Mireștean Camil Ciprian, Stan Mihai Cosmin, Iancu Roxana Irina, Iancu Dragoș Petru Teodor, Bădulescu Florinel
Department of Medical Oncology and Radiotherapy, University of Medicine and Pharmacy Craiova, 200349 Craiova, Romania.
Department of Surgery, Railways Clinical Hospital, 700506 Iasi, Romania.
Diagnostics (Basel). 2023 Nov 7;13(22):3396. doi: 10.3390/diagnostics13223396.
Neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), and pallets-to-lymphocyte ratio (PLR) are currently validated as cheap and accessible biomarkers in different types of solid tumors, including head and neck cancers (HNC).
To evaluate the possible purposes and biomarker value of NLR, PLR, and MLR recorded pre-treatment (radiotherapy/chemotherapy) in HNC.
From 190 patients with HNC included in the oncology records in the oncology outpatient clinic of the Craiova County Emergency Hospital (from January 2002 to December 2022), 39 cases met the inclusion criteria (squamous cell carcinoma and the possibility to calculate the pre-treatment (chemotherapy/radiotherapy) value of NLR, PLR, and MLR. Overall survival (OS) values were correlated with NLR, PLR, and MLR.
The median values for NLR, PLR, and MLR were 6.15 (1.24-69), 200.79 (61.3-1775.0), and 0.53 (0.12-5.5), respectively. In the study, the mean values for NLR, PLR, and MLR of 2.88, 142.97, and 0.36, respectively, were obtained. The median OS in the study group was 11 months (1-120). Although a negative Pearson's correlation was present, the relationship between the variables was only weak, with values of R = 0.07, = 0.67, R = 0.02, = 0.31, and R = 0.07, = 0.62 being related to NLR, PLR, and MLR, respectively, in correlation with OS. The median values of NLR, PLR, and MLR were calculated (1.53, 90.32, and 0.18, respectively) for the HNC cases with pre-treatment values of NLR < 2 and for the HNC cases with NLR values ≥ 6 (23.5, 232.78, and 0.79, respectively). The median OS for cases with NLR < 2 and NLR ≥ 6 were 17.4 and 13 months, respectively.
The comparative analysis of the data highlights a benefit to OS for cases low values of NLR. The role of not only borderline NLR values (between 2 and 6) as a prognostic marker in HNSCC but also the inclusion of PLR and MLR in a prognostic score must also be defined in the future. Prospective studies with more uniformly selected inclusion criteria could demonstrate the value of pre-treatment NLR, PLR, and MLR for treatment stratification through the intensification or de-escalation of non-surgical curative treatment in HNSCC.
中性粒细胞与淋巴细胞比值（NLR）、淋巴细胞与单核细胞比值（LMR）以及血小板与淋巴细胞比值（PLR）目前已被确认为不同类型实体瘤（包括头颈癌，HNC）中廉价且易于获取的生物标志物。
评估头颈癌患者在预处理（放疗/化疗）时记录的NLR、PLR和MLR的潜在作用及生物标志物价值。
从克拉约瓦县急诊医院肿瘤门诊的肿瘤记录中纳入的190例头颈癌患者（2002年1月至2022年12月）中，39例符合纳入标准（鳞状细胞癌且能够计算NLR、PLR和MLR的预处理（化疗/放疗）值）。总生存期（OS）值与NLR、PLR和MLR相关。
NLR、PLR和MLR的中位数分别为6.15（1.24 - 69）、200.79（61.3 - 1775.0）和0.53（0.12 - 5.5）。在该研究中，NLR、PLR和MLR的平均值分别为2.88、142.97和0.36。研究组的中位OS为11个月（1 - 120）。尽管存在负的Pearson相关性，但变量之间的关系仅为弱相关，与OS相关时，NLR、PLR和MLR的R值分别为0.07、P = 0.67，R = 0.02、P = 0.31，以及R = 0.07、P = 0.62。对于预处理时NLR < 2的头颈癌病例和NLR值≥ 6的头颈癌病例，分别计算了NLR、PLR和MLR的中位数（分别为1.53、90.32和0.18）（分别为23.5、232.78和0.79）。NLR < 2和NLR≥ 6的病例的中位OS分别为17.4个月和13个月。
数据的对比分析突出了NLR低值对OS的益处。未来还必须明确不仅是临界NLR值（2至6之间）在头颈部鳞状细胞癌（HNSCC）中作为预后标志物的作用，以及将PLR和MLR纳入预后评分中的作用。采用更统一选定的纳入标准的前瞻性研究可以证明预处理时的NLR、PLR和MLR对于通过强化或降低HNSCC非手术根治性治疗来进行治疗分层的价值。
