Is the neutrophil-to-lymphocyte ratio a marker for differentiating between benign and malignant submandibular gland masses?

Abstract

OBJECTIVE: This study aimed to evaluate the effect of the neutrophil-to-lymphocyte ratio on the differentiation of benign and malignant masses in the submandibular triangle. METHODS: We retrospectively evaluated 48 patients who underwent surgery for submandibular gland masses between January 2013 and February 2023. The patient's age, gender, preoperative complete blood count and imaging findings, postoperative histopathological diagnosis, and hemogram data were analysed. Patients were evaluated according to their postoperative histopathological diagnoses and categorised into four main groups: sialolithiasis, sialadenitis, benign tumours, and malignant tumours. Benign submandibular gland disease formations were evaluated under group B and malignant tumour formations under group M. RESULTS: A preoperative fine needle aspiration biopsy was performed on 19 patients due to sialadenitis, pleomorphic adenoma, and malignant diseases other than sialolithiasis. One patient died among the patients with malignant disease and the remaining 7 patients were compared with the benign group of 40 patients regarding preoperative and postoperative neutrophil-to-lymphocyte ratio. In the benign group, the neutrophil-to-lymphocyte ratio was 2.64 preoperatively and decreased to 2.34 in the first postoperative year. The preoperative neutrophil-to-lymphocyte ratio decreased from 4.79 to 1.77 postoperatively in the malignant group. A statistically significant difference was observed (p<0.05). CONCLUSION: This is the first study to demonstrate that the neutrophil-to-lymphocyte ratio can be used as a biomarker in submandibular gland masses and has prognostic significance in malignant masses. In addition to fine needle aspiration biopsy results, neutrophil-to-lymphocyte ratio can be used as a biomarker.

Is the neutrophil-to-lymphocyte "ratio"nale from head and neck to thyroidology for thyroidologists?: promise or passé?

“…We read with a great deal the research article entitled "Is the neutrophil-to-lymphocyte ratio a marker for differentiating between benign and malignant submandibular gland masses?" by Bora 1 . This research of high quality seems to demand portraying to evaluation of the effect of the neutrophil-to-lymphocyte ratio (N/L) on distinguishing benign from malignant masses in the submandibular triangle of the head and neck which has recently been published in the 69th volume of Rev Assoc Med Bras 1 .…”

“…by Bora 1 . This research of high quality seems to demand portraying to evaluation of the effect of the neutrophil-to-lymphocyte ratio (N/L) on distinguishing benign from malignant masses in the submandibular triangle of the head and neck which has recently been published in the 69th volume of Rev Assoc Med Bras 1 . The author stated that he retrospectively evaluated 48 cases who had undergone surgery for submandibular gland masses with the histopathology of sialolithiasis, sialadenitis, pleomorphic adenoma 2 – 4 , and malignant conditions.…”

“…Moreover, he proposed that N/L can be utilized as a biomarker beyond fine needle aspiration cytology. Thereto, he highlighted N/L as being proven in distinguishing between benign and malignant nodules in patients 1 with suspicious thyroid nodules 1 , 5 – 17 . Nevertheless, at least a minimal debate is still ongoing on an accurate decision on N/L whether it is a biomarker in discrimination of malignity or not.…”

“…As a matter of fact, this issue merits further investigation. We thank Bora 1 for his valuable study.…”