Prediction of lymph node metastasis in oral tongue squamous cell carcinoma using the neutrophil‐to‐lymphocyte ratio and platelet‐to‐neutrophil ratio

Abstract

Background Lymph node metastasis in a variety of tumors is associated with systemic inflammatory markers. However, this association has not been reported in oral tongue squamous cell carcinoma (OTSCC). This study aimed to investigate how the preoperative neutrophil‐to‐lymphocyte ratio (NLR) and platelet‐to‐neutrophil ratio (PNR) in OTSCC patients correlated with the occurrence of OTSCC and lymph node metastasis. Methods The data of 73 patients with primary OTSCC who underwent surgical resection were retrospectively analyzed. Patients with other malignant tumors, patients who had received radiotherapy or chemotherapy before surgery, and patients with active inflammation were excluded. The enrolled patients were divided into groups N0 (no early‐stage lymph node metastasis) and N1 (early‐stage lymph node metastasis). Venous blood samples were collected before surgery and at the third week after surgery and subjected to complete blood counting in a blood analyzer. Eighty‐seven healthy people were included as a control group. In addition, the NLR and PNR in OTSCC patients were compared with those in the controls, and the postoperative NLR and PNR of group N0 were compared with those of group N1. Results The NLR was significantly higher in the OTSCC patients than the controls (p < 0.05). The area under the receiver operating characteristic curve was 0.595. Further comparison of the NLR and PLR between group N0 and group N1 showed that when NLR was ≤1.622, and the probability of early‐stage lymph node metastasis in OTSCC patients was 73.3%, and when PNR was >60.889, the probability was 86.7%. In re‐examination 3 weeks postoperatively, the NLR and PNR were not significantly different between groups. Conclusion The NLR has certain reference value for the diagnosis of OTSCC. The preoperative NLR and PNR can be used to predict early‐stage lymph node metastasis in patients with histopathologically confirmed OTSCC.

Emerging roles of platelets in cancer biology and their potential as therapeutic targets

“…In patients with metastatic colorectal cancer and upper urinary tract cancer with a tumor diameter >3 cm, the platelet/lymphocyte ratio was found to be correlated with tumor location and prognosis (106,107). In patients with oral and lingual squamous cell carcinoma, the platelet-to-neutrophil ratio can predict lymph node metastasis (108). Further research is needed to understand the mechanism of RNA transfer between platelets and tumor cells; this would include the use of mouse models, megakaryocyte analysis, and platelet RNA and proteomic multi-omics analysis.…”

Rhaponticin suppresses the hypoxia-induced factor-1 alpha-mediated aggressive phenotype of tongue squamous cell carcinoma

“…TSCC, as a tumor with an extremely high incidence in the oral and maxillofacial region, has a 5-year survival rate of less than 50%, although with the continuous improvement of surgery as well as comprehensive treatments such as radiotherapy and chemotherapy (Carr et al 2021). Among them, the significant biological predisposition to local invasion and the high incidence of early cervical lymph node metastasis are important factors contributing to the poor prognosis of patients with TSCC (Wang et al 2021a). In this study, we found that the invasion and migration abilities as well as EMT of TSCC cells were significantly enhanced under hypoxia.…”

Predictors of Occult Metastasis and Prognostic Factors in Patients with cN0 Oral Cancer Who Underwent Elective Neck Dissection

“…When OSCC did not metastasize, innate immunity was dominant, and the neutrophil count was elevated; after tumor metastasis, innate immunity weakened, and adaptive immunity became dominant. The neutrophil count decreases significantly compared to before tumor metastasis, and the mean lymphocyte count is greater than that in the no-metastasis group, resulting in a low NLR in the OM group [23]. This study identified a lymphocyte count of 1518/mm 3 as the cut-off value in survival with ROC analysis; a significant difference in OM was identified between <1518/mm 3 vs. ≥1518/mm 3 .…”