A Novel Scoring System Based On Peripheral Blood Test In Predicting Grade And Prognosis Of Patients With Glioma

Objective To explore the value of F-NLR-AGR score based on preoperative fibrinogen,neutrophil to lymphocyte ratio(NLR),and albumin to globulin ratio(AGR)in predicting the prognosis in patients with glioma.Methods 203 glioma patients were retrospectively analyzed.Receiver-operating characteristic(ROC)curve analysis was used to determine the optimal cut-off values for NLR,AGR,and fibrinogen.According to these cut-off values,patients with high NLR(>1.90),low AGR(<1.54),and elevated fibrinogen(>2.61 g/L)were defined as a score of 3,if none of the patients’ three parameters met these standards they were given a score of 0,if any two or one parameter met these standards they were scored as 2 or 1,respectively.The correlation between F-NLR-AGR score and glioma grade was also evaluated.Results The three-year overall survival(OS)rate and the mean overall survival in patients with F-NLR-AGR=3 were lower than those of patients with F-NLR-AGR = 2,1 or 0[17.6% vs 35.2%,66.9% or 83.7%(26.0 vs 39.0,64.0 or 81.0 months),P<0.001].Multivariate analysis revealed that age(HR=2.071;95% CI=1.195-3.588;P=0.009),WHO grade(P<0.001),and F-NLR-AGR score(P<0.001)were independent prognostic factors for OS.Spearman’s rank correlation analysis revealed that F-NLR-AGR score was positively correlated with glioma grade(r=0.278,P<0.01).Conclusion Preoperative F-NLR-AGR score was correlated with glioma grading,high F-NLR-AGR score was an independent predictor of poor prognosis in glioma.Therefore,the scoring system may be applied in clinical practice to identify high-risk patients.