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

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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
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