Diagnostic Significance of Pre-Treatment Prognostic Nutritional Index, Platelet/Albumin Ratio and Red Cell Distribution Width in Patients with Differentiated Glioblastoma from Brain Metastasis

Abstract

[LANGUAGE= "English"] Objectives: Due to a lack of similar research, this retrospective analysis of patients indicated the blood parameters of pre-treatment inflammatory markers to assess the diagnostic accuracy of the protein nutritional index (PNI), platelet albumin ratio (PAR) and red cell distribution width (RDW) in patients with brain metastasis (BM) and glioblastome multiforme (GBM). Methods: Clinical and laboratory data were retrospectively collected from a group of 244 patients and randomly divided into GBM (142 patients) and BM (102 patients). PNI (serum albumin concentration and lymphocyte count), PAR (platelet count and albumin concentration) and RDW values were calculated 3 weeks before from a chosen pre-treatment modality (preoperative or pre-radiotherapy ). Patients were classified as PNI (? 49.1% vs. > 49.1%), Plt/alb (< 61.6% vs. ? 61.6%) and RDW (< 14.3% vs. ?14.3%). We used receiver operating characteristic (ROC) curve analysis to discover the ideal cutoff values. Results: The neutrophil and trombocyte counts were higher, while the lymphocyte count was lower in patients with GBM and BM. A lower PNI value (P = 0.019), higher PAR value (P = 0.027) and higher RDW value (P = 0.008) were independent diagnostic factors for brain metastasis. Although both PNI and PAR were diagnostically accurate, RDW had proven the highest accuracy of them all. Conclusion: Our study shows that the retrospective analysis provided a robust and independent diagnostic value for pretreatment. The RDW ?14.3%, PNI ? 49.1%, and Plt/alb ? 61.6 ratios also support this diagnostic index for differentiating between GBM and BM .

Alternate abstract:

Objectives: Due to a lack of similar research, this retrospective analysis of patients indicated the blood parameters of pre-treatment inflammatory markers to assess the diagnostic accuracy of the protein nutritional index (PNI), platelet albumin ratio (PAR) and red cell distribution width (RDW) in patients with brain metastasis (BM) and glioblastome multiforme (GBM). Methods: Clinical and laboratory data were retrospectively collected from a group of 244 patients and randomly divided into GBM (142 patients) and BM (102 patients). PNI (serum albumin concentration and lymphocyte count), PAR (platelet count and albumin concentration) and RDW values were calculated 3 weeks before from a chosen pre-treatment modality (preoperative or pre-radiotherapy ). Patients were classified as PNI (? 49.1% vs. > 49.1%), Plt/alb (< 61.6% vs. ? 61.6%) and RDW (< 14.3% vs. ?14.3%). We used receiver operating characteristic (ROC) curve analysis to discover the ideal cutoff values. Results: The neutrophil and trombocyte counts were higher, while the lymphocyte count was lower in patients with GBM and BM. A lower PNI value (P = 0.019), higher PAR value (P = 0.027) and higher RDW value (P = 0.008) were independent diagnostic factors for brain metastasis. Although both PNI and PAR were diagnostically accurate, RDW had proven the highest accuracy of them all. Conclusion: Our study shows that the retrospective analysis provided a robust and independent diagnostic value for pretreatment. The RDW ?14.3%, PNI ? 49.1%, and Plt/alb ? 61.6 ratios also support this diagnostic index for differentiating between GBM and BM .