Journal of Otolaryngology and Ophthalmology of Shandong University ›› 2019, Vol. 33 ›› Issue (3): 106-110.doi: 10.6040/j.issn.1673-3770.1.2019.018

• Original Article • Previous Articles     Next Articles

Preoperative platelet-lymphocyte ratio is an independent prognostic factor for laryngeal squamous cell carcinoma

Huijun CHEN,Shenghua SONG,Han ZHOU(),Weida DONG,Mingzhe QIAO,Xi CHEN,Jin XU,Ziping LIN,Guangqian XING()   

  1. Department of Otorhinolaryngology，The First Affiliated Hospital，Nanjing Medical University，Nanjing 210029，Jiangsu，China
  • Received:2019-02-26 Revised:2019-04-26 Online:2019-05-20 Published:2019-08-07
  • Contact: Han ZHOU,Guangqian XING E-mail:zhouhan1979@sina.com;xing-gq@163.com

RichHTML

6

PDF (PC)

272

Abstract: Objective

To evaluate the impact of preoperative platelet-lymphocyte ratio (PLR), neutrophil-lymphocyte ratio (NLR) and derived NLR (dNLR) on the prognosis in patients with laryngeal squamous cell carcinoma.

Methods

The clinical data of 473 patients with laryngeal squamous cell carcinoma who underwent primary surgery in the First Affiliated Hospital of Nanjing Medical University were analyzed retrospectively. According to preoperative PLR, NLR and dNLR, the receiver operating characteristic curve (ROC) for diagnosing tumor recurrence was drawn to determine PLR, NLR and dNLR thresholds, and then the patients were divided into the lower groups and the higher groups. Kaplan-Meier analysis and COX risk model were used to analyze the relationship between PLR, NLR, dNLR, and other clinicopathological parameters and recurrence of laryngeal squamous cell carcinoma.

Results

The area under the ROC curve (AUC) of PLR, NLR and dNLR for the diagnosis of tumor recurrence were 0.683, 0.720 and 0.696, respectively. Univariate analysis showed that PLR, NLR, dNLR, tumor classification, TNM stages, pathological differentiation, invasion of thyroid cartilage plate, lymph nodes metastasis, age and coagulation were associated with recurrence in patients with laryngeal squamous cell carcinoma; In COX regression model, a higher PLR, tumor classification and age were identified as independent risk factors for the recurrence of laryngeal squamous cell carcinoma (P<0.001; P=0.033; P=0.030).

Conclusion

Laryngeal squamous cell carcinoma patients with high preoperative dNLR are more likely to relapse. Preoperative PLR is a more valuable prognostic factor than NLR and dNLR for recurrence of laryngeal squamous cell carcinoma. It could be a clinically biomarker for the prognosis of laryngeal squamous cell carcinoma.

Key words: Laryngeal neoplasms, squamous cell, Platelet-lymphocyte ratio, Neutrophil-lymphocyte ratio, Recurrence, Prognosis

CLC Number: 

  • R767

Fig.1

ROC analysis based on dNLR，NLR and PLR for recurrence of laryngeal squamous cell carcinoma"

Fig.2

Comparison of survival rate between low PLR group and high PLR group with recurrence as the endpoint event"

Fig.3

Comparison of survival rate between low NLR group and high NLR group with recurrence as the endpoint event"

Fig.4

Comparison of survival rate between low dNLR group and high dNLR group with recurrence as the endpoint event"

Table 1

Kaplan-Meier survival analysis: a study of differences between different groups at the end of recurrence of laryngeal squamous cell carcinoma"

变量平均值（月）CI（月）3年生存率（%）χ2P

dNLR

低

高

93.988

67.571

90.167~97.810

60.724~74.419

78.164

59.864

49.165<0.001

NLR

低

高

96.185

72.316

92.107~100.262

66.675~77.958

78.039

64.762

43.232<0.001

PLR

低

高

94.284

72.035

90.176~98.392

66.185~77.885

75.800

66.304

39.036<0.001

分型

非声门型

声门型

67.656

90.374

59.090~76.222

86.639~94.109

54.286

75.543

28.447<0.001

分期

I+II

III+IV

90.823

70.084

87.098~94.549

62.052~78.116

77.778

52.672

26.108<0.001

病理分化

低分化

中+高分化

64.908

87.606

52.291~77.525

83.940~91.272

47.541

74.272

14.723<0.001

甲状软骨板累及

无

有

86.757

65.196

83.144~90.371

48.735~81.656

72.789

43.750

11.9920.001

淋巴结转移

无

有

88.984

61.431

85.359~92.609

50.596~72.266

74.631

47.761

28.793<0.001

年龄

＜60岁

≥60岁

90.846

81.306

85.451~96.242

76.620~85.991

77.325

67.110

6.2560.012

凝血功能

正常

异常

88.411

74.446

84.610~92.212

65.512~83.379

77.839

51.430

11.6850.001

Table 2

COX risk model analysis: classification,age and PLR are independent risk factors"

变量HRHR（CI）BP
分型0.6400.424~0.964-0.4470.033
PLR2.0111.378~2.9360.699＜0.001
年龄1.5371.043~2.2650.4300.030
1 黄选兆, 汪吉宝, 孔维佳. 实用耳鼻咽喉头颈外科学[M]. 北京: 人民卫生出版社，2008:488.
2 FengJF, HuangY, ChenQX. Preoperative platelet lymphocyte ratio (PLR) is superior to neutrophil lymphocyte ratio (NLR) as a predictive factor in patients with esophageal squamous cell carcinoma[J]. World J Surg Oncol, 2014, 12: 58. doi:10.1186/1477-7819-12-58.
doi: 10.1186/1477-7819-12-58
3 IshizukaM, NagataH, TakagiK, et al. Combination of platelet count and neutrophil to lymphocyte ratio is a useful predictor of postoperative survival in patients with colorectal cancer[J]. Br J Cancer, 2013, 109(2): 401-407. doi:10.1038/bjc.2013.350.
doi: 10.1038/bjc.2013.350
4 RussoA, FranchinaT, RicciardiGRR, et al. Baseline neutrophilia, derived neutrophil-to-lymphocyte ratio (dNLR), platelet-to-lymphocyte ratio (PLR), and outcome in non small cell lung cancer (NSCLC) treated with Nivolumab or Docetaxel[J]. J Cell Physiol, 2018, 233(10): 6337-6343. doi:10.1002/jcp.26609.
doi: 10.1002/jcp.26609
5 KangMY, JeongCW, KwakC, et al. Preoperative neutrophil-lymphocyte ratio can significantly predict mortality outcomes in patients with non-muscle invasive bladder cancer undergoing transurethral resection of bladder tumor[J]. Oncotarget, 2017, 8(8): 12891-12901. doi:10. 18632/oncotarget.14179.
doi: 10. 18632/oncotarget.14179
6 SabrkhanyS, GriffioenAW, Oude EgbrinkMG. The role of blood platelets in tumor angiogenesis[J]. Biochim Biophys Acta, 2011, 1815(2): 189-196. doi:10.1016/j.bbcan. 2010.12.001.
doi: 10.1016/j.bbcan. 2010.12.001
7 MantovaniA, AllavenaP, SicaA, et al. Cancer-related inflammation[J]. Nature, 2008, 454(7203): 436-444. doi:10.1038/nature07205.
doi: 10.1038/nature07205
8 GrenaderT, NashS, PlotkinY, et al. Derived neutrophil lymphocyte ratio may predict benefit from cisplatin in the advanced biliary cancer: the ABC-02 and BT-22 studies[J]. Ann Oncol, 2015, 26(9): 1910-1916. doi:10.1093/annonc/mdv253.
doi: 10.1093/annonc/mdv253
9 KucharczykJ, SullivanC, LuJ, et al. Prognostic and predictive value of pretreatment derived neutrophil-to-lymphocyte ratio in non-small-cell lung cancer patients treated with an immune checkpoint inhibitor[J]. JCT, 2018, 9(1): 23-34. doi:10.4236/jct.2018.91004.
doi: 10.4236/jct.2018.91004
10 DiricanA, KucukzeybekBB, AlacaciogluA, et al. Do the derived neutrophil to lymphocyte ratio and the neutrophil to lymphocyte ratio predict prognosis in breast cancer?[J]. Int J Clin Oncol, 2015, 20(1): 70-81. doi:10.1007/s10147-014-0672-8.
doi: 10.1007/s10147-014-0672-8
11 EthierJL, DesautelsD, TempletonA, et al. Prognostic role of neutrophil-to-lymphocyte ratio in breast cancer: a systematic review and meta-analysis[J]. Breast Cancer Res, 2017, 19(1): 2. doi:10.1186/s13058-016-0794-1.
doi: 10.1186/s13058-016-0794-1
12 ChenL, ZhangF, ShengXG, et al. Peripheral platelet/lymphocyte ratio predicts lymph node metastasis and acts as a superior prognostic factor for cervical cancer when combined with neutrophil: lymphocyte[J]. Medicine (Baltimore), 2016, 95(32): e4381. doi:10.1097/MD. 000-0000000004381.
doi: 10.1097/MD. 000-0000000004381
13 JainS, HarrisJ, WareJ. Platelets: linking hemostasis and cancer[J]. Arterioscler Thromb Vasc Biol, 2010, 30(12): 2362-2367. doi:10.1161/ATVBAHA.110.207514.
doi: 10.1161/ATVBAHA.110.207514
14 SuzukiK, AiuraK, UedaM, et al. The influence of platelets on the promotion of invasion by tumor cells and inhibition by antiplatelet agents[J]. Pancreas, 2004, 29(2): 132-140.
[1] HUANG He, OUYANG Hui. Risk factors and prognosis of esophageal cancer with hypopharyngeal carcinoma [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2019, 33(4): 82-86.
[2] Qing ZHAO,Han ZHOU,Min YIN,Jian FENG,Jiacheng ZHANG,Yaqin LIU,Yujie SHEN,Ziping LIN,Weida DONG. Value of preoperative hyperselective vascular embolization in juvenile nasopharyngeal angiofibroma treatment [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2019, 33(3): 100-105.
[3] Jiacheng ZHANG,Liqing ZHANG,Han ZHOU,Meiping LU,Wanyun XU,Yujie SHEN,Yaqin LIU,Min YIN,Weida DONG. Analysis of malignant melanoma of the nasal cavity and paranasal sinuses in 23 cases [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2019, 33(3): 95-99.
[4] Yan JIANG. Recurrence of nasopharyngeal carcinoma and application of endoscopic surgery [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2019, 33(2): 1-11.
[5] Dongping CHEN,Zhihuan YANG,Yan ZHANG,Nan FANG,Bin QI. Status of surgical treatment for recurrent nasopharyngeal carcinoma [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2019, 33(2): 12-16.
[6] Wenrui XU,Yan JIANG. Surgery Treatment for Recurrent Nasopharyngeal Carcinoma [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2019, 33(2): 35-38.
[7] Chuanhe LIU. The prevalence, diagnosis and management of asthma in children in China [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2019, 33(1): 28-32.
[8] LÜ Dan, LI Mingxia, MA Lanzhi, ZHANG Xinyuan, XIAO Hao, CHEN Fei, LIU Jun, LI Zhen. Neurofibromatosis of the head and neck involving the mediastinum: two cases report [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2018, 32(1): 82-86.
[9] LUN Jie, ZHANG Ya′nan. Analysis on the factors related to the recurrence of chronic rhinosinusitis with nasal polyps. [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2017, 31(3): 80-83.
[10] BAO Weijing, NING Jiayu, ZHU Zhongshou, WEI Rifu, LIN Chang. A clinical analysis of CO2 laser microsurgery for early glottic laryngeal carcinoma with anterior commissure involvement. [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2016, 30(5): 101-105.
[11] JIA Yanfeng, YANG Chunwei, SONG Fuchun, YANG Xiangli, WANG Lin, LIU Jixiang. Efficacy of CO2 laser combined with proton pump inhibitors in the treatment of recurrent vocal process granuloma. [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2016, 30(5): 106-109.
[12] MA Rongfeng, ZHU Fugao, SUN Meihong, FU Tao, ZHANG Xiaoheng, CAO Lin. Analysis on the relevant prognostic factors of sudden deafness and selection of course of treatment. [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2016, 30(4): 69-74.
[13] XIE Zhaofeng, LIN Honghao. Analysis of clinical risk factors on the postoperative prognosis of chronic rhinosinusitis. [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2016, 30(4): 90-93.
[14] JIN Shu. Influence of tracheal infection after total laryngectomy on pulmonary function and tumor recurrence rate in patients with laryngocarcinoma. [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2016, 30(3): 37-39.
[15] CHEN Xiaohong. Precision therapy on medullary thyroid carcinoma. [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2016, 30(2): 23-27.
Viewed
Full text


Abstract

Cited
  Shared   
  Discussed   
[1] LIN Bin,WANGHui-ge . Functional endoscopic sinus surgery, FESS[J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2006, 20(6): 481 -487 .
[2] . [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2006, 20(1): 84 -87 .
[3] . [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2006, 20(1): 90 -91 .
[4] . [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2008, 22(3): 200 -203 .
[5] BAI Guang-ping,LI Jun,DONG Pin . Endscopic surgery for chronic nasosinusitis and nasal polyps in 180 cases[J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2008, 22(3): 242 -243 .
[6] . [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2008, 22(3): 285 -285 .
[7] ZHANG Ji-zhong,LI Da-jian . Chondroseptum or ethmoid in repairing of nasal septum perforation under endoscopy[J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2008, 22(4): 336 -337 .
[8]

YU De-xian,ZHANG Wen-shan,PI Shi-jun,CAO Gui-xia,LI Yong-qiang,MA Qing,HUANG Jian

. Oil gauze of traditional Chinese medicine for nasal packing after functional endoscopic sinus surgery[J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2008, 22(4): 340 -342 .
[9] WEI Li-ping,LIU Hong-ying,XU Zhao-xia . Effect of trans-nasal endoscopic sinus surgery on chronic sinusitis[J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2008, 22(4): 345 -346 .
[10] . [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2008, 22(4): 349 -349 .
Website Copyright: Editorial Office of Journal of Otolaryngology and Ophthalmology of Shandong University
Address: No.27 Shanda South Road, Jinan, Shandong, China. Post code: 250100 Tel: +86-0531-88366912 Email: ebhxb@sdu.edu.cn Supported by Beijing Magtech Co.Ltd