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Prognostic Significance of Pre-Treatment Neutrophil–Lymphocyte Ratio and Platelet-Lymphocyte Ratio in Head and Neck Malignancies

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Indian Journal of Otolaryngology and Head & Neck Surgery Aims and scope Submit manuscript

Abstract

Introduction

Carcinoma is the second most common cause of death worldwide. The neutrophil–lymphocyte ratio (NLR) and the platelet-lymphocyte ratio (PLR) are essential markers of inflammation and tumorigenesis in various cancers including head and neck cancers. Pretreatment platelet- lymphocytic ratio can be used as an independent predictor of mortality whereas neutrophil- lymphocytic ratio is an independent predictor of recurrence. The main aim of this study is to compare the pre-treatment neutrophil lymphocyte ratio and platelet-lymphocyte ratio in the patients of head and neck malignancies with those of the control group.

Material and Method

100 patients with histologically diagnosed cases of head and neck malignancies. Age and sex matched healthy subjects attending Otorhinolaryngology out-patient department for any other complaints (100 control subjects). Complete blood count had been done to calculate absolute neutrophil count and absolute lymphocyte count.

Results

The mean age of the subjects in the study group was 55.73 ± 11.56 years. In control group, the mean age group was 54.11 ± 10.46 years. NLR and PLR significantly increased in cases than controls. NLR associated with T stage, histological type and histological grade but not with site and nodal involvement. PLR associated with T stage, metastasis but not with the histological grade, histological type, site and nodal involvement.

Conclusion

From this study, we conclude that pre-treatment NLR and PLR were closely associated both with the size of primary tumor and also with the stage of malignant disease in patients of head and neck malignancies.

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References

  1. Mantovani A, Allaveni P, Sica A et al (2008) Cancer-related inflammation. Nature 454(7203):436–444

    Article  ADS  CAS  PubMed  Google Scholar 

  2. Hanahan D, Weinberg RA (2011) Hallmarks of cancer: the next generation. Cell 144(5):646–674

    Article  CAS  PubMed  Google Scholar 

  3. Jenne CN, Urrutia R, Kubes P (2013) Platelets: bridging hemostasis, inflammation, and immunity. Int J Lab Hematol 35:254–261

    Article  CAS  PubMed  Google Scholar 

  4. Tazzyman S, Lewis CE, Murdoch C (2009) Neutrophils: key mediators of tumor angiogenesis. Int J Exp Pathol 90:222–231

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Zhang J, Qiao X, Shi H et al (2016) Circulating tumor-associated neutrophils (cTAN) contribute to circulating tumor cell survival by suppressing peripheral leukocyte activation. Tumour Biol 37:5397–5404

    Article  CAS  PubMed  Google Scholar 

  6. Hoffmann TK, Dworacki G, Tsukihiro T et al (2002) Spontaneous apoptosis of circulating T lymphocytes in patients of head and neck cancer and its clinical importance. Clin Cancer Res 8:2553–2562

    PubMed  Google Scholar 

  7. Sumner WA, Stokes WA, Oweida A et al (2017) Survival impact of pre-treatment neutrophils on oropharyngeal and laryngeal cancer patients undergoing definitive radiotherapy. J Transl Med 15(1):168

    Article  PubMed  PubMed Central  Google Scholar 

  8. Chen L, Zeng H, Yang J et al (2018) Survival and prognostic analysis of preoperative inflammatory markers in patients undergoing surgical resection for laryngeal squamous cell carcinoma. BMC Cancer 18(1):816

    Article  PubMed  PubMed Central  Google Scholar 

  9. Nakayama M, Gosho M, Hirose Y et al (2018) Modified combination of platelet count and neutrophil “to" lymphocyte ratio as a prognostic factor in patients with advanced head and neck cancer. Head Neck 40(6):1138–1146

    Article  PubMed  Google Scholar 

  10. Seetohul YB, Singh V, Jain RK et al (2020) Prognostic value of neutrophil-lymphocyte ratio and platelet-lymphocyte ratio in head and neck malignancies. Indian J Otolaryngol Head Neck Surg 72:128–132

    Article  PubMed  Google Scholar 

  11. Mittal S, Krishnamurthy A, Kothandaraman SK et al (2020) Exploring the prognostic significance of the pretreatment inflammatory markers in hypopharyngeal cancers: a retrospective analysis. Cancer Res Stat Treat 3:437–444

    Article  Google Scholar 

  12. Tazeen S, Prasad K, Harish K et al (2020) Assessment of pretreatment neutrophil/lymphocyte ratio and platelet/lymphocyte ratio in prognosis of oral squamous cell carcinoma. J Oral Maxillofac Surg 78(6):949–960

    Article  PubMed  Google Scholar 

  13. Chen S, Guo J, Feng C, Ke Z, Chen L, Pan Y (2016) The preoperative platelet–lymphocyte ratio versus neutrophil–lymphocyte ratio: which is better as a prognostic factor in oral squamous cell carcinoma? Therapeutic Adv Med Oncol 8(3):160–167

    Article  Google Scholar 

  14. Lee S, Kim DW, Kwon S, Kim HJ, Cha IH, Nam W (2020) Prognostic value of systemic inflammatory markers for oral cancer patients based on the 8th edition of AJCC staging system. Sci Rep 10(1): 12111

  15. Kuzucu I, Güler ̇ I, Kum RO et al (2020) Increased neutrophil lymphocyte ratio and platelet lymphocyteratio in malignant parotid tumors. Braz J Otorhinolaryngol 86:105–110

    Article  PubMed  Google Scholar 

  16. Abelardo E, Davies G, Kamhieh Y et al (2020) Are inflammatory markers significant prognostic factors for head and neck cancer patients? ORL J Otorhinolaryngo Relat Spec 82(5):235–244

    Article  Google Scholar 

  17. Szilasi Z, Jósa V, Zrubka Z et al (2020) Neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios as prognostic markers of survival in patients with head and neck tumours—results of a retrospective multicentric study. Int J Environ Res Public Health 17:1742

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. Ni L, Tao J, Xu J et al (2020) Prognostic values of pretreatment neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios in endometrial cancer: a systematic review and meta-analysis. Arch Gynecol Obstet 301(1):251–261

    Article  CAS  PubMed  Google Scholar 

  19. Hsueh C, Tao L, Zhang M et al (2017) The prognostic value of preoperative neutrophils, platelets, lymphocytes, monocytes and calculated ratios in patients with laryngeal squamous cell cancer. Oncotarget 8(36):6051460527

    Article  Google Scholar 

  20. Acmaz G, Aksoy H, Unal D et al (2014) Are neutrophil/lymphocyte and platelet/lymphocyte ratios associated with endometrial precancerous and cancerous lesions in patients with abnormal uterine bleeding? Asian Pac J Cancer Prev 15(4):1689–1692

    Article  PubMed  Google Scholar 

  21. Duzlu M, Karamert R, Tutar H et al (2015) Neutrophil lymphocyte ratio findings and larynx carcinoma: a preliminary study in Turkey. Asian Pac J Cancer Prev 16:351–354

    Article  PubMed  Google Scholar 

  22. EnginŞengül Y, Murat Ş, Musa Ö (2016) Prognostic value of mean platelet volume and platelet to lymphocyte ratio in laryngeal carcinoma. J Clin Exp Investig 7(2):134–138

    Google Scholar 

  23. Zhou H, Song P, Gu Y et al (2021) High pretreatment platelet-to-lymphocyte ratio is related to poor prognosis in the squamous cell carcinoma of the larynx and hypopharynx in male patients. Acta Otolaryngol 141(4):419–423

    Article  CAS  PubMed  Google Scholar 

  24. Park YM, Oh KH, Cho JG et al (2018) A prognostic scoring system using inflammatory response biomarkers in oral cavity squamous cell carcinoma patients who underwent surgery-based treatment. Acta Otolaryngol 138:422–427

    Article  PubMed  Google Scholar 

  25. Acharya S, Rai P, Hallikeri K, Anehosur V, Kale J (2017) Preoperative platelet lymphocyte ratio is superior to neutrophil lymphocyte ratio to be used as predictive marker for lymph node metastasis in oral squamous cell carcinoma. J Investig Clin Dent 8(3):e12219

    Article  Google Scholar 

  26. Templeton AJ, McNamara MG, Šeruga B et al (2014) Prognostic role of neutrophil-to-lymphocyte ratio in solid tumors: a systematic review and meta-analysis. J Natl Cancer Inst 106(6):124

    Article  Google Scholar 

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Authors and Affiliations

  1. Department of ENT and Head Neck Surgery, Government Medical College, Jammu, Jammu and Kashmir, India

    Rupali Sharma, Gopika Kalsotra & Parmod Kalsotra

  2. Department of Community Medicine, Government Medical College, Jammu, Jammu and Kashmir, India

    Dev Raj

  3. Department of Pathology, Government Medical College, Jammu, Jammu and Kashmir, India

    Deepti Mahajan

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  1. Rupali Sharma
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  2. Gopika Kalsotra
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  4. Parmod Kalsotra
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Correspondence to Gopika Kalsotra.

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Sharma, R., Kalsotra, G., Mahajan, D. et al. Prognostic Significance of Pre-Treatment Neutrophil–Lymphocyte Ratio and Platelet-Lymphocyte Ratio in Head and Neck Malignancies. Indian J Otolaryngol Head Neck Surg 76, 567–574 (2024). https://doi.org/10.1007/s12070-023-04213-2

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  • DOI: https://doi.org/10.1007/s12070-023-04213-2

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