, PNI and their combinations for gliomas, particularly GBM, as well as the diagnostic significance of IDH molecular typing of gliomas.

Results: There were 182 healthy samples and 3101 diseased samples in our study. Compared with other groups, glioma patients had significantly higher preoperative NLR, dNLR and PLR values, but lower LMR and PNI values. Further analysis showed that NLR, dNLR, and PLR were positively correlated with glioma grading, while LMR and PNI were negatively correlated with glioma grading. For the diagnosis of glioma, NLR showed a maximum AUC value of 0.8099 (0.7823-0.8374). For GBM, NLR showed a maximum AUC value of 0.9585 (0.9467-0.9703). In the combination, NLR+dNLR showed the highest AUC value of 0.8070(0.7849-0.8291). NLR showed significant statistical significance in all grades of glioma IDH molecular typing, while PLR did not show statistical significance.

Conclusions: NLR has the greatest value for the diagnosis, differential diagnosis, grading and molecular typing of gliomas. The NLR+dNLR combination also showed high sensitivity and specificity. We believe that inflammatory parameters may serve as economical and specific markers for glioma diagnosis, grading, molecular typing, and progression.

Keywords: IDH status; diagnosis; glioma; inflammatory markers; meningioma; molecular typing.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Violin diagram showing comparative results of preoperative inflammatory markers in the healthy control group, the trigeminal neuralgia/hemifacial spasm group, schwannoma group, pituitary adenomas group, meningioma group, and glioma group. (A) NLR, (B) dNLR, (C) PLR, (D) LMR, (E) PNI, (F) Heat map of inflammatory marker features between the groups. The dashed line in the middle represents the median and the dashed lines on both sides represent the interquartile range.
Figure 2
Figure 2
Violin diagram showing comparative results of preoperative inflammatory markers in different grades of glioma groups. (A) NLR, (B) dNLR, (C) PLR, (D) LMR, (E) PNI, (F) Heat map of inflammatory marker profiles in different grades of glioma and healthy controls. The dashed line in the middle represents the median and the dashed lines on both sides represent the interquartile range.
Figure 3
Figure 3
Correlation between preoperative inflammatory markers in patients with glioma. (A) NLR vs dNLR, NLR vs PLR, dNLR vs PLR, PLR vs LMR in Glioma; (B) NLR vs dNLR, NLR vs PLR, dNLR vs PLR, LMR vs PNI in GBM.
Figure 4
Figure 4
The diagnostic value of preoperative inflammatory markers in glioma diagnosis and glioma grading. Glioma vs Healthy control, GBM vs Healthy control, GBM vs WHO I-III, GBM vs WHO I-II.
Figure 5
Figure 5
Potential influences on preoperative inflammatory markers caused by IDH1 mutation within glioma grade. (A) NLR, (B) dNLR, (C) PLR, (D) LMR.
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