The Diagnostic Significance of Cellular Immune Inflammation Markers in Assessing Different Malignancy Grades Gliomas

Purpose. The purpose of this study was to evaluate the diagnostic relevance of inflammatory markers in gliomas, taking into account different histological subtypes and malignancy levels. Methods. This prospective study included 139 adult glioma patients. Patients were stratified by tumour grade and genetic mutation, yielding 25 cases of diffuse astrocytoma grade 2, 25 cases of glioma grade 3 or 4 with IDH1/2-mutations and 89 cases with glioblastoma. IDH1/2-mutations were detected in 50 patients, 15 of which had co-deletion at 1p19q. The pre-operative neutrophil-lymphocyte ratio (NLR), lymphocyte-monocyte ratio (LMR) and platelet-lymphocyte ratio (PLR) were calculated. Results. The LMR in the glioma grade 2 group was higher than that in the glioma grade 3, 4 and glioblastoma groups (3,71 vs 3,09 vs 3; p < 0,05) with areas under the curve (AUCs) of 0,6552 (0,4930-0,8174) and 0,6586 (0,5583-0,7590) respectively. LMR was higher in patients with IDH1/2-mutation gliomas (3.44 vs 3.0; p = 0.039). No differences in LMR were observed between patients with oligodendroglioma and astrocytoma (3.43 vs 3.19; p = 0.76). LMR in all cohorts was not affected by use of corticosteroids. The NLR was higher in glioblastoma patients than in patients with glioma grade 2 (2.9 vs 1.96, p < 0.05). Increases in neutrophils and NLR in glioblastoma patients were correlated with the corticosteroids (3.7 vs. 8.0, p < 0.05 and 1.95 vs. 3.79, p < 0.05, respectively). Conclusion. LMR is a reliable, non-corticosteroid independent biomarker for diagnosing diffuse adult gliomas, with lower levels indicating higher tumor malignancy. Conversely, NLR is an unreliable biomarker due to its elevation, which often results from glucocorticoid therapy.