University of Glasgow Medical School, University Avenue, Glasgow G12 8QQ, United Kingdom.
Consultant Maxillofacial Head & Neck Surgeon, Queen Elizabeth University Hospital, NHS Greater Glasgow and Clyde, 1345 Govan Road, Glasgow G51 4TF, United Kingdom.
Br J Oral Maxillofac Surg. 2022 Jun;60(5):589-595. doi: 10.1016/j.bjoms.2021.10.017. Epub 2021 Nov 10.
This study aimed to evaluate the prognostic significance of the modified Glasgow prognostic score (mGPS), neutrophil:lymphocyte ratio (NLR), and platelet:lymphocyte ratio (PLR) in patients undergoing resection of oral squamous cell carcinoma (OSCC) with curative intent. We also aimed to explore the relation between activated systemic inflammation and adverse tumour characteristics. Between February 2006 and December 2019, data on 825 patients undergoing curative resection of OSCC were retrospectively gathered. Preoperative C-reactive protein and serum albumin levels were obtained to calculate a mGPS. Full blood count parameters were collected to calculate NLR and PLR values. Categorical factors were analysed using the chi squared test. Multivariate regression was performed to identify independent prognostic variables and the predictive value of each model generated. For disease-specific survival (DSS) and overall survival (OS), mGPS (DSS and OS both p<0.001), NLR (DSS and OS both p<0.001) and PLR (DSS and OS both p<0.001) were significant on univariate analysis. Independent predictive variables for DSS included mGPS, clinical node stage, categorised depth of tumour invasion, non-cohesive invasive front, and lymphovascular invasion. The concordance index was acceptable (0.756) for this model. Replacing mGPS with NLR or PLR as a marker of systemic inflammation demonstrated the same preoperative variables as independently predictive for DSS. The concordance index for these models were acceptable (NLR 0.76 and PLR 0.756). The systemic inflammatory response is prognostically significant in patients undergoing curative resection of OSCC. The potential link between an inflammatory tumour microenvironment and activated systemic inflammation merits further investigation.
本研究旨在评估改良格拉斯哥预后评分（mGPS）、中性粒细胞与淋巴细胞比值（NLR）和血小板与淋巴细胞比值（PLR）在接受根治性手术切除口腔鳞状细胞癌（OSCC）患者中的预后意义。我们还旨在探讨全身炎症激活与不良肿瘤特征之间的关系。2006 年 2 月至 2019 年 12 月，回顾性收集了 825 例接受根治性 OSCC 切除术的患者数据。术前获得 C-反应蛋白和血清白蛋白水平以计算 mGPS。收集全血计数参数以计算 NLR 和 PLR 值。使用卡方检验分析分类因素。进行多变量回归以确定独立的预后变量，并生成每个模型的预测值。对于疾病特异性生存（DSS）和总生存（OS），mGPS（DSS 和 OS 均 p<0.001）、NLR（DSS 和 OS 均 p<0.001）和 PLR（DSS 和 OS 均 p<0.001）在单因素分析中均有显著意义。DSS 的独立预测变量包括 mGPS、临床淋巴结分期、肿瘤侵袭深度分类、非黏附性浸润前缘和血管淋巴管侵犯。该模型的一致性指数可接受（0.756）。用 NLR 或 PLR 替代 mGPS 作为全身炎症的标志物，显示出相同的术前变量作为 DSS 的独立预测因子。这些模型的一致性指数可接受（NLR 为 0.76，PLR 为 0.756）。全身炎症反应在接受根治性 OSCC 切除术的患者中具有预后意义。炎症肿瘤微环境与激活的全身炎症之间的潜在联系值得进一步研究。
