Neutrophil-lymphocyte ratio as a possible prognostic marker in central nervous system tumors: an integrative literature review

Authors

DOI:

https://doi.org/10.33448/rsd-v11i11.33998

Keywords:

Glioma; Glioblastoma; Prognosis; NLR.

Abstract

Introduction: Gliomas are primary tumors originating in the brain parenchyma. Recent studies explore the role of some leukocytes and other markers of inflammation in clinical outcomes associated with the development and progression of this cancer, among them there is the neutrophil per lymphocyte ratio (NLR). Aim: The purpose of this study is to understand, through studies published in the literature, the quantitative neutrophil/lymphocyte ratio and its implications for the prognosis of patients. Methodology: Integrative literature review on the PubMed database of productions from the last 11 years. The descriptors used were: "glioma", "glioblastoma", "NLR", "neutrophil to lymphocyte ratio", "neutrophil lymphocyte ratio", "neutrophil-to-lymphocyte ratio", "prognostic", "prognosis" and "outcome". Results: Sixteen articles were selected at the end of the search steps. The year 2019 being the most prevalent with 31.25% of the publications, followed by the years 2017 and 2018 appearing each year with 18.75%. Regarding the countries of origin of the studies, 50% were conducted in China, followed by the studies conducted in Turkey with 25%. Therefore, it is assertive that a high NLR rate suggests a worse prognosis in patients with gliomas. This is based on two important considerations: (1) the rate varies according to the grade of the glioma, with high grade gliomas (III and IV) having in most cases higher NLR than low grade gliomas (I and II) and (2) the overall survival of individuals with low NLR is considerably higher than in those with high. Final Considerations: NLR has important value as a low-cost and reliable prognostic biomarker, however, further studies are needed seeking to obtain a common NLR cutoff point.

References

Ary, A., & Gunver, F. (2019). Comparison of neutrophil–lymphocyte ratio and platelet–lymphocyte ratio in patients with thyroiditis and papillary tumors. Journal of International Medical Research, 47(5), 2077-2083. https://doi.org/10.1177/0300060519838392

Chovanec, M., Cierna, Z., Miskovska, V., Machalekova, K., Kalavska, K., Rejlekova, K., Svetlovska, D., Macak, D., Spanik, S., Kajo, K., Babal, P., De Giorgi, U., Mego, M., & Mardiak, J. (2018). Systemic immune-inflammation index in germ-cell tumours. British Journal of Cancer, 118(6), 831-838. https://doi.org/10.1038/bjc.2017.460

Gandhi, P., Khare, R., Gulwani, H., & Kaur, S. (2018). Circulatory YKL-40 & NLR: Underestimated Prognostic Indicators in Diffuse Glioma. International Journal of Molecular and Cellular Medicine, 7(2), 111-118. https://doi.org/10.22088/IJMCM.BUMS.7.2.111

Grier, J. T., & Batchelor, T. (2006). Low-Grade Gliomas in Adults. The Oncologist, 11(6), 681-693. https://doi.org/10.1634/theoncologist.11-6-681

Haksoyler , V., Bensen , A. A., Koseci, T., Olgun, P., Bayram, E., & Topkan, E. (2021). Neutrophil-to-lymphocyte ratio is prognostic in recurrent glioblastoma multiforme treated with bevacizumab plus irinotecan. Future Medicine, 15(11), 851-859. https://doi.org/10.2217/bmm-2021-0271

Huang, Y., Ding, H., Wu, Q., Li, Z., Li, H., Li, S., Xie, C., & Zhong, Y. (2019). Neutrophil–lymphocyte ratio dynamics are useful for distinguishing between recurrence and pseudoprogression in high-grade gliomas. Dovepress, 11, 6003-6009. https://doi.org/10.2147/CMAR.S202546

Kaya, V., Yildirim, M., Yazici, G., Yalçin, A. Y., Orhan, N., & Guzel, A. (2017). Prognostic Significance of Indicators of Systemic Inflammatory Responses in Glioblastoma Patients. Asian Pacific Journal of Cancer Prevention, 18(12), 3287-3291. https://doi.org/10.22034/APJCP.2017.18.12.3287

Kemerdere, R., Akgun, M. Y., Toklu, S., Alizada, O., & Tanriverdi, T. (2019). Preoperative systemic inflammatory markers in low- and high-grade gliomas: A retrospective analysis of 171 patients. Heliyon, 5(5), 1-5. https://doi.org/10.1016/j.heliyon.2019.e01681

Ma, L., Li, G., & Wei, M. (2020). Neutrophil-to-Lymphocyte Ratio and Its Changes are Related to Grade II–IV Glioma Recurrence. Dovepress, 12, 9429-9434. https://doi.org/10.2147/CMAR.S267523

Margetts, J., Ogle, L. F., Chan, S. L., Chan, A. W. H., Chan, K. C. A., Jamieson, D., Willoughby, C. E., Mann, D. A., Wilson, C. L., Manas, D. M., Yeo, W., & Reeves, H. L. (2017). Neutrophils: driving progression and poor prognosis in hepatocellular carcinoma? British Journal of Cancer, 118(2), 248-257. https://doi.org/10.1038/bjc.2017.386

Mermut, O., & Inanc, B. (2020). The Effect of Indicators of Systemic Inflammatory Response on Survival in Glioblastoma Multiforme. Turkish Neurosurgery, 30(5), 658-665. https://doi.org/10.5137/1019-5149.JTN.27068-19.1

Ocana, A., Nieto-Jiménez, C., Pandiella, A., & Templeton, A. J. (2017). Neutrophils in cancer: prognostic role and therapeutic strategies. Molecular Cancer, 16(137), 1-7. https://doi.org/10.1186/s12943-017-0707-7

Ostrom, Q. T., Patil, N., Waite, K., Kruchko, C., & Barnholtz-Sloan, J. S. (2020). CBTRUS Statistical Report: Primary Brain and Other Central Nervous System Tumors Diagnosed in the United States in 2013-2017. Neuro-Oncology, 22(1), iv1-iv96. https://doi.org/10.1093/neuonc/noaa200

Sharma, G., Jain, S. K., & Sinha, V. D. (2021). Peripheral Inflammatory Blood Markers in Diagnosis of Glioma and IDH Status. Thieme, 12(01), 88-94. https://doi.org/10.1055/s-0040-1721166

Siegel, R. L., Miller, K. D., Fuchs, H. E., & Jemal, A. (2021). Cancer Statistics, 2021. CA: A Cancer Journal for Clinicians, 71(1), 1-27. https://doi.org/10.3322/caac.21654

Stupp, R., Brada, M., van den Bent, M., Tonn, J., & Pentheroudakis, G. (2014). High-grade glioma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up†. Annals of Oncology, 25(3), iii93-iii101. https://doi.org/10.1093/annonc/mdu050

Subeikshanan, V., Dutt, A., Basu, D., Tejus, M., Maurya, V., & Madhugiri, V. (2016). A prospective comparative clinical study of peripheral blood counts and indices in patients with primary brain tumors. Journal of Postgraduate Medicine, 62(2), 86-90. https://doi.org/10.4103/0022-3859.180551

The Cancer Genome Atlas Research Network. (2013). Comprehensive genomic characterization defines human glioblastoma genes and core pathways. Nature, 455(506), 1061-1068. https://doi.org/10.1038/nature07385

Wang, J., Xiao, W., Chen, W., & Hu, Y. (2018). Prognostic significance of preoperative neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio in patients with glioma. EXCLI Journal, 17, 505-512. https://doi.org/https://10.17179/excli2017-978

Wang, P., Meng, Z., Song, H., Yao, K., Duan, Z., Yu, C., Li, S., & Yan, C. (2018). Preoperative Changes in Hematological Markers and Predictors of Glioma Grade and Survival. Frontiers in Farmacology, 9(886), 1-7. https://doi.org/10.3389/fphar.2018.00886

Wang P., Song H., Cai H., Kong L., Yao K., Jiang T., Li S., Yan C. (2017). Preoperative inflammation markers and IDH mutation status predict glioblastoma patient survival. Oncotarget, 8(30), 50117-50123. https://doi.org/10.18632/oncotarget.15235

Wang, Z., Zhang, C., Liu, Y., Wang, Z., & Jiang, T. (2019). Peripheral blood test provides a practical method for glioma evaluation and prognosis prediction. CNS Neuroscience & Therapeutics, 25(8), 876-883. https://doi.org/10.1111/cns.13120

Wiencke, J. K., Koestler, D. C., Salas, L. A., Wiemels, J. L., Roy, R. P., Hansen, H. M., Rice, T., McCoy, L. S., Bracci, P. M., Molinaro, A. M., Kelsey, K. T., Wrensch, M. R., & Christensen, B. C. (2017). Immunomethylomic approach to explore the blood neutrophil lymphocyte ratio (NLR) in glioma survival. Clinical Epigenetics, 9(1), 10-21. https://doi.org/10.1186/s13148-017-0316-8

Yang, T., Mao, P., Chen, X., Niu, X., Xu, G., Bai, X., & Xie, W. (2018). Inflammatory biomarkers in prognostic analysis for patients with glioma and the establishment of a nomogram. Oncology Letters, 17(2), 2516-2522. https://doi.org/10.3892/ol.2018.9870

Zhang, Z., Zhan, Y., Zhang, F., Yu, B., Ji, Y., Zhou, J., Bai, Y., Wang, Y., Wang, L., Jing, Y., Duan, W., Sun, C., Sun, T., Zhao, H., Li, K., Wang, W., Li, R., Sun, H., Zhai, G., Wang, S., Wei, X., Yang, B., Yan, D., Liu, X., & Wang, W. (2019). Prognostic value of preoperative hematological markers combined with molecular pathology in patients with diffuse gliomas. Aging, 11(16), 6252-6272. https://doi.org/10.18632/aging.102186

Published

01/09/2022

How to Cite

SOUZA, L. F. C. de .; ALVES, P. A. . de L. .; ABDALLA, M. R. .; CARVALHO, E. E. V. de .; SALGE, A. K. M. .; ABDALLA, G. K. .; ABDALLA, D. R. . Neutrophil-lymphocyte ratio as a possible prognostic marker in central nervous system tumors: an integrative literature review. Research, Society and Development, [S. l.], v. 11, n. 11, p. e536111133998, 2022. DOI: 10.33448/rsd-v11i11.33998. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/33998. Acesso em: 22 nov. 2024.

Issue

Section

Health Sciences