术前血液炎性反应标志物指标对不同级别脑胶质瘤诊断的价值

Value of Preoperative Hematologic Inflammatory Markers in the Diagnosis of Different Grades of Glioma

目的:探讨术前外周血中性粒细胞与淋巴细胞比值(neutrophil to lymphocyte ratio, NLR)、单核细胞与淋巴细胞比值(monocyte to lymphocyte ratio, MLR)、血小板与淋巴细胞比值(platelet to lymphocyte ratio, PLR)等血液炎性反应标志物指标对低级别脑胶质瘤(low-grade glioma, LGG)和高级别脑胶质瘤(high-grade glioma, HGG)的诊断价值。方法:回顾性纳入2015年1月至2021年12月我院神经外科手术治疗且经术后病理证实的102例脑胶质瘤患者作为研究对象,收集相关临床资料,按照脑胶质瘤级别分为LGG组(n=41)和HGG组(n=61),比较两组血液炎性反应标志物指标的差异,采用多因素Logistic回归模型分析NLR、MLR、PLR与不同脑胶质瘤级别的关系。结果:LGG组患者术前的中性粒细胞计数水平低于HGG组,淋巴细胞计数水平LGG组高于HGG组,差异均有统计学意义(均P <0.05);LGG组的NLR、MLR、PLR低于HGG组,差异均有统计学意义(均P <0.05)。术前NLR、MLR、PLR水平越高,患者胶质瘤病理分级程度也越高,差异具有统计学意义(均P <0.05)。单因素Logistic回归分析显示:术前高NLR、高MLR和高PLR水平均与高级别脑胶质瘤相关(均P <0.05)。在多因素模型中,术前高NLR水平与高级别脑胶质瘤密切相关(P <0.05)。结论:术前NLR、MLR、PLR作为一类方便、客观、易获取的血液炎症反应标志物指标,在LGG和HGG的鉴别诊断中具有一定的价值,术前高NLR水平与高级别脑胶质瘤密切相关。

Objective: To explore the values of hematologic inflammatory markers [neutrophil to lymphocyte ratio(NLR), monocyte to lymphocyte ratio(MLR) and platelet to lymphocyte ratio(PLR)] in the diagnosis of low-grade gliomas(LGG) and high-grade gliomas(HGG). Methods: 102 glioma patients treated by neurosurgery and confirmed by postoperative pathology in our hospital from January 2015 to December 2021 were retrospectively included as the research objects. Clinical data were collected and assigned to LGG group(n = 41) and HGG group(n = 61) according to the grade of glioma. Differences in hematologic inflammatory markers between the two groups were compared. The relations of NLR, MLR and PLR to different grades of glioma were analyzed by multivariate logistic regression models. Results: The preoperative neutrophil count in LGG group was lower than that in HGG group(P < 0.05);the lymphocyte count in LGG group was higher than that in HGG group(P < 0.05);NLR, MLR and PLR in LGG group were lower than those in HGG group(all P < 0.05). The preoperative NLR, MLR and PLR increased as the pathological grade of glioma increased, and the differences were statistically significan(tall P < 0.05). Univariate logistic regression analysis showed that preoperative high NLR, MLR and PLR levels were associated with HGG(all P < 0.05). In the multivariate model, high preoperative NLR level was closely related to HGG(P < 0.05). Conclusion: Preoperative NLR, MLR and PLR, as convenient, objective and obtained hematologic inflammatory markers, are valuable in the differential diagnosis of LGG and HGG. High preoperative NLR level is closely related to HGG.