Role of inflammatory markers in differentiation and prognostication of gliomas - A prospective cohort study.

Background: The tumor microenvironment is an indispensable component of the tumorigenesis of gliomas. Retrospective studies reveal that certain inflammatory markers could represent the aggressive variants due to the systemic inflammation associated with them. The primary objective is to study the association between procalcitonin (PCT), C-reactive protein (CRP), and hematological inflammatory markers in gliomas. The secondary objective is to prognosticate gliomas using the Karnofsky performance score (KPS) at 6 months based on these markers. Methods: This prospective cohort study comprises 100 patients diagnosed with glioma radiologically. Multivariate logistic regression analysis was performed to assess the association of the biomarkers with KPS, and the Odds ratio (OR) was calculated. Results: 92.8% of all glioma patients had PCT <0.05 ng/dL, and 85.4% had low CRP of <0.3 mg/L. High-grade gliomas (HGGs) had a low median basophil count compared to low-grade gliomas (P = 0.02). HGGs had increased values of hematological inflammatory markers compared to the low-grade group. The OR of low KPS (<70) is 7.4 times more in the high neutrophil-lymphocyte ratio group (P < 0.05). Conclusion: We found no significant association between PCT, CRP, and inflammatory biomarkers with grades of gliomas. However, there was a significant difference in the distribution of basophil count between the two groups. Further studies are required to validate their role in gliomas.