The evaluation of pretreatment neutrophil-lymphocyte ratio and derived neutrophil-lymphocyte ratio in patients with laryngeal neoplasms

Abstract Introduction: Systemic inflammatory biomarkers are promising predictive and prognostic factors for solid cancers. The neutrophil-lymphocyte ratio and derived neutrophil-lymphocyte ratio are used to predict inflammation and used as biomarker in several malignancies. Objective: The purpose of this study was to demonstrate the diagnostic, predictive and prognostic role of neutrophil-lymphocyte ratio and derived neutrophil-lymphocyte ratio in patients with laryngeal neoplasms. Methods: A retrospective study was conducted on medical records involving 229 patients with benign, premalignant and malignant laryngeal neoplasms between 2002 and 2015. The diagnostic, predictive and prognostic role of neutrophil-lymphocyte ratio and derived neutrophil-lymphocyte ratio were evaluated using uni- and multivariate analysis. Results: The neutrophil-lymphocyte ratio and derived neutrophil-lymphocyte ratio were not statistically different between patients with benign, premalignant and malignant laryngeal neoplasms. Both neutrophil-lymphocyte ratio and derived neutrophil-lymphocyte ratio were predictive factors for stage, lymph node metastasis, and distant metastasis. Patients with high neutrophil-lymphocyte ratio value (≥4) had a poor prognosis when compared with patients with low neutrophil-lymphocyte ratio value (5 year, Overall Survival: 69.0% vs. 31.1%, p < 0.001; 5 year, disease free survival: 70.0% vs. 32.7%, p ˂ 0.001; 5 year, locoregional recurrence free survival: 69.7% vs. 32.0%, p < 0.001). Furthermore, neutrophil-lymphocyte ratio was an independent prognostic factor for 5 year: Overall survival (HR = 2.396; 95% CI 1.408-4.077; p = 0.001), Disease free survival (HR = 2.246; 95% CI 1.322-3.816; p = 0.006) and locoregional recurrence free survival (HR = 2.210; 95% CI 1.301-3.753; p = 0.003). Conclusion: Pretreatment neutrophil-lymphocyte ratio is a useful and reliable predictive and prognostic biomarker for patients with laryngeal carcinoma.

引言：全身炎症生物标志物是实体瘤颇具前景的预测与预后因子。中性粒细胞与淋巴细胞比值（neutrophil-lymphocyte ratio, NLR）及其衍生比值（derived neutrophil-lymphocyte ratio, dNLR）被用于评估炎症状态，并已在多种恶性肿瘤中作为生物标志物应用。
研究目的：本研究旨在明确中性粒细胞与淋巴细胞比值及衍生中性粒细胞与淋巴细胞比值在喉部肿瘤患者中的诊断、预测及预后价值。
研究方法：本研究为回顾性研究，纳入2002年至2015年间的229例良性、癌前病变及恶性喉部肿瘤患者的病历资料。采用单因素及多因素分析，评估中性粒细胞与淋巴细胞比值及衍生中性粒细胞与淋巴细胞比值的诊断、预测及预后作用。
研究结果：良性、癌前病变及恶性喉部肿瘤患者的中性粒细胞与淋巴细胞比值及衍生中性粒细胞与淋巴细胞比值均无统计学差异。二者均为肿瘤分期、淋巴结转移及远处转移的预测因子。当中性粒细胞与淋巴细胞比值≥4时，患者预后较差，与比值＜4的患者相比，其5年总生存率分别为31.1%与69.0%（p＜0.001），5年无病生存率分别为32.7%与70.0%（p＜0.001），5年局部区域无复发生存率分别为32.0%与69.7%（p＜0.001）。此外，中性粒细胞与淋巴细胞比值是5年总生存率（风险比HR=2.396，95%置信区间CI：1.408~4.077，p=0.001）、无病生存率（HR=2.246，95%CI：1.322~3.816，p=0.006）及局部区域无复发生存率（HR=2.210，95%CI：1.301~3.753，p=0.003）的独立预后因子。
研究结论：治疗前中性粒细胞与淋巴细胞比值可作为喉癌患者实用且可靠的预测及预后生物标志物。