Prognostic role of systemic inflammation in oral cavity squamous cell carcinoma

Background. The inflammatory is an integral part of the formation and development of malignant neoplasms, including oral cavity squamous cell carcinoma (OCSCC).

The aim. Identification of the prognostic role of the factors of systemic inflammation in the peripheral blood of patients with OCSCC, as well as the relative indicators: neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and lymphocyte-to-monocyte ratio (LMR), with an assessment of their effect on overall survival (OS) and progression-free survival (PFS).

Materials and methods. A prospective study was included 165 patients with OCSCC. At the initial assessment, all patients underwent counting of peripheral blood parameters: leukocytes, lymphocytes, monocytes, eosinophils, platelets, as well as calculation of NLR, PLR and LMR.

Results. Due to univariate analysis a negative effect on OS is exerted by: the relative number of neutrophils > 61.18 % (HR = 0.66; p = 0.0280), the absolute number of lymphocytes ≤ 2.12 × 109/L (HR = 0.65; p = 0.0025), relative number of monocytes > 9.1 % (HR = 0.67; p = 0.0313), NLR > 2.30 (HR = 0.63; p = 0.0130) and LMR ≤ 3.47 (HR = 0.64; p = 0.0157). The PFS in univariate analysis was significantly negatively influenced by: the level of peripheral blood leukocytes ≤ 5.23 × 109/L (HR = 0.58; p = 0.0492), the absolute number of neutrophils > 2.86 × 109/L (HR = 0.62; p = 0.0386), the relative number of neutrophils > 61.18 % (HR = 0.53; p = 0.0028), the absolute number of lymphocytes ≤ 2.88 × 109/L (HR = 0.55; p = 0.0097), relative lymphocyte number 29.71 % (HR = 0.52; p = 0.0006), absolute number of eosinophils ≤ 0.09 × 109/L (HR = 0.55; p = 0.0244), relative number of monocytes > 6.96 % (HR = 0.58; p = 0.0087), NLR > 1.74 (HR = 0.52; p = 0.0006), PLR > 111.39 (HR = 0.63; p = 0.0196) and LMR ≤ 3.71 (HR = 0.55; p = 0.0019). According to the results of multivariate analysis, a significant negative effect on PFS was exerted by the relative number of monocytes > 6.96 %, and the absolute number of eosinophils in the peripheral blood ≤ 0.09 × 109/L. 

Conclusion. The analysis allows us to consider the factors of systemic inflammation recorded in the peripheral blood, as well as the NLR, PLR and LMR can serve as reliable additional factors in predicting the course of OCSCC.

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