Changes in the level of neutrophils, lymphocytes in the peripheral blood in primary and secondary operations for brain tumors

Lisyany O.M., Belskay L.M., Lisyany A.O., Klyuchnikov A.I. , Kot L.A., Palamarchuk N.V.

Summary. Abstract. In patients with brain tumors, especially with malignant glioma grade IV anaplasia, as well as patients with malignant tumors of other origin and histogenesis, there is an imbalance in different subpopulations of immune cells, leading to specific antitumor immunosuppression. For a comprehensive clinical assessment of tumor malignancy, the nature of immune disorders and prediction of consequences, it is recommended to use the definition of both absolute content and relative level of absolute values of these immune cells in the blood, namely the ratio of platelets to neutrophils (Tr/Nf), (Tr/Lf) and neutrophils to lymphocytes (Nf/Lf) which integrally reflect changes in individual indicators of innate and acquired immunity. The aim of the study was to determine the content of lymphocytes, neutrophils and platelets in the blood during primary surgery and prolonged growth in different histogenesis and anaplasia of brain tumors. Material and methods of research. The case histories of 138 patients with brain tumors at the stages of treatment, namely before surgery and before reoperation, were studied. Of these, 71 patients with glial tumors of various degrees of anaplasia were initially operated on — 40 patients with glioblastomas (IV degree of anaplasia), 15 patients with anaplastic astrocytomas (111 degrees of anaplasia), 16 patients with diffuse astrocytomas (1–2 degrees of anaplasia) and 25 patients with meningiomas and 18 patients with pituitary adenomas. 24 patients were re-operated with continued growth 1–5 years after the first operation. Peripheral blood parameters were determined on an automatic hematology analyzer Mindray 3000 plus. Statistical processing of the results was performed according to the program Statistika 8 with the determination of the arithmetic mean and square deviation (m±ð) and t-Student’s index (p <0,05). Research results. Malignant glial tumors (glioblastomas and anaplastic astrocytomas) significantly increase the relative levels of Nf/Lf compared with benign tumors, which indicates a different effect of tumor factors on immunity, namely the stimulation of neutrophil production and inhibition of lymphoma formation. With prolonged growth and recurrence of different histogenesis of brain tumors changes the balance in the composition of immune cells in the peripheral blood. Thus, in malignant tumors of glial origin, changes in the level of Nf/Lf persists as in primary operations, while in benign astrocytomas, the value of the Nf/Lf index increases and approaches the values observed in malignant tumors. The index of the ratio of peripheral blood immune cells, namely Nf/Lf, more than the ratio of platelets to lymphocytes or neutrophils reproduces the state of innate and acquired immunity of patients. Conclusions. The index of the ratio of peripheral blood immune cells, namely Nf/Lf, allows us to recommend its use in the clinic as an additional indicator of the patient’s condition, the degree of anaplasia of brain tumors and possibly to predict the tumor process.

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