A Systematic Analysis Of The Clinical Characteristics Of High-grade Glioma Based On Blood Markers

Objective:This study aimed to investigate the clinical characteristics of high-grade glioma(HGG),and to explore the relationship between the detection of hematological biomarkers and the pathological grade,treatment cycle,time interval from postoperative to chemoradiotherapy adjuvant therapy,and the prognostic living quality of high-grade glioma.Methods:This retrospective analysis was conducted on patients with high-grade glioma(HGG)who underwent surgical treatment and chemoradiation in the neurosurgery of Tianjin Medical University General Hospital from 2017 to 2019.The pathological diagnosis was in line with the World Health Organization(WHO)classification grades III – IV.We collected information which was extracted from clinical cases and laboratory test,including age,gender,preoperative examination(blood cell analysis,biochemical examination and coagulation function),postoperative examination,pathological results,the number of days from the first day after operation to chemoradiation,the total treatment cycle,KPS score and chemoradiation therapy period.Except for metabolism of liver and kidney disease,blood system diseases,autoimmune diseases and patients with preoperative infection,then calculate and hematology index: the ratio of absolute value of neutrophils to absolute value of lymphocytes(NLR),the ratio of platelets to absolute value of lymphocytes(PLR),the ratio of albumin to globulin(AGR),and the prognostic nutrient index(PNI).IBM SPSS 23.0 was used for statistical processing.Multivariate Logistic regression was used to analyze the correlation between each clinical factor and pathological grade(WHO grade III or IV),and then ROC was used to analyze the optimal critical value of the significant factor.Multiple linear regression was applied to discover the inherent relationship between each clinical factor and the correlation between the multiple factors and KPS score and the time between postoperative time to start chemoradiation.Results:In this study,62 patients with high-grade glioma were included,including 19 WHO grade III gliomas and 43 WHO grade IV gliomas.The age and fibrinogen level of WHO grade III patients were different from that of grade IV patients,and the difference was statistically significant(P < 0.05).Logistic regression pathological grade analysis showed that age and fibrinogen values were positively correlated with HGG pathological grade,and the optimal critical value of age was obtained by ROC curve.For HGG,other hematological markers and preoperative NLR,PLR,AGR and PNI were not associated with pathological grading.In addition,multiple linear regression results showed that globulin was negatively correlated with preoperative AGR and postoperative KPS score,and that preoperative AGR was negatively correlated with the interval between postoperative to chemoradiotherapy adjuvant treatment,which was meaningless with the total treatment cycle.We also found that age was negatively correlated with AGR and PNI.Conclusion:Preoperative hematological marker level varies with the grade of glioma.Age and FIB level have high predictive value for HGG pathological grade,and some markers and indexes have clinical significance for postoperative evaluation of glioma.