Huang Chun-Hou, Chou Yu-Fu, Hsieh Tsung-Cheng, Chen Peir-Rong
Department of Nursing, Tzu Chi University, Hualien 97004, Taiwan.
Department of Otolaryngology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien 970374, Taiwan.
Diagnostics (Basel). 2023 Jan 29;13(3):493. doi: 10.3390/diagnostics13030493.
Patients with oral cavity squamous cell carcinoma (OSCC) undergoing curative-intent treatment may become immunocompromised. This study aimed to investigate the association of pretreatment sarcopenia, nutritional status, comorbidities, and blood-based inflammation prognostic biomarkers in bloodstream infection (BSI) with survival status in elderly patients with OSCC. Retrospective data were collected from 235 patients who were newly diagnosed with OSCC, were aged ≥ 65 years, had undergone curative-intent treatment, and were classified into either the BSI group or the no-BSI group within 6 months after surgery and/or adjuvant therapy initiation. Of the 235 elderly patients, 27 presented with BSI episodes. A preoperative high neutrophil-to-lymphocyte ratio (NLR) was a significant independent risk factor for BSI. BSI was not significantly associated with survival status. Ever betel nut chewing, hypoalbuminemia, and advanced tumor stage were associated with shorter overall survival. Moreover, a high NLR was an independent risk factor associated with disease-free survival. A high NLR was associated with BSI and resistance to curative-intent treatment. Pretreatment of NLR could act as an independent prognostic indicator and help inform treatment strategies for older patients with OSCC.
接受根治性治疗的口腔鳞状细胞癌（OSCC）患者可能会出现免疫功能低下。本研究旨在调查老年OSCC患者治疗前肌肉减少症、营养状况、合并症以及血流感染（BSI）中基于血液的炎症预后生物标志物与生存状况之间的关联。回顾性收集了235例新诊断为OSCC、年龄≥65岁、接受根治性治疗且在手术和/或辅助治疗开始后6个月内被分为BSI组或非BSI组的患者的数据。在这235例老年患者中，27例出现了BSI发作。术前高中性粒细胞与淋巴细胞比值（NLR）是BSI的显著独立危险因素。BSI与生存状况无显著关联。既往嚼槟榔、低白蛋白血症和晚期肿瘤分期与总生存期较短有关。此外，高NLR是与无病生存期相关的独立危险因素。高NLR与BSI及对根治性治疗的抵抗有关。NLR的预处理可作为独立的预后指标，并有助于为老年OSCC患者的治疗策略提供参考。
