Salem Eman Hamdy, Habaza Fedaey Ramadan, Ebada Hisham Atef, Abu Shady Eslam Farid, Elkotamy Somaya Noaman, Thabet Ahmed Hossam, Abdelmeguid Ahmed Salama, Kamal Elsharawy, Hamza Ashraf, Abdelaziz Mahmoud, Tawfik Ali, Abd El-Fattah Ahmed Musaad
Department of Otolaryngology - Head and Neck Surgery, Mansoura University, Mansoura, Egypt.
Department of Otolaryngology - Head and Neck Surgery, Benha University, Benha, Egypt.
Laryngoscope. 2025 Jun;135(6):2037-2043. doi: 10.1002/lary.31986. Epub 2025 Jan 4.
The aim of this study was to investigate the role of lymph node yield (LNY), lymph node ratio (LNR), and neutrophil to lymphocyte ratio (NLR) as prognostic factors, their impact on survival in patients with advanced laryngeal squamous cell carcinoma (LSCC).
This multicentric retrospective study included 195 patients with clinical N0 advanced laryngeal carcinoma who underwent total laryngectomy and/or total pharyngolaryngectomy over 5 years. The number of lymph nodes extracted (LNY) and the number of positive nodes were counted. The lymph node ratio "LNR" was calculated as follows: (positive nodes /LNY). Moreover, neutrophil to lymphocyte ratio (NLR) was calculated and documented for analysis.
The mean 5-years DFS and overall survival (OS) was 33 and 35 months. The following were statistically significant factors negatively associated with overall survival; LNR (p = 0.047), NLR > 7 (p = 0.05), preoperative tracheostomy (p = 0.016), infiltrated safety margin (p = 0.01), postoperative radiotherapy (p < 0.001), N stage (p = 0.019), and unilateral neck dissection (p = 0.03). On the other hand, DFS was negatively associated with LNR (p = 0.001), N stage (p = 0.001), and infiltration of the surgical margins (p = 0.001).
LNY and LNR are both linked to survival outcomes following neck dissection in patients with clinical N0, locally advanced laryngeal carcinoma, where higher LNY and lower LNR correlated with improved survival and could be easily incorporated into cancer staging systems to aid in the prognostic stratification of patients. Additionally, NLR could act as a cost-effective inflammatory biomarker predicting poor prognosis in LSCC.
3 Laryngoscope, 135:2037-2043, 2025.
本研究旨在探讨淋巴结收获量（LNY）、淋巴结比率（LNR）和中性粒细胞与淋巴细胞比率（NLR）作为预后因素的作用，以及它们对晚期喉鳞状细胞癌（LSCC）患者生存的影响。
这项多中心回顾性研究纳入了195例临床N0期晚期喉癌患者，这些患者在5年期间接受了全喉切除术和/或全下咽喉切除术。统计提取的淋巴结数量（LNY）和阳性淋巴结数量。淋巴结比率“LNR”的计算方法如下：（阳性淋巴结数/LNY）。此外，计算并记录中性粒细胞与淋巴细胞比率（NLR）用于分析。
平均5年无病生存期（DFS）和总生存期（OS）分别为33个月和35个月。以下是与总生存期负相关的具有统计学意义的因素；LNR（p = 0.047）、NLR>7（p = 0.05）、术前气管切开术（p = 0.016）、手术切缘浸润（p = 0.01）、术后放疗（p < 0.001）、N分期（p = 0.019）和单侧颈部清扫术（p = 0.03）。另一方面，DFS与LNR（p = 0.001）、N分期（p = 0.001）和手术切缘浸润（p = 0.001）负相关。
LNY和LNR均与临床N0期局部晚期喉癌患者颈部清扫术后的生存结果相关，其中较高的LNY和较低的LNR与生存改善相关，并且可以很容易地纳入癌症分期系统以帮助对患者进行预后分层。此外，NLR可作为一种经济有效的炎症生物标志物，预测LSCC患者预后不良。
3《喉镜》，135:2037 - 2043，2025。
