The Hidden Treasures of Preoperative Blood Assessment in Oral Cancer: A Potential Source of Biomarkers

Abstract

(1) Background: Oral squamous cell carcinoma (OSCC) is a common malignancy, and the impact of immune and inflammatory mechanisms in its development and progression are of major interest. The aim of our study is to assess the prognostic potential of circulating immune and inflammatory elements determined preoperatively in patients with OSCC, as well as the development of a new compound parameter with predictive value. (2) Methods: We assessed preoperative fibrinogen (Fib) and the platelet-to-lymphocyte ratio (PLR) in 111 OSCC patients. Using a mathematic algorithm, we determined a composite parameter with cumulative information from Fib and PLR, named Fibrinogen-PLR Algorithm (FiPLA). Survival analysis, followed by bivariate and multivariate analyses, was subsequently conducted. (3) Results: Increased preoperative Fib and PLR levels were associated with poor outcome in OSCC (p = 0.0001 and p = 0.0015, respectively). Preoperative FiPLA values were also associated with poor patient survival (p < 0.0001). Multivariate analysis confirmed the independent prognostic role for FiPLA only (CI95% 1.232–67.770, p = 0.03), showing the superior predictive value of FiPLA compared to its individual components. (4) Conclusions: Preoperative assessments of circulating immune and inflammatory elements can provide high-quality prognostic information, and they represent valuable tools in clinical practice, facilitating the early risk stratification of patients with OSCC.

Prognostic implications of preoperative systemic inflammatory markers in oral squamous cell carcinoma, and correlations with the local immune tumor microenvironment

“…Tumor cells can increase the number of platelets in blood via thrombopoietin, IL-6 or leukemia inhibitory factor ( 62 ), and in turn, platelets facilitate tumor cell survival and escape from immune clearance mechanisms ( 63 ). Moreover, platelets could secrete transforming growth factor-beta (TGF-β) to suppress NK cells, and VEGF to promote tumor angiogenesis, ultimately contributing to tumor progression and metastasis ( 1 , 37 ). In this study, our data reveal a relationship between NLR and SII with tumor size and clinical stage, which is in line with the aforementioned promotion of tumor growth and spreading.…”

“…Oral squamous cell carcinoma (OSCC) is one of the most common tumors in the world, with a global incidence of 377,713 new cases in 2020 ( 1 ). Due to the lack of specific symptoms in the early stage of this entity, most OSCC patients are in an advanced stage at the time of diagnosis, more than half of them suffer from a recurrence within 2 years of the initial surgical treatment ( 2 ), and the 5-year survival remains approximately 60% ( 3 ).…”

Principe et applicabilité de la chirurgie de précision aux cancers de la tête et du cou

“…Apprécier de façon précise, pour chaque patient, les conséquences de la chirurgie sur le tissu tumoral permettrait donc de proposer une prise en charge péri-opératoire optimisée, conçue pour être plus efficacement anti-tumorale [20]. Les biomarqueurs de la coagulation pourraient ainsi trouver un intérêt pour apprécier le risque de récidive post-chirurgicale des cancers de la tête et du cou, comme cela est suggéré par des études récentes [22,23].…”

Assessment of Serum Urea, Creatinine and Uric Acid in Oral Cancer

“…However, despite all progress made in surgical and non-surgical treatment strategies in OSCC, survival rates have not improved significantly during the last decades, except when the disease was diagnosed and treated in early stages [ 8 , 9 ]. Recent scientific literature provides important results in the investigation of different pathogenetic mechanisms in oral cancer, such as the involvement of genetic, immune or inflammatory elements in cancer emergence and progression [ 10 , 11 , 12 , 13 ], leading to novel approaches in terms of disease characterization and treatment strategies [ 14 , 15 , 16 , 17 ].…”