A Novel Scoring System Based on Peripheral Blood Test in Predicting Grade and Prognosis of Patients with Glioma

PURPOSE: 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. PATIENTS AND 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.