PDF(Pubmed)
Abstract：
In our study, we investigated the prognostic significance of hematological markers-NLR (Neutrophil-to-Lymphocyte Ratio), PLR (Platelet-to-Lymphocyte Ratio), and RDW-CV (Red Blood Cell Distribution Width-Coefficient of Variation)-in 117 glioblastoma patients. The data collected from January 2016 to December 2018 included demographics, clinical scores, and treatment regimens. Unlike previous research, which often examined these markers solely before surgery, our unique approach analyzed them at multiple stages: preoperative, postoperative, and before adjuvant therapies. We correlated these markers with the overall survival (OS) and progression-free survival (PFS) using statistical tools, including ANOVA, Cox regression, and Kaplan-Meier survival analyses, employing SPSS version 29.0. Our findings revealed notable variations in the NLR, PLR, and RDW-CV across different treatment stages. The NLR and PLR decreased after surgery, with some stabilization post-STUPP phase (NLR: p = 0.007, η2p = 0.06; PLR: p = 0.001, η2p = 0.23), while the RDW-CV increased post-surgery and during subsequent treatments (RDW-CV: p < 0.001, η2p = 0.67). Importantly, we observed significant differences between the preoperative phase and other treatment phases. Additionally, a higher NLR and RDW-CV at the second-line treatment and disease progression were associated with an increased risk of death (NLR at 2nd line: HR = 1.03, p = 0.029; RDW-CV at progression: HR = 1.14, p = 0.004). We proposed specific marker cut-offs that demonstrated significant associations with survival outcomes when applied to Kaplan-Meier survival curves (NLR at 2nd line < 5: p < 0.017; RDW-CV at progression < 15: p = 0.007). An elevated NLR and RDW-CV at later treatment stages correlated with poorer OS and PFS. No significant preoperative differences were detected. These biomarkers may serve as non-invasive tools for glioblastoma management.
摘要：
在我们的研究中,我们调查了血液学标志物NLR（中性粒细胞与淋巴细胞比率）的预后意义，PLR（血小板与淋巴细胞比率），和RDW-CV（红细胞分布宽度-变异系数）-在117例胶质母细胞瘤患者中。2016年1月至2018年12月收集的数据包括人口统计，临床评分,和治疗方案。与以往的研究不同,通常只在手术前检查这些标记，我们独特的方法在多个阶段分析它们：术前，术后,在辅助治疗之前。我们使用统计工具将这些标志物与总生存期（OS）和无进展生存期（PFS）相关联，包括方差分析,Cox回归,和Kaplan-Meier生存分析，采用SPSS29.0版。我们的发现揭示了NLR的显着变化，PLR,不同治疗阶段的RDW-CV。手术后NLR和PLR下降，具有一定的稳定后STUPP阶段（NLR：p=0.007，η2p=0.06；PLR：p=0.001，η2p=0.23），而RDW-CV在术后和后续治疗期间增加（RDW-CV：p<0.001，η2p=0.67）。重要的是,我们观察到术前阶段和其他治疗阶段之间存在显著差异.此外,二线治疗和疾病进展时较高的NLR和RDW-CV与死亡风险增加相关(二线治疗时NLR:HR=1.03,p=0.029;进展时RDW-CV:HR=1.14,p=0.004).我们提出了特定的标记截止值，当应用于Kaplan-Meier存活曲线时，显示与生存结果显着相关（第二行NLR<5：p<0.017；进展时RDW-CV<15：p=0.007）。治疗后期NLR和RDW-CV升高与OS和PFS较差相关。术前没有检测到显著差异。这些生物标志物可以作为胶质母细胞瘤管理的非侵入性工具。
