Refining the role of preoperative C‐reactive protein by neutrophil/lymphocyte ratio in oral cavity squamous cell carcinoma

Abstract

The present study demonstrates that elevated CRP is an independent prognostic factor in OSCC. Elevated NLR in the high CRP group identifies patients at high risks of recurrence and shorter survival. Incorporating NLR into CRP level therefore has significant potential as a biomarker for risk stratification in OSCC.

C-reactive protein/albumin ratio as prognostic score in oral squamous cell carcinoma

“…To evaluate the relationship between inflammatory response and tumor development, researchers have recently introduced the use of inflammation-based prognostic scores, as determined by means of general serological indicators such as neutrophils, lymphocytes, CRP, and alb363738. The initial study related to the CRP/alb ratio involved a patient with a severe illness.…”

Primary radiotherapy or postoperative radiotherapy in patients with head and neck cancer

“…Multivariate analysis demonstrated that a high LPI was an independent prognostic factor for survival. Fang et al [9] analyzed preoperative NLR and CRP levels in OSCC patients treated by ences between PI 1 and PI 2 were not significant. Median OS was 1099 days in PI 0, 500 days in PI 1, and 700 days in PI 2.…”

“…The primarily irradiated patient (non-PORT) collective was very homogenous regarding risk factors, as it consisted of predominantly locally advanced cancers (90 % stage IV cancer; 66 % T4 tumors; 79 % N2b-N3 lymph-node stage), thus, simplifying interpretation of the impact of the scoring system on OS, which was confirmed by univariate analysis (Table 7). Multivariate Cox regression analyses of the impact on OS including various factors (GPS, mGPS, PI, Primary radiotherapy or postoperative radiotherapy in patients with head and neck cancer PORT primary surgery followed by postoperative radiotherapy, GPS Glasgow Prognostic Score, mGPS modified Glasgow Prognostic Score, NLR neutrophil-lymphocyte ratio, PLR platelet-lymphocyte ratio, PI prognostic index Table 5 Inflammation-based scoring systems Type of score Score Glasgow Prognostic Score (GPS) CRP < 10 mg/l and albumin > 35 g/l 0 CRP > 10 mg/l or albumin < 35 g/l 1 CRP > 10 mg/l and albumin < 35 g/l 2 Modified Glasgow Prognostic Score (mGPS) CRP ≤ 10 mg/l and albumin ≥ 35 g/l 0 CRP ≤ 10 mg/l and albumin < 35 g/l 0 CRP > 10 mg/l 1 CRP > 10 mg/l and albumin < 35 g/l 2 Neutrophil-lymphocyte ratio (NLR) Neutrophil count:lymphocyte count < 5:1 0 Neutrophil count:lymphocyte count ≥ 5:1 1 Platelet-lymphocyte ratio (PLR) Platelet count:lymphocyte count < 150:1 0 Platelet count:lymphocyte count 150-300:1 1 Platelet count:lymphocyte count > 300: 1 2 Prognostic index (PI) CRP ≤ 10 mg/l and leukocyte count ≤ 11 × 10 9 0 CRP ≤ 10 mg/l and leukocyte count > 11 × 10 9 1 CRP > 10 mg/l and leukocyte count ≤ 11 × 10 9 1 CRP > 10 mg/l and leukocyte count > 11 × 10 9 2 CRP c-reactive protein and NLR) did not predict prognosis in the PORT group was unexpected and we are not able to provide a rationale for this observation. However, to the best of our knowledge, the relevance of prognostic scoring systems in sufficiently welldefined postoperatively irradiated treatment groups has not been investigated so far.…”

“…In head and neck cancer, the role of tumor environment and inflammation has been discussed in the literature [8]. Evidence for an association of inflammation with prognosis in head and neck cancer patients has been presented recently ( [1,2,9,15,16,19,22] Grimm und Lazariotou [12], and references therein).…”

Systemic Markers and Survival of Oral Cancer Patients in Egypt.

“…Neutrophilia as an inflammatory reaction suppresses the immune system through decreasing the cytolytic activity of immune cells, for example lymphocytes, natural killer cells and activated T cells 1851 (6) . Another possible explanation is that neutrophils have been reported to secrete tumor growth promoting factors, such as circulating vascular endothelial growth factor, platelet-derived growth factor, fibroblast growth factor and matrix metalloproteinases (7) .…”