Do Selected Blood Inflammatory Markers Combined with Radiological Features Predict Proliferation Index in Glioma Patients?

BACKGROUND: The tumor microenvironment is partially characterized by a state of chronic inflammation, and radiologic features are related to the tumor's biological behavior. This study was conducted to explore whether peripheral blood inflammatory markers combined with radiologic features could predict proliferation potency. - METHODS: This study retrospectively reviewed 183 patients with a primary diagnosis of glioma. Clinical characteristics, preoperative peripheral full blood count data, and brain magnetic resonance imaging findings were reviewed to analyze the expression of inflammatory markers neutrophil lymphocyte ratio (NLR), monocyte lymphocyte ratio, and platelet lymphocyte ratio (PLR), as well as radiologic features such as location, peritumor edema, and contrast enhancement. Immunohistochemical staining was performed to determine the proliferation index (i.e., expression of Ki-67). Receiver operating characteristic curves for cutoff value, various bivariate tests, and binary logistic regression analyses were applied. RESULTS: Proliferation index was highly associated with tumor grade, showing a gradually increasing tendency. A Ki-67 cutoff value > 9% predicted high-grade glioma (HGG). Mean NLR and PLR were significantly higher in the HGG group compared with the low-grade glioma group (NLR: 3.11 +/- 0.59 vs. 4.27 +/- 1.13; PLR: 133.07 +/- 13.17 vs. 161.51 +/- 38.99; P < 0.01 for both). Contrast enhancement was more likely in the HGG group, but there was no significant between-group difference in peritumor edema. Logistic regression analysis identified the following risk factors for prediction of proliferation potency: age, Karnofsky Performance Score, NLR, PLR, and contrast enhancement. However, age > 43 years, NLR > 3.68, and positive contrast enhancement independently predicted a higher proliferation rate. CONCLUSIONS: NLR and contrast enhancement were positively correlated with the proliferation potency of gliomas.