The prognostic value of preoperative derived neutrophil-to-lymphocyte ratio in patients undergoing total laryngectomy with laryngeal carcinoma

Abstract

Background: Emerging evidence indicate that inflammation plays a crucial role in carcinogenesis and tumor progression. Inflammatory response biomarkers are recognized as promising prognostic factors in laryngeal squamous cell carcinoma (LSCC).

Objective: To evaluate the prognostic significance of preoperative derived neutrophil-to-lymphocyte ratio (dNLR) in patients with total laryngectomy.

Methods: This was a retrospective analysis of 137 patients with LSCC who received total laryngectomy from January 2009 to December 2015. The preoperative neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and dNLR were calculated. Receiver-operating characteristic (ROC) curve was used to determine the cut-off values of these parameters. Univariate analysis and multivariate Cox regression model were used to evaluate the association between these parameters and recurrence-free survival (RFS) and overall survival (OS).

Results: The optimal critical value of dNLR was 1.85, by which cases were divided into high dNLR group (dNLR ≥ 1.85) and low dNLR group (dNLR < 1.85). The elevated dNLR was significantly associated with decreased RFS (HR 2.72, 95% CI 1.56–4.75, p = .000) and remained significant in multivariate analysis (p = .034). However, we did not find any significant correlation between dNLR and OS.

Conclusions: An elevated preoperative dNLR may be an independent prognostic biomarker for RFS in patients undergoing total laryngectomy with LSCC.

Chinese abstract

背景：新的证据表明炎症在致癌和肿瘤进展中起着关键作用。炎症反应生物标志物被认为是前景的喉鳞状细胞癌（LSCC）预后因子。

目的：探讨接受全喉切除术的患者在术前的中性粒细胞与淋巴细胞比值（DNLR）的预测意义。

方法：对2009年1月至2015年12月收治的137例LSCC患者进行回顾性分析。计算术前中性粒细胞与淋巴细胞比值（NLR）、血小板与淋巴细胞比值（PLR）和DNLR。根据受试者工作特性曲线确定这些参数的截止值。采用单变量分析和多变量Cox回归模型评估这些参数与无复发生存率（RFS）和总生存率（OS）之间的相关性。

结果：dNLR的最佳临界值为1.85.据此, 病例分为高dNLR组（dNLR≥1.85）和低dNLR组（dNLR＜1.85）。dNLR升高与RFS降低显著相关（HR 2.72, 95%可信区间1.56-4.75, p=.000）, 并且在多变量分析中保持显著性（p=.034）。然而, 我们没有发现dNLR 和OS之间有任何显著的相关性。

结论：术前dNLR升高可能是LSCC全喉切除患者的RFS的独立预后生物标志。

Keywords:

• Laryngeal carcinoma
• dNLR
• recurrence-free survival (RFS)
• prognosis

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This study was supported by the Research Grant from Jiangsu Provincial Commission of Health (H201603) and the Health Promotion Project (QNRC2016614) of Jiangsu Province, the People's Republic of China.