Is There Any Relationship Between Systemic Inflammatory Markers and Meningioma Grade?

Background: Systemic inflammatory markers have been found to be of value in predicting the prognosis in renal cell and gastrointestinal cancers. Recent studies in gliomas correlating with Systemic inflammatory markers (SIMS) have shown promise in predicting survival. Objective: Meningiomas are the commonest intracranial primary brain tumors in adults. There is a need to distinguish low and high grade meningiomas preoperatively as they have crucial implications for the radicality of surgical excision and prognostication. Methods: A retrospective search was conducted, and the newly diagnosed meningioma cases were studied. The preoperative hematological parameters of the patients and pathological tumor grades were noted. The grade 1 meningioma was defined as low-grade meningioma while grade 2 and 3 meningiomas were defined as high-grade meningioma. Statistical analysis was performed to determine the association between the hematological parameters and tumor grade. Results: Seven hundred and eighty meningioma cases with a mean age of 43.5 years were included. The ANC, NLR, and dNLR were found to be significantly elevated in high-grade meningioma (P = 0.03). Other inflammatory parameters including TLC failed to show a statistically significant difference when compared between the grades of meningioma. ROC analysis further showed limited value of these markers in predicting meningioma grade. However, an elevated ANC (OR = 1.08, 95% CI = 1.02-1.14), male sex (OR = 1.71, 95% CI = 1.13-2.58), and tumor origin from sites other than the skull base or theca! sac (OR = 3.33, 95% CI = 1.93-6.12) were predictive of high-grade meningioma in regression analysis. Conclusion: Preoperative hematological inflammatory parameters have limited value in predicting the grade of tumor in meningiomas. An elevated preoperative ANC, NLR. and dNLR were found to be more frequently associated with high grade of meningiomas.