title: Association of preoperative levels of selected blood inflammatory markers with prognosis in gliomas.
abstract: BACKGROUND
  Red cell distribution width (RDW), neutrophil-lymphocyte ratio (NLR), and platelet count (PLT) routinely tested as part of the complete blood count are indicative of systemic inflammation. The prognostic significance of NLR and PLT in cancer was demonstrated in many studies while the role of RDW has been hardly investigated. The present study aimed to assess the association of RDW, NLR, and PLT with survival and tumor grade in glioma patients.
  
  
  METHODS
  Clinical data from 178 patients with primary gliomas treated in a single institution were retrospectively analyzed. Receiver operating characteristic curves for cutoff value determination, Kaplan-Meier survival analysis, various bivariate tests, and univariate and multivariate Cox regression analyses were performed.
  
  
  RESULTS
  Patients with high RDW (≥13.95) and NLR (≥4) levels had worse overall survival (OS) (Wilcoxon test,P<0.026 andP<0.003, respectively) while the effect of thrombocytosis (≥400×109/L) on prognosis was not significant. Besides, a strong association between RDW and NLR was found (Spearman's rho =0.230,P<0.02;χ2=8.887,P<0.03; Mann-WhitneyU-test,P<0.017). Moreover, RDW and NLR were significantly associated with tumor grade. In univariate Cox analysis, elevated NLR (hazard ratio, HR 1.385; confidence interval, CI 1.020-1.881,P<0.037), older age (HR 0.452, CI 0.329-0.621,P<0), and higher tumor grade (HR 1.624, CI 1.187-2.223,P<0.002) were associated with poor outcomes. In the multivariate analysis, tumor grade, age, and Karnofsky performance score were identified as being independently prognostic for OS.
  
  
  CONCLUSIONS
  Preoperative NLR and RDW values can help to evaluate disease progression and outcomes in patients with gliomas, thereby contributing to patient follow-up optimization.
authors: Department of Pathology of the Central Nervous System, National Centre for Neurosurgery, Astana, Kazakhstan.
authors: Raushan
authors: R
authors: Auezova
authors: Department of Pathology of the Central Nervous System, National Centre for Neurosurgery, Astana, Kazakhstan.
authors: Nurzhan
authors: N
authors: Ryskeldiev
authors: Department of Pathology of the Central Nervous System, National Centre for Neurosurgery, Astana, Kazakhstan.
authors: Aidos
authors: A
authors: Doskaliyev
authors: Department of Pathology of the Central Nervous System, National Centre for Neurosurgery, Astana, Kazakhstan.
authors: Yerbol
authors: Y
authors: Kuanyshev
authors: Department of Pathology of the Central Nervous System, National Centre for Neurosurgery, Astana, Kazakhstan.
authors: Berik
authors: B
authors: Zhetpisbaev
authors: Department of Pathology of the Central Nervous System, National Centre for Neurosurgery, Astana, Kazakhstan.
authors: Nurgul
authors: N
authors: Aldiyarova
authors: Polenov Russian Scientific Research Institute of Neurosurgery (a branch of Federal Almazov North-West Medical Research Centre), Ministry of Health of the Russian Federation, Saint-Petersburg, Russia.
authors: Natalia
authors: N
authors: Ivanova
authors: Department of Pathology of the Central Nervous System, National Centre for Neurosurgery, Astana, Kazakhstan.
authors: Serik
authors: S
authors: Akshulakov
authors: Bioactive Molecules Research Group, Department of Chemistry and Biochemistry, Faculty of Sciences-II, Lebanese University, Beirut, Lebanon.
authors: Lizette
authors: L
authors: Auezova
keywords: glioma; neutrophil–lymphocyte ratio; platelet; red cell distribution width; survival; tumor grade