title: Pediatric central nervous system tumors in the first 3 years of life: pre-operative mean platelet volume, neutrophil/lymphocyte count ratio, and white blood cell count correlate with the presence of a central nervous system tumor.
abstract: OBJECTIVE
  The aim of this study is to describe the relationship of pre-operative complete blood count parameters [mean platelet volume (MPV), neutrophil/lymphocyte count ratio (NLCR), and white blood cell count (WBC)], with the clinical, radiological, and histopathological features and the management options for patients under 3 years of age with a newly diagnosed central nervous system tumors.
  
  
  METHODS
  Children with central nervous system (CNS) tumors in the first 3 years of life admitted in the Erciyes University Hospital between April 2004 and April 2014 were enrolled in this study. The CBC parameters were compared with those of an age- and sex-matched normal control group.
  
  
  RESULTS
  In the study group, the means of MPV and WBC were 8.00 ± 1.24 fl, and 10,855 ± 3642/mm3respectively; the median (25-75%) of NLCR was 0.98 (0.66-1.46). For the control group, the means of MPV and WBC were 6.8 ± 0.73 fl and 8565 ± 2522/mm3; the median (25-75%) of NLCR was 0.52 (0.36-0.70). The MPV, WBC, and NLCR were higher in the study group. The median overall survival (OS) of the patients was 60 months (range 0-81.6 months); and median event free survival (EFS) was 24 months (range 0-70.1 months). The formulation of MPV, NLCR, and WBC was found to be predictive for the diagnosis of CNS tumor in children with nonspecific symptoms. The univariate and multiple binary regression analyses showed a positive association of MPV, NLCR, and WBC and the risk of a diagnosis of CNS tumor. There was no relationship between MPV, WBC, NLCR, and histological subgroups. However, there were no associations between CBC parameters and OS or EFS of the patients.
  
  
  CONCLUSIONS
  By causing suspicion, MPV, NLCR, and WBC may provide both an earlier radiological investigation decision and thereby an early diagnosis of CNS tumor in children with nonspecific symptoms in the first 3 years of life.
authors.affiliation: Department of Neurosurgery Faculty of Medicine, Erciyes University, 38039, Talas, Kayseri, Turkey.
authors.forename: Abdulfettah
authors.initials: A
authors.lastname: Tumturk
authors.affiliation: Department of Pediatrics, Division of Pediatric Hematology and Oncology, Faculty of Medicine, Erciyes University, 38039, Talas, Kayseri, Turkey.
authors.forename: Mehmet Akif
authors.initials: MA
authors.lastname: Ozdemir
authors.affiliation: Department of Pediatrics, Division of Pediatric Neurology, Faculty of Medicine, Erciyes University, Kayseri, Turkey.
authors.forename: Huseyin
authors.initials: H
authors.lastname: Per
authors.affiliation: Department of Pediatrics, Division of Pediatric Hematology and Oncology, Faculty of Medicine, Erciyes University, 38039, Talas, Kayseri, Turkey. drekremunal@yahoo.comtr.
authors.forename: Ekrem
authors.initials: E
authors.lastname: Unal
authors.affiliation: Department of Neurosurgery Faculty of Medicine, Erciyes University, 38039, Talas, Kayseri, Turkey.
authors.forename: Ahmet
authors.initials: A
authors.lastname: Kucuk
authors.affiliation: Department of Neurosurgery Faculty of Medicine, Erciyes University, 38039, Talas, Kayseri, Turkey.
authors.forename: Halil
authors.initials: H
authors.lastname: Ulutabanca
authors.affiliation: Department of Pediatrics, Division of Pediatric Hematology and Oncology, Faculty of Medicine, Erciyes University, 38039, Talas, Kayseri, Turkey.
authors.forename: Musa
authors.initials: M
authors.lastname: Karakukcu
authors.affiliation: Department of Pathology, Faculty of Medicine, Erciyes University, Kayseri, Turkey.
authors.forename: Ozlem
authors.initials: O
authors.lastname: Canoz
authors.affiliation: Department of Pediatrics, Division of Pediatric Neurology, Faculty of Medicine, Erciyes University, Kayseri, Turkey.
authors.forename: Hakan
authors.initials: H
authors.lastname: Gumus
authors.affiliation: Department of Radiology, Division of Pediatric Radiology, Faculty of Medicine, Erciyes University, Kayseri, Turkey.
authors.forename: Abdulhakim
authors.initials: A
authors.lastname: Coskun
authors.affiliation: Department of Neurosurgery Faculty of Medicine, Erciyes University, 38039, Talas, Kayseri, Turkey. kurtsoya@erciyes.edu.tr.
authors.forename: Ali
authors.initials: A
authors.lastname: Kurtsoy
mesh_terms: D000367:Age Factors; D002097:C-Reactive Protein / Q000378:metabolism; D016022:Case-Control Studies; D016543:Central Nervous System Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007958:Leukocyte Count; D008137:Longitudinal Studies; D018655:Lymphocyte Count; D008279:Magnetic Resonance Imaging; D008297:Male; D063847:Mean Platelet Volume; D010976:Platelet Count; D012189:Retrospective Studies; D018709:Statistics, Nonparametric
chemical_list: D002097:C-Reactive Protein
keywords: CNS tumors; Children; Infant; Mean platelet volume; Neutrophil/lymphocyte count ratio; White blood cell count