Prognostic value of preoperative neutrophil to lymphocyte ratio is superior to systemic immune inflammation index for survival in patients with Glioblastoma

Abstract

Objective: This study evaluated the prognostic value of preoperative neutrophil to lymphocyte ratio(NLR), platelet to lymphocyte ratio(PLR), and systemic immune inflammation index(SII) in patients with Glioblastoma(GBM).

Patients and methods: The peripheral blood indexes and other clinical data were obtained within 1 week before surgery. Receiving operating characteristics(ROC) curve was used to find the optimal cut-off value of NLR, SII and PLR, respectively. Kaplan-Meier (KM) analysis and cox proportional hazard models were used to assess the prognostic value of SII and other indexes.

Results: The optimal cut-off values for NLR, SII, PLR were 2.7, 718, 87, respectively. The high NLR group has a higher proportion of Ki67 expression than the low NLR group. KM survival curves revealed that patients with high NLR (>2.7) or high SII (>718) had worse overall survival. Multivariable Cox analysis revealed NLR, adjuvant therapy and age were prognostic factors for overall survival(OS). The AUC area (the area under the receiver operating characteristics curves) of the NLR was higher than the area of PLR or SII.

Conclusion: Preoperative NLR was superior to SII in prognostic value of patients with glioblastoma.

Keywords: Glioblastoma; Neutrophil lymphocyte ratio; Overall survival; Systemic immune-inflammation index.