Prognostic Role Of Neutrophil-Lymphocyte Ratio In Pediatric Cystic Adamantinomatous Craniopharyngioma

Aim: Neutrophil-lymphocyte ratio (NLR) in peripheral blood, a hematological indicator of systemic inflammation, has been shown as a prognocytic factor in various types of cancer. There is a limited number of studies evaluating the NLR in patients with craniopharyngioma (CP), and also the relationship between cystic component size and NLR in pediatric patients with CPs has not been investigated in the current literature before. This study aimed to investigate the relationship between NLR and cystic component size in pediatric patients with CP. Methods: The medical records of pediatric patients who underwent surgery for a sellar/suprasellar cyst and whose pathology results indicated adamantinomatous CP between January 2008 and December 2019 were retrospectively reviewed. The cystic component size in the preoperative MRI with NLR in the preoperative peripheral blood count were measured. Results: 19 patients (10 females) - age range 2-17 years (mean 9 years) - were recruited. The minimum and maximum cystic component dimensions in MRI were 1.12 cm(3) and 26.32 cm(3), respectively. A positive correlation was found between NLR and cystic component size (r = 0.992; P < 0.05), preoperative diabetes insipidus (r = 0.624), preoperative hydrocephalus (r = 0.825), and subtotal resection (r = 0.634). A negative correlation was found between NLR and gross total resection (r = - 0.634) and preoperative anterior skull base surgery questionnaire scores (r = -0.729). Conclusion: Cystic component size and NLR are closely related in pediatric patients with CP. Preoperative NLR can not only reflect local inflammatory information on CP but also provide guidance in cystic component size, severity of symptoms, and prognosis. NLR >= 2 may have poor prognosis.