Elevated Neutrophil-to-Lymphocyte Ratio in Squamous Cell Carcinoma of Larynx Compared to Benign and Precancerous Laryngeal Lesions

Abstract

Background: Laryngeal carcinogenesis is a multifactorial process that has not been fully elucidated. Despite extensive research, reliable markers with diagnostic and prognostic value are still lacking. It was recently reported that an elevated preoperative neutrophil-to-lymphocyte ratio (NLR) may correlate with an increased risk of recurrence, tumor aggressiveness and poorer prognosis in various malignancies. The aim of this study was to examine whether NLR could be used as an inflammatory marker to differentiate laryngeal squamous cell carcinoma (LSCC) patients from benign laryngeal lesion (BLL) and precancerous laryngeal lesion (PLL) patients. Materials and Methods: This retrospective study was performed on 209 patients admitted to a tertiary referral center with laryngeal lesions and undergoing biopsies to establish their histopathological diagnosis. We reviewed the patient files for their clinical, histopathological and laboratory data. The patients were divided into three groups according to their histopathological findings, as BLL, PLL and LSCC groups. The patients in the PLL group were also divided into three subgroups as mild, moderate and severe dysplasia/ carcinoma in situ (CIS) subgroups. The groups were compared for NLR and the other laboratory data. Results: The mean NLRs of the BLL, PLL and the LSCC groups were 2.12±0.86, 2.32±0.68 and 3.46±1.51, respectively, and the difference was statistically significant (p=0.001). The mean NLRs of the patients with PLL and LSCC were significantly higher than the patients with BLL (p=0.031 and p=0.001, respectively). The mean NLRs were similar among mild dysplasia, moderate dysplasia and severe dysplasia / CIS groups (p>0.05). Conclusions: To our knowledge, this is the first study investigating NLR in BLL, PLL and LSCC. NLR is an inexpensive, reproducible and widely available blood test, and could be a useful inflammatory marker to differentiate LSCC from BLL and PLL.

Neutrophil to lymphocyte ratio and platelet to lymphocyte ratio in malignant and precancerous laryngeal lesions

“…[11,12] According to recent studies, elevated PLR and NLR values were associated with poor survival in different solid tumors. Kum et al [13] found statistical significance between the NLR values and the groups in the study conducted with 209 patients by studying three groups of benign, premalignant, and malignant lesions. In their study of 141 patients, Tu et al [14] found that elevated preoperative NLR was an independent predictor for poor prognosis after surgical resection in patients with LSCC.…”

“…[13,14] To the best of our knowledge, this is the first study to suggest that PLR maybe used for PLL and LSCC discrimination. According to the current results PLR may be used for PLL and LSCC discrimination.…”

Can Platelet and Leukocyte Indicators Give Us an Idea about Distant Metastasis in Nasopharyngeal Cancer?

“…This facilitates tumoral growth and the development of resistance to apoptosis (Jaiswal et al, 2000;Kacan et al, 2014;Kum et al, 2014). The NLR is a well-known marker of inflammation.…”

“…An increase in this ratio is an important indicator of elevated systemic inflammation. Previous research reported that a high NLR value was a poor prognostic factor in various cancers (Kum et al, 2014).…”

“…The NLR is obtained by calculating the average of the absolute neutrophil count and absolute lymphocyte count in blood (Kum et al, 2014). An increase in this ratio is an important indicator of elevated systemic inflammation.…”