Prognostic Significance of Peripheral T-Cell Subsets in Laryngeal Squamous Cell Carcinoma

Filippo Marchi; Francesco Missale; Fabiola Incandela; Marta Filauro; Francesco Mazzola; Francesco Mora; Alberto Paderno; Giampiero Parrinello; Cesare Piazza; Giorgio Peretti

doi:10.1002/lio2.304

Prognostic Significance of Peripheral T-Cell Subsets in Laryngeal Squamous Cell Carcinoma

Laryngoscope Investig Otolaryngol. 2019 Aug 28;4(5):513-519. doi: 10.1002/lio2.304. eCollection 2019 Oct.

Authors

Filippo Marchi^{1

2}, Francesco Missale^{1

2}, Fabiola Incandela³, Marta Filauro^{1

2}, Francesco Mazzola^{1

2}, Francesco Mora^{1

2}, Alberto Paderno⁴, Giampiero Parrinello^{1

2}, Cesare Piazza³, Giorgio Peretti^{1

2}

Affiliations

¹ IRCCS Ospedale Policlinico San Martino Genoa Italy.
² Department of Otorhinolaryngology, Head and Neck Surgery University of Genoa Genoa Italy.
³ Department of Otorhinolaryngology, Maxillofacial and Thyroid Surgery, Fondazione IRCCS, National Cancer Institute of Milan University of Milan Milan Italy.
⁴ Department of Otorhinolaryngology, Head and Neck Surgery University of Brescia Brescia Italy.

Abstract

Objectives: The role of the immune system in head and neck squamous cell carcinoma is controversial. The aim of our study was to analyze full blood counts and distribution of T cell subsets in patients affected by laryngeal squamous cell cancer (LSCC) and their association with clinical variables and survival.

Study design: Retrospective study.

Methods: We analyzed the levels of platelets, lymphocytes, and neutrophils, as well as the CD4⁺, CD8⁺, and CD3⁺ T-cell subpopulations by cytofluorometry in LSCC patients. A cohort of healthy patients was used as control group. The disease-specific survival (DSS) was considered as survival outcome.

Results: Sixty-five LSCC patients and 48 controls were enrolled. In LSCC patients, neutrophils were higher than in the healthy group (P < .0001). The neutrophil-to-lymphocyte ratio (NLR) and the platelet-to-lymphocyte ratio (PLR) were both higher in LSCC patients (P < .0001). In patients treated for recurrent disease, the CD8⁺/CD3⁺ ratio was increased (P = .02), while the CD4⁺/CD8⁺ (P = .03) and CD4⁺/CD3⁺ (P = .04) ratios were lower. In patients with lymph node metastases, leukocytes (P = .03), CD3⁺ (P = .04), and CD4⁺ (P = .0098) were all higher. Among Stages III-IV patients, low lymphocyte and low leukocyte count were associated with worse DSS.

Conclusion: Our data demonstrate that NLR and PLR are significantly increased in LSCC. Lower CD4⁺/CD8⁺ and CD3⁺/CD8⁺ ratios are related to recurrent disease and a higher level of CD3⁺ and CD4⁺ is associated with nodal metastasis.

Level of evidence: 4.

Keywords: Laryngeal cancer; hematologic tests; immune system; lymphocytes; outcome.