Effect of preoperative peripheral blood neutrophil to lymphocyte ratio and platelet distribution width on clinical prognosis of childhood medulloblastoma / 中华实用儿科临床杂志

ABSTRACT

Objective:To investigate the effect of peripheral blood neutrophil to lymphocyte ratio (NLR) and platelet distribution width (PDW) on the clinical prognosis of childhood medulloblastomaMethods:Clinical data and survival data of 76 pediatric patients who were diagnosed as medulloblastoma by post-operative pathology in the First Affiliated Hospital of Zhengzhou University from January 2009 to December 2016 were collected. Kaplan- Meier method was used to calculate the overall survival(OS) and progression free survival(EFS) rates, Log- rank test was employed to compare the survival rates of different groups, and Cox proportional hazards regression model was used for multivariate analysis. Results:The log- rank test revealed that 5-year PFS rate and OS rate (22.2%, 22.2%) in the high NLR group (NLR>4.94) were significantly lower than those in the low NLR group (NLR≤4.94) (45.6%, 55.7%), and the differences were statistically significant(PFS P=0.009, OS P=0.001), and the 5-year PFS and OS (52.3%, 66.5%) of the high PDW group (PDW>15.90) were significantly higher than those in the low PDW group (PDW ≤ 15.90) (27.1%, 32.5%), and the differences were statistically significant(PFS P=0.032, OS P=0.039). Univa-riate analysis showed that the extent of resection (PFS P=0.006, OS P=0.009), and postoperative radiotherapy (PFS P=0.011, OS P=0.001) and postoperative radiotherapy(PFS P=0.011, OS P=0.001) were the factors influencing the prognosis of children with medulloblastoma.Multivariate Cox proportional hazards regression model analysis suggested that no postoperative radiotherapy (PFS P=0.048, OS P=0.008), NLR>4.94 (PFS P=0.023, OS P=0.003) and PDW≤15.90 (PFS P=0.028, OS P=0.006) were the independent risk factors for the prognosis of childhood medulloblastoma. Conclusions:Increased NLR and decreased PDW indicate unfavorable prognosis of the childhood medulloblastoma.Therefore, preoperative NLR and PDW may be the potential prognostic markers for childhood medulloblastoma.