Title: Prognostication of NLR and PLR in Oral Squamous Cell Carcinoma

Authors: Dr Ananthaneni Anuradha, Dr Penumala Vignatha, Dr G. Vijay Srinivas, Dr Bagalad S Bhavana, Dr Md. Asif Kiresur, Dr Puneeth HK

 DOI:  https://dx.doi.org/10.18535/jmscr/v5i10.100

Abstract

Background: Inflammatory status of host plays an important role in assessing the prognosis in cancer patients. Neutrophil lymphocyte ratio (NLR) and platelet neutrophil ratio (PLR) reflect the status of systematic inflammation. These novel markers have emerged as valuable and reliable prognostic and mortality evaluators in cancer patients. So we aimed to determine the prognostic significance of these inflammatory indices in oral squamous cell carcinoma patients.

Objective: The purpose of this study is to determine the prognostic value of PLR and NLR in patients with resected oral squamous cell carcinoma who had undergone concurrent chemotherapy and radiotherapy (CTRT).

Method: We performed a retrospective analysis of 20 oral carcinoma patients who underwent concurrent CTRT following resection. The prognostic value of the laboratory parameters were evaluated by ‘t’ test and univariate analysis.

Results: The statistical analysis revealed that there was an increase in NLR and PLR  post treatment but the increase was statistically significant only in PLR. Univariate analysis was done pertaining to parameters such as age, gender, NLR, PLR, PFS (progression free survival) and OS (overall survival) to evaluate the association between these factors and PFS and OS.

Conclusion: This study provided evidence for the association between NLR, PLR to outcome in oral squamous cell carcinoma. Preoperative NLR, PLR may represent a simple and cost-effective method for predicting the prognosis.

Keywords: Neutrophil Lymphocyte Ratio, Platelet Neutrophil Ratio, Progression Free Survival, Overall Survival.

References

  1. Williams HK. Molecular pathogenesis of oral squamous carcinoma.Mol Pathol 2000; 53: 165-72.
  2. Siddiqui IA, Farooq MU, Siddiqui RA, Rafi SMT. Role of toluidine blue in early detection of oral cancer. Pak J Med Sci 2006;22:184-7.
  3. Choi S, Myers JN. Molecular pathogenesis of oral squamous cell carcinoma: implications for therapy. J Dent Res 2008; 87: 14-32.
  4. Sara Socorro Faria et al. The neutrophil-to-lymphocyte ratio: a narrative review. ecancer 2016, 10:702 DOI: 10.3332/ ecancer.2016.702.
  5. Lisa M. Coussens et al. Inflammation and cancer. 2002 December 19; 420(6917): 860–867.
  6. Louise W. Treffers. Neutrophils in Immunological reviews.2016;273(1), 312–328.
  7. Barbara Molon, Bianca Calì and Antonella Viola. T Cells and Cancer: How Metabolism Shapes immunity. Frontiers in Immunology;2016;7(20):1-7.
  8. P Mehta. Potential role of platelets in the pathogenesis of tumor metastasis.

Corresponding Author

Dr Penumala Vignatha

St. Joseph Dental College, Duggirala,

Eluru, Andhra Pradesh