Skip to main content
SpringerLink
Log in

The prognostic value of before treatment neutrophil-to-lymphocyte ratio in nasopharyngeal carcinoma

  • Rhinology
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Objective

The aim of this analysis was to evaluate the prognostic significance of inflammatory biomarkers (NLR, dNLR, PLR and LMR) in NPC patients.

Methods

This was a retrospective analysis of 111 NPC patients from January 2013 and December 2016. Receiver-operating characteristic (ROC) curve was plotted to determine the cut-off values of these inflammatory biomarkers. Univariate analysis and multivariate Cox regression model were used to evaluate the association between these parameters and progression-free survival (PFS) and overall survival (OS).

Results

The optimal critical value of NLR was 2.02, by which cases were divided into high NLR group (NLR ≥ 2.02) and low NLR group (NLR < 2.02). The elevated NLR was significantly associated with decreased OS (P = 0.009) and remained significant in multivariate analysis (HR 8.48, 95% CI 1.69–42.46, P = 0.009).

Conclusions

The before treatment NLR may be an independent prognostic biomarker for OS in patients with NPC. NLR, dNLR and PLR might be a useful complement to TNM staging in the prognosis evaluation of NPC patients.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  1. Wei KR, Zheng RS, Zhang SW et al (2017) Nasopharyngeal carcinoma incidence and mortality in China, 2013. Chin J Cancer. https://doi.org/10.1186/s40880-017-0257-9

    Article  PubMed  PubMed Central  Google Scholar 

  2. Poh SS, Chua MLK, Wee JTS (2016) Carcinogenesis of nasopharyngeal carcinoma: an alternate hypothetical mechanism. Chin J Cancer 35:9

    Article  Google Scholar 

  3. Wee J (2012) Nasopharyngeal cancer: a promising future. Lancet Oncology 13(2):116–118

    Article  Google Scholar 

  4. Blanchard P, Lee A, Marguet S et al (2015) Chemotherapy and radiotherapy in nasopharyngeal carcinoma: an update of the MAC-NPC meta-analysis. Lancet Oncol 16(6):645–655

    Article  Google Scholar 

  5. Rui S, Hui-Zhi Q, Hai-Qiang M et al (2013) Prognostic value and differences of the sixth and seventh editions of the UICC/AJCC staging systems in nasopharyngeal carcinoma. J Cancer Res Clin Oncol 139(2):307–314

    Article  Google Scholar 

  6. Au JSK, Law CK, Foo W et al (2003) In-depth evaluation of the AJCC/UICC 1997 staging system of nasopharyngeal carcinoma: Prognostic homogeneity and proposed refinements. Int J Radiat Oncol Biol Phys 56(2):413–426

    Article  Google Scholar 

  7. Grivennikov SI, Greten FR, Karin M (2010) Immunity, Inflammation, and Cancer. Cell 140(6):883–899

    Article  CAS  Google Scholar 

  8. Song S, Chen H, Dong W et al (2019) The prognostic value of preoperative derived neutrophil-to-lymphocyte ratio in patients undergoing total laryngectomy with laryngeal carcinoma. Acta Oto Laryngologica 139(3):294–298

    Article  Google Scholar 

  9. Azab B, Mohammad F et al (2014) The value of the before treatment neutrophil lymphocyte ratio vs. platelet lymphocyte ratio in predicting the long-term survival in colorectal cancer. CBM. https://doi.org/10.3233/CBM-140416

    Article  Google Scholar 

  10. Lin GN, Peng JW, Xiao JJ et al (2014) Prognostic impact of circulating monocytes and lymphocyte-to-monocyte ratio on previously untreated metastatic non-small cell lung cancer patients receiving platinum-based doublet. Med Oncol 31(7):1–6

    Google Scholar 

  11. Jiang N, Deng JY, Liu Y et al (2014) The role of preoperative neutrophil–lymphocyte and platelet–lymphocyte ratio in patients after radical resection for gastric cancer. Biomarkers 19(6):444–451

    Article  CAS  Google Scholar 

  12. Roxburgh CSD, Mcmillan DC (2014) Cancer and systemic inflammation: treat the tumour and treat the host. Br J Cancer 110(6):1409–1412

    Article  CAS  Google Scholar 

  13. Azab B, Bhatt VR, Phookan J, Murukutla S et al (2012) Usefulness of the neutrophil-to-lymphocyte ratio in predicting short-and long-term mortality in breast patients. Ann Surg Oncol 19(1):217–224

    Article  Google Scholar 

  14. Pichler M, Stoeckigt C, Chromecki TF et al (2013) Validation of the before treatment neutrophil-lymphocyte ratio as prognostic factor regarding cancer-specific, metastasis-free, and overall survival in a European cohort of patients with renal cell carcinoma. JCO 31(6_suppl):410

    Article  Google Scholar 

  15. Fridlender ZG, Sun J, Kim S et al (2009) Polarization of tumor-associated neutrophil phenotype by TGF-beta: “N1” versus “N2” TAN. Cancer Cell 16(3):183–194

    Article  CAS  Google Scholar 

  16. Smith HA, Kang Y (2013) The metastasis-promoting roles of tumor-associated immune cells. J Mol Med 91(4):411–429

    Article  CAS  Google Scholar 

  17. Dunn GP, Old LJ, Schreiber RD (2004) The three Es of cancer immunoediting. Annu Rev Immunol 22(22):329–360

    Article  CAS  Google Scholar 

  18. Kryczek I, Banerjee M, Cheng P et al (2009) Phenotype, distribution, generation, and functional and clinical relevance of Th17 cells in the human tumor environments. Blood 114(6):1141–1149

    Article  CAS  Google Scholar 

  19. Varki A (2007) Trousseau’s syndrome: multiple definitions and multiple mechanisms. Blood 110:1723–1729

    Article  CAS  Google Scholar 

  20. Jin Y, Ye X, He C, Zhang B, Zhang Y (2015) before treatment neutrophil-to-lymphocyte ratio as predictor of survival for patients with metastatic nasopharyngeal carcinoma. Head Neck 37(1):69–75

    Article  Google Scholar 

  21. An X, Ding PR, Wang FH, Jiang WQ, Li YH (2011) Elevated neutrophil to lymphocyte ratio predicts poor prognosis in nasopharyngeal carcinoma. Tumour Biol 32(2):317–324

    Article  CAS  Google Scholar 

  22. Takenaka Y, Kitamura T, Oya R et al (2017) Prognostic role of neutrophil–lymphocyte ratio in nasopharyngeal carcinoma: a meta-analysis. PLoS ONE 12(7):e0181478

    Article  Google Scholar 

  23. Lu A, Li H, Zheng Y et al (2017) Prognostic significance of neutrophil to lymphocyte ratio, lymphocyte to monocyte ratio, and platelet to lymphocyte ratio in patients with nasopharyngeal carcinoma. Biomed Res Int 2017:3047802

    PubMed  PubMed Central  Google Scholar 

Download references

Funding

This study was supported by the National Natural Science Foundation of China (Nos. 81670928), Nanjing Medical Science and technique Development Foundation (QRX17051), and the Project of Invigorating Health Care through Science, Technology and Education (ZDXKB2016015).

Author information

Author notes

  1. Shenghua Song and Hong Chen contributed equally to this work.

Authors and Affiliations

  1. Department of Otorhinolaryngology, Affiliated Drum Tower Hospital of Nanjing University Medical School, Jiangsu Provincial Key Medical Discipline, No.321 Zhongshan Road, Nanjing, 210008, People’s Republic of China

    Shenghua Song, Hong Chen & Chenjie Yu

  2. Department of Otorhinolaryngology, Drum Tower Clinical Medical College, Nanjing Medical University, No.321 Zhongshan Road, Nanjing, 210008, People’s Republic of China

    Shenghua Song, Hong Chen & Chenjie Yu

  3. Research Institute of Otorhinolaryngology, Drum Tower Hospital, No.321 Zhongshan Road, Nanjing, 210008, People’s Republic of China

    Shenghua Song, Hong Chen & Chenjie Yu

  4. Department of Radiology, Affiliated Drum Tower Hospital of Nanjing University Medical School, No.321 Zhongshan Road, Nanjing, 210008, People’s Republic of China

    Xin Dou

  5. Department of Oncology, Affiliated Drum Tower Hospital of Nanjing University Medical School, No.321 Zhongshan Road, Nanjing, 210008, People’s Republic of China

    Kongcheng Wang & Jing Yan

Authors
  1. Shenghua Song
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Hong Chen
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Xin Dou
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Kongcheng Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Jing Yan
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Chenjie Yu
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Chenjie Yu.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

Not applicable.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Song, S., Chen, H., Dou, X. et al. The prognostic value of before treatment neutrophil-to-lymphocyte ratio in nasopharyngeal carcinoma. Eur Arch Otorhinolaryngol 279, 2485–2492 (2022). https://doi.org/10.1007/s00405-021-07070-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00405-021-07070-3

Keywords

Search

Navigation