Jiang Yu, Ji Xiaodong, Gao Shanshan, Yang Xiaohuang, Li Qing, Yu Zhuo, Yang Xilong, Shen Zhuo, Shen Jie, Xia Shuang
Department of Radiology, First Central Hospital of Tianjin Medical University, Nankai District, Tianjin, China.
Department of Radiology, The First Affiliated Hospital of Guilin Medical University, Guilin, Guangxi, China.
Cancer Imaging. 2025 Jul 29;25(1):95. doi: 10.1186/s40644-025-00913-w.
The impact of neck adipose tissue (NAT) on the invasiveness of hypopharyngeal squamous cell carcinoma (HPSCC) and laryngeal squamous cell carcinoma (LSCC) remains uncertain. We investigated the roles of NAT and derived - neutrophil to lymphocyte ratio (dNLR) in the aggressiveness of HPSCC and LSCC, and established an adipose- inflammation-aggressiveness axis to identify high-risk factors.
This retrospective study involved 412 patients with HPSCC or LSCC. Clinical characteristics, body mass index (BMI), NAT and dNLR were collected and calculated. Logistic regression models, restricted cubic splines (RCS) and mediation analysis were employed to evaluate the associations between NAT, dNLR and the aggressiveness of HPSCC and LSCC.
The cohort included 412 patients (mean age, 63 years; 93.69% male). Lower NAT was independently associated with advanced TNM stage (adjusted Odds Ratio [OR], 0.54; p = 0.015) and tumor local invasion (adjusted OR, 0.53; p = 0.008). Higher dNLR was significantly associated with advanced TNM stage (adjusted OR, 3.26; p < 0.001), lymph node metastasis (LNM) (adjusted OR, 1.40; p = 0.021), and tumor local invasion (adjusted OR, 2.29; p < 0.001). NAT showed a modest negative correlation with dNLR (R = -0.138, p = 0.005). Mediation analysis indicated that dNLR partially mediated the relationship between NAT and tumor aggressiveness.
Reduced NAT is associated with increased tumor aggressiveness in HPSCC and LSCC, and this relationship may be partially mediated by elevated dNLR. The association appeared more pronounced in male patients. These findings suggest that local adiposity and inflammation may play a role in tumor behavior and warrant further investigation in future studies.
颈部脂肪组织（NAT）对下咽鳞状细胞癌（HPSCC）和喉鳞状细胞癌（LSCC）侵袭性的影响仍不确定。我们研究了NAT及衍生的中性粒细胞与淋巴细胞比值（dNLR）在HPSCC和LSCC侵袭性中的作用，并建立了脂肪-炎症-侵袭性轴以识别高危因素。
这项回顾性研究纳入了412例HPSCC或LSCC患者。收集并计算临床特征、体重指数（BMI）、NAT和dNLR。采用逻辑回归模型、限制性立方样条（RCS）和中介分析来评估NAT、dNLR与HPSCC和LSCC侵袭性之间的关联。
该队列包括412例患者（平均年龄63岁；93.69%为男性）。较低的NAT与晚期TNM分期（校正比值比[OR]，0.54；p = 0.015）和肿瘤局部侵犯（校正OR，0.53；p = 0.008）独立相关。较高的dNLR与晚期TNM分期（校正OR，3.26；p < 0.001）、淋巴结转移（LNM）（校正OR，1.40；p = 0.021）和肿瘤局部侵犯（校正OR，2.29；p < 0.001）显著相关。NAT与dNLR呈适度负相关（R = -0.138，p = 0.005）。中介分析表明，dNLR部分介导了NAT与肿瘤侵袭性之间的关系。
在HPSCC和LSCC中，NAT减少与肿瘤侵袭性增加相关，这种关系可能部分由升高的dNLR介导。这种关联在男性患者中似乎更为明显。这些发现表明局部肥胖和炎症可能在肿瘤行为中起作用，值得在未来研究中进一步探讨。
