Prognostic Analysis of Preoperative Inflammatory Biomarkers in Patients With Laryngeal Squamous Cell Carcinoma

Ear Nose Throat J. 2020 Jul;99(6):371-378. doi: 10.1177/0145561319876910. Epub 2019 Sep 30.

Abstract

Objective: The purpose of this study was to demonstrate the prognostic role of inflammatory biomarkers in patients with laryngeal squamous cell carcinoma.

Methods: For this study, we enrolled 151 patients who had undergone surgery for laryngeal squamous cell carcinoma. We assessed the preoperative neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), monocyte to lymphocyte ratio (MLR), mean platelet volume, red cell distribution width, and alkaline phosphatase. The chi-square test, Kaplan-Meier survival analysis, and Cox proportional hazards model were conducted on overall survival, progression-free survival, locoregional recurrence-free survival, and distant metastasis-free survival of patients with laryngeal squamous cell carcinoma.

Results: Both Kaplan-Meier analysis and univariate analysis showed significant prognostic differences with age, laryngectomy methods, Tumor Node Metastasis (TNM) staging, tumor location, NLR, PLR, MLR, and mean platelet volume. Multivariate analysis indicated that NLR (overall survival: hazard ratio [HR] = 3.02, 95% confidence interval [CI]: 1.28-7.10, P = .011), PLR (overall survival: HR = 0.33, 95% CI: 0.14-0.78, P = .011; progression-free survival: HR = 0.016,95% CI: 0.10-0.79, P = .016), and MLR (overall survival: HR = 0.29, 95% CI: 0.11-0.76, P = .012) were independent prognostic factors for 5-year survival. However, red cell distribution width and alkaline phosphatase had no significant difference in overall survival and progression-free survival.

Conclusions: Preoperative high NLR, PLR, and MLR were associated with poor prognosis. They were found to be effective and reliable inflammatory biomarkers for patients with laryngeal squamous cell carcinoma.

Keywords: laryngeal squamous cell carcinoma; monocyte to lymphocyte ratio; neutrophil to lymphocyte ratio; platelet to lymphocyte ratio; prognostic.

Publication types

  • Evaluation Study

MeSH terms

  • Aged
  • Alkaline Phosphatase / blood
  • Biomarkers / blood
  • Carcinoma, Squamous Cell / blood*
  • Carcinoma, Squamous Cell / mortality*
  • Carcinoma, Squamous Cell / surgery
  • Female
  • Hematologic Tests / statistics & numerical data*
  • Humans
  • Kaplan-Meier Estimate
  • Laryngeal Neoplasms / blood*
  • Laryngeal Neoplasms / mortality*
  • Laryngeal Neoplasms / surgery
  • Laryngectomy / mortality*
  • Lymphocytes / metabolism
  • Male
  • Middle Aged
  • Monocytes / metabolism
  • Neutrophils / metabolism
  • Predictive Value of Tests
  • Preoperative Period
  • Prognosis
  • Progression-Free Survival
  • Proportional Hazards Models
  • Retrospective Studies
  • Treatment Outcome

Substances

  • Biomarkers
  • Alkaline Phosphatase