Background and Aims:

There is an urgent need for sufficiently sensitive, specific and routine biomarkers for glioma, tumour of glial cells.

The main purpose of this study was to identify possible biomarkers in glioma comparing some routine coagulation factors and Neutrophil-to-lymphocyte ratio (NLR) among the following subgroups: a) glioma and MS patients, controls; b) non-recurrent and recurrent glioma patients. As a secondary endpoint we assessed if these markers could be predictive of overall (OS) and progression-free survival (PFS) in glioma patients.

Methods:

This is a single-center, 10-year retrospective study. We evaluated d-dimer, fibrinogen, Antithrombin III (ATIII), Factor VIII (FVIII) and NLR in 138 glioma patients and, for comparison, in 56 multiple sclerosis (MS) patients and 23 healthy controls.

Results:

NLR, d-dimer, ATIII and FVIII were significantly higher in glioma compared to both MS and controls (p<0.0001 for all). ROC curves confirmed that either NLR, ATIII or FVIII were moderately accurate biomarkers (0.7<AUC<0.9) for glioma compared to other two groups. In multivariable analysis, NLR ≥4.3 (median) (HR 1.53 [95%CI 1.04-2.26], p=0.03) together with Karnofsky Performance Status (KPS) ≥80 (median) (0.46 [0.31-0.69], p<0.0001) and use of steroids (1.75 [1.19-2.57], p=0.004) resulted independent predictors of OS while only KPS was independently associated with PFS.

Conclusions:

Our study showed increased levels of either NLR, ATIII, FVIII, or d-dimer in glioma patients compared to MS patients and controls, with the first three representing moderately accurate biomarkers for this cancer. Among these markers, only NLR was found to be predictive for overall survival together with a disability severity and steroid therapy.