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Abstract
Introduction. The study of oncological pathology has now moved beyond the tumor cell. An increasing number of publications in the modern literature highlight the importance of the immune system and inflammation in the prognosis of oncological diseases. The prognostic role of indicators of systemic inflammatory cellular in glioblastoma has not been fully determined.
Aim. To investigate the prognostic value of cellular markers of inflammation in patients with glioblastoma.
Material and methods. The trial included 89 patients with primary supratentorial glioblastoma aged over 18 years. In each case, the levels of neutrophils, lymphocytes, monocytes and cellular markers of inflammation (NLR (neutrophils/lymphocytes ratio), LMR (lymphocytes/monocytes ratio), PLR (platelets/lymphocytes ratio)) were assessed in peripheral blood before surgery, taking into account symptomatic treatment with glucocorticosteroids. The histological diagnosis was made according to the 2021 WHO classification of CNS tumors. After neurosurgery, all patients received standard anti-tumour treatment (radiotherapy, chemotherapy with temozolomide). Of the 89 patients enrolled, 45 (50 %) had progressed for the first time. The remaining 44 (50 %) patients are in the first relapse-free period and are receiving the first line of treatment.
Results. Patients receiving dexamethasone therapy showed a significant increase in the absolute number of neutrophils (p < 0.0001), monocytes (p = 0.014) and NLR (p < 0.0001) compared to patients not receiving hormone therapy. At the same time, the use of dexamethasone did not affect the levels of lymphocytes, platelets, LMR and PLR. The median first relapse-free period was statistically higher in patients with neutrophil counts below 5.9 per 109/L (p = 0.017; 28 vs 16 weeks), platelet counts below 250 per 109/L (p = 0.018; 20.5 vs 17 weeks), LMR greater than 4 (p = 0.002; 31.5 vs 16 weeks), PLR less than 150 (p = 0.0001; 23.5 vs 14 weeks) and NLR less than 3 (p = 0.017; 28 vs 14 weeks).
Conclusion. According to the results obtained, low LMR and high PLR are markers for the prognosis of early disease recurrence. Given that neutrophil and NLR levels were directly correlated with the administration of glucocorticosteroids to patients, it is not recommended that these indicators be used reliably to assess disease prognosis.
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