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Review
. 2024 Mar 8:15:77.
doi: 10.25259/SNI_849_2023. eCollection 2024.

The role of preoperative hematological inflammatory markers as a predictor of meningioma grade: A systematic review and meta-analysis

Hanan Anwar Rusidi  1 , Rohadi Muhammad Rosyidi  2 , Dewa Putu Wisnu Wardhana  3 , Wisnu Baskoro  1 , Geizar Arsika Ramadhana  4
Affiliations
Review

The role of preoperative hematological inflammatory markers as a predictor of meningioma grade: A systematic review and meta-analysis

Hanan Anwar Rusidi et al. Surg Neurol Int. .

Abstract

Background: Inflammatory processes play an important role in the aggressiveness of a tumor. However, the relationship between inflammatory markers in meningioma grade is not well known. Knowledge of preoperative meningioma grade plays an important role in the prognosis and treatment of this tumor. This study aims to assess preoperative hematological inflammatory markers as a predictor of the pathological grade of meningioma.

Methods: To ensure comprehensive retrieval of relevant studies, we searched the following key databases, PubMed, Science Direct, and Biomed Central, with evidence related to preoperative hematological inflammatory markers among meningioma up to September 2023. The studies involved were selected based on established eligibility criteria. The analysis in this study uses Review Manager 5.4.

Results: Six studies were obtained from the search results. The total number of patients 2789 (469 high-grade meningioma and 2320 low-grade meningioma) analysis shows elevated neutrophil-to-lymphocyte ratio (NLR) (mean difference [MD]: 0.29; 95% confidence interval [CI] 0.13-0.45; P = 0.0004), monocyte-to-lymphocyte ratio (MLR) (MD: 0.02; 95% CI 0.00-0.04; P = 0.003), and low lymphocyte-to-monocyte ratio (LMR) (MD: -0.82; 95% CI -1.46--0.18; P = 0.005) significantly associated with high-grade meningioma compared to low-grade meningioma. No significant correlation between high-grade and low-grade meningioma based on platelet-lymphocyte ratio value is observed.

Conclusion: The parameters of NLR, MLR, and LMR have been found to be cost-effective preoperative methods that demonstrate potential value in the prediction of meningioma grade. To enhance the reliability of the findings, it is imperative to do further prospective study.

Keywords: Grade; Inflammatory markers; Meningioma.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1:
Figure 1:
Study flow diagram in this review.
Figure 2:
Figure 2:
Forest plot of neutrophil-to-lymphocyte ratio between high-grade and low-grade tumor groups. CI: Confidence interval, SD: Standard deviation. The green box shows the effect value of each study and the size indicates the weight of the study. The black rectangle shows the combined effect value of each study. The analysis showed that NLR was higher in high grade meningioma than in low grade meningioma significantly.
Figure 3:
Figure 3:
Forest plot of platelet-to-lymphocyte ratio between high-grade and low-grade tumor groups. CI: Confidence interval, SD: Standard deviation. The green box shows the effect value of each study and the size indicates the weight of the study. The black rectangle shows the combined effect value of each study. Analysis showed PLR has no significant relationship between high-grade and low-grade meningioma.
Figure 4:
Figure 4:
Forest plot of monocyte-to-lymphocyte ratio between high-grade and low-grade tumor groups. CI: Confidence interval, SD: Standard deviation. The green box shows the effect value of each study and the size indicates the weight of the study.The black rectangle shows the combined effect value of each study. The analysis showed that MLR was higher in high grade meningioma than in low grade meningioma significantly.
Figure 5:
Figure 5:
Forest plot of lymphocyte-to-monocyte ratio between high-grade and low-grade tumor groups. CI: Confidence interval, SD: Standard deviation. The green box shows the effect value of each study and the size indicates the weight of the study. The black rectangle shows the combined effect value of each study. The analysis showed that LMR was lower in high grade meningioma than in low grade meningioma significantly.
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