Abstract
Inflammation and immunoreaction markers were correlated with the survival of patients in many tumors. However, there were no reports investigating the relationships between preoperative hematological markers and the prognosis of medulloblastoma (MB) patients based on the molecular subgroups (WNT, SHH, Group 3, and Group 4). A total 144 MB patients were enrolled in the study. The differences of preoperative hematological markers among molecular subgroups of MB were compared by One-way ANOVA method. Kaplan-Meier method was used to calculate the curves of progression free survival (PFS) and overall survival (OS). The comparison of survival rates in different groups were conducted by the Log-rank test. Multivariate analysis was used to evaluate independent prognostic factors. Increased preoperative NLR (neutrophil-to-lymphocyte ratio, PFS, P = 0.004, OS, P < 0.001) and PLR (platelet-to-lymphocyte ratio, PFS, P = 0.028, OS, P = 0.003) predicted poor prognosis in patients with MB, while preoperative MLR (monocyte-to-lymphocyte ratio), MPV (mean platelet volume), PDW (platelet distribution width), and AGR (albumin-to-globulin ratio) were revealed no predictive value on the prognosis of patients with MB. Furthermore, high preoperative NLR and PLR predicted unfavorable prognosis in childhood MB patients. However, preoperative NLR and PLR were not associated with the prognosis in adult MB patients. Multivariate analysis demonstrated preoperative NLR (PFS, P = 0.029, OS, P = 0.005) and PLR (PFS, P = 0.023, OS, P = 0.005) were the independent prognostic factors in MB patients. Emphatically, the levels of preoperative NLR and PLR in Group 3 MB were significantly higher than those in WNT MB. High preoperative NLR was associated with unfavorable OS in Group 3 (P = 0.032) and Group 4 (P = 0.027) tumors. Similarly, increased preoperative PLR predicted poor PFS (P = 0.012) and OS (P = 0.009) in Group 4 tumors. Preoperative NLR and PLR were the potential prognostic markers for MB patients. Preoperative NLR and PLR were significantly associated with the survival of Group 3 and Group 4 tumors.
Highlights
Medulloblastoma (MB) is one of the most common brain malignant tumors in children, which accounts approximately 20% of all the pediatric brain tumors[1]
We investigated the relationship between preoperative hematological markers and the prognosis of MB patients
We found that high preoperative neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) predicted unfavorable survival in MB patients, while preoperative monocyte-to-lymphocyte ratio (MLR), mean platelet volume (MPV), platelet distribution width (PDW) and AGR had no predictive value on the prognosis in MB patients
Summary
Medulloblastoma (MB) is one of the most common brain malignant tumors in children, which accounts approximately 20% of all the pediatric brain tumors[1]. More and more studies demonstrated that the preoperative hematological markers played important roles in predicting prognosis of several types of tumors, such as esophageal cancer, colorectal cancer, renal cell www.nature.com/scientificreports/. Mounting evidences demonstrated that MB is a heterogenous disease and composed of different molecular subgroups: sonic hedgehog (SHH), wingless (WNT), Group 3, and Group 4. These subgroups are significantly different in transcriptional profiles, genetic abnormalities, clinical characteristics, and prognosis[1,11]. The purpose of the present study was to investigate the prognostic significance of the preoperative hematological markers (NLR, PLR, MLR, MPV, PDW, and albumin-to-globulin ratio (AGR)) combined with molecular subgroups (WNT, SHH, Group 3, and Group 4) on the survival of patients with MB
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