Objective: To investigate whether neutrophil to lymphocyte ratio (NLR) in peripheral blood can be an independent prognostic factor in patients with head and neck squamous cell carcinoma (HNSCC). Methods: Clinical data of 97 HNSCC patients who received surgical treatment in our department between January 2008 and January 2012 were analyzed retrospectively. The 97 patients were divided into low NLR group (NLR≤5, n=69) and high NLR group (NLR>5, n=28) according to the NLR in preoperative peripheral blood. The relationships of NLR and clinicopathological features were analyzed. Kaplan-Meier method was used for univariate survival analysis and Cox proportional hazard model for multivariate survival analysis. Results: The clinical stages were significantly different between high NLR group and low NLR group (P<0.05), however, the age, gender, location, lymph node metastasis, smoking and alcohol of the two groups showed no significant differences (P> 0.05 of all). Univariate survival analysis showed that smoking, lymph node metastasis, clinical stage and NLR value were risk factors for 3-year overall survival (OS) rate and relapse-free survival (RFS) rate of HNSCC patients (P<0.05). The OS rate of high NLR and low NLR groups was 42.9% and 91.3%, and the RFS rate was 44.2% and 80.1%, respectively, with a statistically significant difference (P<0.05 for both). Cox multivariate survival analysis showed that clinical stage and NLR were independent factors for prognostic evaluation of HNSCC patients (P<0.05 for both). Conclusions: NLR level is significantly associated with clinical stage of HNSCC. High NLR is an independent prognostic rick factor and plays an important role in prognostic evaluation of HNSCC patients.
目的： 探讨术前外周血中性粒细胞与淋巴细胞比值(NLR)与头颈部鳞状细胞癌(HNSCC)患者预后的关系。 方法： 回顾性分析2008年1月至2012年1月收治的97例HNSCC患者的临床资料，根据患者术前外周血NLR分为低NLR组(NLR≤5)和高NLR组 (NLR>5)，其中低NLR组69例，高NLR组28例。分析NLR与临床病理特征的关系。单因素生存分析采用Kaplan－Meier法，多因素分析采用Cox比例风险回归模型。 结果： 高NLR组与低NLR组患者的临床分期差异有统计学意义(P<0.05)，年龄、性别、发病部位、淋巴结转移、吸烟和饮酒差异均无统计学意义(均P>0.05)。单因素分析显示，吸烟、淋巴结转移、临床分期和NLR为影响HNSCC患者3年总生存率和无进展生存率的因素(均P<0.05)。高NLR组和低NLR组患者的总生存率分别为42.9%和91.3%，无进展生存率分别为44.2%和80.1%，差异均有统计学意义(均P<0.05)。Cox多因素分析结果显示，临床分期和NLR为影响HNSCC患者预后的独立因素(均P<0.05)。 结论： NLR与HNSCC临床分期密切相关，高NLR为影响HNSCC患者预后的独立危险因素，对患者预后的判断有重要价值。.
Keywords: Carcinoma, squamous cell; Head and neck neoplasms; Neutrophil to lymphocyte ratio; Prognosis.