Is medulloblastoma associated with systemic immunomodulation? - A comparative analysis of preoperative inflammatory markers
| Autor: | Varidh Katiyar, Ravi Sharma, Mehar Chand Sharma, Zainab Vora, Revanth Goda, Hitesh Gurjar |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
Systemic immunosuppression medicine.medical_treatment Gastroenterology 03 medical and health sciences 0302 clinical medicine Internal medicine Lymphopenia medicine neoplasms Neutrophil-lymphocyte ratio Medulloblastoma Predictive marker Receiver operating characteristic Pilocytic astrocytoma business.industry Area under the curve Absolute lymphocyte count Immunosuppression medicine.disease nervous system diseases stomatognathic diseases 030220 oncology & carcinogenesis Surgery Original Article Neurology (clinical) business 030217 neurology & neurosurgery |
| Zdroj: | Surgical Neurology International |
| ISSN: | 2229-5097 |
| Popis: | Background: We attempt to compare preoperative inflammatory markers among children with medulloblastoma and pilocytic astrocytoma and establish their diagnostic efficacy to distinguish these tumors. Methods: Children ( Results: Patients with medulloblastoma were found to have higher neutrophil-lymphocyte ratio (NLR), derived neutrophil-lymphocyte ratio (dNLR), platelet-lymphocyte ratio (PLR), and platelet counts compared with pilocytic astrocytoma. Absolute lymphocyte count (ALC) was significantly lower in medulloblastoma group as compared to healthy controls but not with pilocytic astrocytoma. NLR and dNLR demonstrated maximum diagnostic accuracy in distinguishing patients with medulloblastoma from healthy controls and pilocytic astrocytoma. Using a cutoff of 2.45 for NLR distinguishes medulloblastoma from healthy controls as well as pilocytic astrocytoma with a sensitivity of 75.5% and specificity of 66.7%. Similarly, dNLR cutoff of 1.47 distinguishes medulloblastoma from healthy controls with a sensitivity of 83% and specificity of 76% and a cutoff of 1.53 distinguishes medulloblastoma from pilocytic astrocytoma with a sensitivity of 81.1% and specificity of 81.8%. Combination of NLR and dNLR performed only marginally better than individual variables with area under the curve being 0.856 for medulloblastoma versus healthy controls and 0.86 for medulloblastoma versus pilocytic astrocytoma. Conclusion: NLR and dNLR can be used as a preoperative predictive marker in medulloblastoma. There is decreased ALC in patients with medulloblastoma contributing to raised NLR and dNLR suggestive of systemic immunosuppression. |
| Databáze: | OpenAIRE |
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