Roles of Neutrophil to Lymphocyte, Lymphocyte to Monocyte, and Platelet to Lymphocyte Ratio in Differentiating Glioblastoma from Brain Metastasis

<strong>Methods</strong> This study is a retrospective, cross-sectional study using medical records from six hospitals in Yogyakarta, Indonesia from 2016 to 2021. Patients with glioblastoma and brain metastasis were included in this study. The laboratory data on initial admission were taken. The diagnosis of glioblastoma and brain metastasis was based on a histopathological examination. <br> <strong>Results</strong> In total, 477 subjects were included in this study. The glioblastoma group consisted of 144 subjects while the brain metastasis group consisted of 275 subjects. The glioblastoma group had higher NLR (12.42 ± 18.67 vs 9.37 ± 10.35, p=0.026), PLR (291.42 ± 549.29 vs 273.10 ± 282.45, p=0.661) and LMR (2.91 ± 2.84 vs 2.74 ± 2.46, p=0.518) than brain metastasis. ROC analysis showed the area under the curve (AUC) of 0.565 (0.510–0.621, p=0.026). An NLR value higher than 7.52 has 54% sensitivity and 59.1% specificity in predicting glioblastoma. <br> <strong>Conclusions</strong> This study showed that the NLR value of glioblastoma patients was significantly higher than brain metastasis, indicating a more severe systemic inflammation in glioblastoma than in brain metastasis. NLR value may be a useful diagnostic tool to distinguish glioblastoma from brain metastasis.