Abstract
SummaryObjectiveTo investigate the relationship between tumor characteristics and the preoperative counts of immune cells in peripheral blood test in glioma patients.MethodsWe included 260 WHO grades II‐IV patients who had preoperative peripheral blood test result from Sanbo hospital as training set. The 66 patients from Tiantan hospital was obtained for validation. RNA sequencing data from CGGA and TCGA datasets were used to evaluate the features of neutrophil subtype and lymphocyte subtype in glioma.ResultsWe revealed that the count of preoperative lymphocytes, eosinophils and neutrophils were associated with glioma grades. Neutrophil‐to‐lymphocyte ratio (NLR) <3.2 was associated with better prognosis, whereas increased NLR was strongly corresponding with a poor prognosis. Lymphocyte type glioma patients demonstrated a positive correlation with isocitrate dehydrogenase (IDH) mutation and lower grade. IDH mutant glioma contained a higher proportion of tumor‐infiltrating lymphocytes than IDH wild‐type glioma. The immune subtype (neutrophil subtype and lymphocyte subtype) was an independent prognostic factor in glioma.ConclusionOur data demonstrated that NLR was an important prognostic factor in glioma. We classified that the immune subtype of glioma may contribute to a better understanding of disease pathogenesis and lead to the identification of new therapeutic targets for glioma patients.
Highlights
Glioma is the most common malignant primary tumor in central ner‐ vous system (CNS) in adults.[1]
We found that patients in highly neutrophil‐ to‐lymphocyte ratio (NLR) group significantly had a shorter overall survival
Similar to the results in Chinese Glioma Genome Atlas (CGGA) dataset, a vast majority of grade II and III (412/519, 79%), oligocytic, isocitrate dehydrogenase (IDH) (396/439, 90%) and ATRX (177/209, 85%) mutation tumors were enriched in this subtype, while 98% (164/168) GBM, 90% (227/251) IDH wild type, 86% (67/78) EGFR, and 89% (50/56) PTEN mutant tumors were clustered in neutrophil subtype
Summary
Glioma is the most common malignant primary tumor in central ner‐ vous system (CNS) in adults.[1]. Glioblastoma remains one of the hardest cancers for treatment in clinical oncology.[3] Previously, due to the presence of the blood‐ brain barrier (BBB) and the absence of a classical lymphatic drainage system, the theory that brain was an immune‐privilege organ was widely accepted.[4] Nowadays, inflammation has been identified to be a hallmark of cancer[5] and the critical role of inflammation compo‐ nents in glioma was a well‐established concept.[6,7] Macrophages, T lymphocytes, and neutrophils were the important infiltrative inflam‐ mation cells in glioma microenvironment which could suppress or promote tumor progression.[8,9,10,11]. The first‐time preoperative routine blood test, RNA sequencing data, and clinicopathological information of glioma patients were included in this study. The integrated analysis of routine blood test and RNA sequencing data may provide a new perspective for immunother‐ apy in the future
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