<p>Predicting Individual Prognosis and Grade of Patients with Glioma Based on Preoperative Eosinophil and Neutrophil-to-Lymphocyte Ratio</p>
Xu Zhang, Can Li, Lifei Xiao, Caibin Gao, Wei Zhao, Maolin Yang, Tao Sun, Feng Wang
Abstract
Purpose: Eosinophils are proven to play a role in the prognosis of some malignant-tumors. The prognostic value of eosinophils in glioma patients is, however, scarcely reported. The authors of this article have designed a novel prognostic indicator based on eosinophils and the neutrophil-to-lymphocyte ratio (NLR), named ENS, to predict the survival of patients with glioma. Methods: A retrospective study was conducted on 217 glioma patients. The cut-off values for eosinophil, NLR, and other clinical variables were determined by the receiver operating characteristic (ROC) curve analysis. Patients with both low eosinophil count (< 0.08 × 10 9 /L) and high NLR (≥ 1.70) were given a score of 2. Those with one or neither got a score of 1 or 0, respectively. The nomogram was based on ENS and several other clinical variables, its performance was determined by the concordance index (c-index). Results: Our results showed that ENS is an independent prognostic indicator for overall survival (OS). The three-year OS rates for low-grade glioma patients (LGGs) were 84.0%, 69.0%, and 46.4% for ENS=0, ENS=1, and ENS=2, respectively ( P =0.014). The three-year OS incidence for LGGs stratified into eosinophils count ≥ 0.08× 109/L and< 0.08× 109/L subgroups were 88.1% and 80.0%, respectively ( P =0.043). ENS was positively correlated with glioma grade (r=0.311, P < 0.001). The c-index for OS prognosis was 0.80 using this nomogram in LGGs. Conclusion: Preoperative ENS can predict OS to some extent for LGGs and can increase prognostic accuracy for individual OS in LGGs postoperatively when incorporating other clinical variables compose a nomogram. Keywords: low-grade glioma, eosinophil, neutrophil-to-lymphocyte ratio, nomogram, prognosis