THE ROLE OF NEUTROPHIL EXTRACELLULAR TRAPS IN TUMOR MICROENVIRONMENT MODULATION AND PROGNOSTIC SIGNIFICANCE OF GLIOBLASTOMA

BACKGROUND: The effects of neutrophil extracellular traps (NET) on cell invasion, inflammation, metastasis, and resistance to treatment are profound. However, little is known about NET's involvement in glioblastoma. OBJECTIVE: The objective was to investigate the expression patterns of NET, their relationships to the tumor microenvironment (TME), and their significance for the survival of glioblastoma patients. METHODOLOGY: The in-silico study was conducted from June 2023 to December 2024. Gene expression patterns and clinical data were obtained from the UCSC Xena database for patients diagnosed with glioblastoma. NET-related gene expression profiles were validated in U251 glioblastoma cells and human astrocytes, and these results were used to construct prognostic signatures. RESULTS: Patients with low NET values compared to individuals with high NET scores had lower overall survival (OS, P<0.001). A high NET score was linked to different TMB and neutrophil-related paths. The NET score correlated greatly with both OS and treatment response after confirming in vitro research. CONCLUSIONS: The NET score system represents a novel, clinically relevant tool for assessing prognostic risk in glioblastoma multiforme (GBM). Our findings suggest that NETs could serve as both biomarkers and therapeutic targets, offering new avenues for personalized treatment strategies in glioblastoma. KEYWORDS: Tumor microenvironment; Neutrophil extracellular traps; Prognosis; Glioblastoma