Abstract
BACKGROUND: Previous studies have found that some indices derived from preoperative complete blood count (CBC) are closely related to the prognosis of glioma, but the results are inconsistent. This study comprehensively discussed the prognostic significance of the preoperative CBC index in patients with glioblastoma (GBM) through a multicenter study. METHODS: In this multicenter study, we retrospectively analyzed clinical data from 143 GBM patients to evaluate the prognostic value of 12 preoperative CBC-derived indicators: Neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), red cell distribution width (RDW), platelet distribution width (PDW), RDW-to-PDW (RPR), systemic inflammation index (SII), systemic inflammation response index (SIRI), hemoglobin-to-red cell distribution width ratio (HRR), platelet-to-basophil ratio (PBR), lymphocyte-to-basophil ratio (LBR), and eosinophil-to-lymphocyte ratio (ELR). Optimal cut-off values for each indicator were determined using maximally selected rank statistics (MSRS). Survival outcomes were assessed by Kaplan-Meier analysis, and univariate and multivariate Cox regression were employed to identify independent prognostic factors. Furthermore, a nomogram was developed by integrating significant prognostic indicators to facilitate individualized prediction of survival in GBM patients. RESULTS: The results showed that higher levels of NLR, PLR, MLR, RDW, PDW, and RPR were associated with shorter survival in GBM patients. In contrast, lower levels of ELR were associated with shorter survival in GBM patients. Among these, RDW (HR 1.905, 95% CI 1.114-3.258, p = 0.019), MLR (HR 1.603, 95% CI 1.029-2.496, p = 0.037), and ELR (HR 0.380, 95% CI 0.193-0.747, p = 0.005) emerged as an independent prognostic factors. The prognostic nomogram was constructed according to the three independent factors, which improved the accuracy of prognosis prediction (AUC = 0.702). CONCLUSION: Routine preoperative CBC parameters, particularly RDW, MLR, and ELR, serve as valuable complementary prognostic indicators for GBM patients. These accessible biomarkers warrant further validation through large-sample, multicenter studies to solidify their clinical utility.