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| ORIGINAL ARTICLE
|Year : 2021 | Volume
| Issue : 4 | Page : 894--901
Biomarkers of Systemic Inflammation in Patients with Glioblastoma: An Analysis of Correlation with Tumour-Related Factors and Survival
Venkatesh S Madhugiri1, Venkatesan Subeikshanan2, Akshat Dutt2, Aliasgar Moiyadi3, Sridhar Epari4, Prakash Shetty3, Tejpal Gupta5, Rakesh Jalali6, Anil K Dutt7
1 Department of Neurosurgery, National Institute of Mental Health and Neuro Sciences, Bangalore, Karnataka, India
2 Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India
3 Division of Neurosurgery, Neuro-Oncology Disease Management Group, Tata Memorial Centre, Mumbai, Maharashtra, India
4 Department of Pathology, Neuro-Oncology Disease Management Group, Tata Memorial Centre, Mumbai, Maharashtra, India
5 Department of Radiation Oncology, Neuro-Oncology Disease Management Group, Tata Memorial Centre, Mumbai, Maharashtra, India
6 Apollo Proton Cancer Centre, Chennai, Tamil Nadu, India
7 Ispat General Hospital, Rourkela, Odisha, India
Background: Biomarkers of systemic inflammation (BMSIs), including haemogram cell counts (CC, e.g., absolute neutrophil count) and cell count-ratios (CCR, e.g., the neutrophil-lymphocyte ratio, etc.), have been found to have prognostic significance in many solid-organ cancers.
Aims: In this three-part study, we first examined if the CCs and CCRs were altered in patients with glioblastoma (GBM) when compared with healthy controls. Second, we evaluated for any correlation between the BMSIs and patient- and tumour-related factors. Third, we evaluated the influence of the CCs and CCRs on survival.
Methods: This was a retrospective analysis of patients who underwent surgery/biopsy for a newly diagnosed brain tumour that was subsequently confirmed to be GBM (Cases). Controls were healthy individuals who underwent pre-employment screening blood tests.
Statistical Methods: Parametric tests were used to compare normally distributed continuous variables, whereas non-normally distributed variables were compared using non-parametric tests. Thresholds for the BMSIs were determined using X-tile analysis. Cox regression using the proportional hazards model was used for survival analyses around the determined thresholds.
Results: All CCs and CCRs were altered in Cases compared with Controls. Presentation with raised intracranial pressure, altered sensorium, poor performance status, loss of ATRX, and lack of p53 overexpression was associated with an inflammatory phenotype of changes in the BMSIs. The inflammatory phenotype of changes was associated with poor survival.
Conclusions: A significant inflammatory response was found in patients with GBM and correlated with clinical features, the molecular profile of the tumour and poor survival.
Dr. Venkatesh S Madhugiri
Department of Neurosurgery, National Institute of Mental Health and Neuro Sciences, Hosur Road, Bangalore - 560 029, Karnataka
Source of Support: None, Conflict of Interest: None
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