Prognostic role of neutrophil-to-lymphocyte ratio to laryngeal squamous cell carcinoma: a meta-analysis

Zhao, Yahui; Qin, Jiangbo; Qiu, Zhaofeng; Guo, Jianzhou; Chang, Wei

doi:10.1016/j.bjorl.2020.09.015

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Brazilian Journal of Otorhinolaryngology

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Sumário

Original article • Braz. j. otorhinolaryngol. 88 (05) • Sep-Oct 2022 • https://doi.org/10.1016/j.bjorl.2020.09.015 copy

Prognostic role of neutrophil-to-lymphocyte ratio to laryngeal squamous cell carcinoma: a meta-analysis^☆ ☆ Peer Review under the responsibility of Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial.

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Introduction

New evidence suggests that the ratio of neutrophils to lymphocytes is associated with the prognosis of other carcinoma, but the ratio of neutrophils to lymphocytes in laryngeal squamous cell carcinoma remains controversial.

Objective

The objective of this meta-analysis was to clarify the prognostic effectiveness of the ratio of neutrophils to lymphocytes in laryngeal squamous cell carcinoma.

Methods

According to the meta-analysis of the free guide, we searched EMBASE, Pubmed, the Cochrane Library databases. The ratio of neutrophils to lymphocytes of laryngeal squamous cell carcinoma patients was evaluated using mean standard vehicle and confidence interval. The overall survival, disease-free survival and progression free survival of patients with laryngeal squamous cell carcinoma were expressed by standard mean carrier method and confidence interval. The risk ratio of 95% confidence interval was used as an evaluation index for patients with laryngeal squamous cell carcinoma.

Results

Eight studies, including 1780 patients, used a variety of different end values to classify the ratio of neutrophils to lymphocytes (range 1.78-4.0). Among the eight studies that reported risk ratio of the overall survival, the higher median value was 2.72, and 2 of 4 studies reported disease-free survival results. The critical value of ratio of neutrophils to lymphocytes and overall survival deterioration (risk ratio = 1.68, 95% confidence interval 1.43-1.99, p< 0.001), disease-free survival (risk ratio = 2.09, 95% confidence interval 1.62-2.6, p< 0.001) and progression free survival (risk ratio = 1.92, 95% confidence interval 1.75-2.10, p< 0.001) was associated with with laryngeal aquamous cell carcinoma. The ratio of neutrophils to lymphocytes had prognostic value for laryngeal squamous cell carcinoma.

Conclusion

The results of this meta-analysis showed that the increase of neutrophils to lymphocytes ratio was related to poor prognosis of laryngeal squamous cell carcinoma. The neutrophils to lymphocytes ratio may serve as a cost-effective prognostic biomarker of poor prognosis of laryngeal squamous cell carcinoma. More high-quality prospective trials are needed to assess the practicability of evaluating the ratio of neutrophils to lymphocytes in laryngeal squamous cell carcinoma.

Keywords
Laryngeal cell carcinoma; Neutrophil-to-lymphocyte ratio; Overall survival; Disease-free survival; Meta-analysis

Study	Time	Country	Ethnicity	Patients (male/female)	Age (range)	Result	Follow-up (month)	Primary location			Cutoff	NOS score
Chen et al.⁷7 Chen L, Zeng H, Yang J, Chen L, Zeng H, Yang J, et al. Survival and prognostic analysis of preoperative inflammatory markers in patients undergoing surgical resection for laryngeal squamous cell carcinoma. BMC Cancer. 2018;18:816.	2018	China	Asia	361 (353/8)	60 (35−87)	OS PFS	47 (4−98)	280 (77.56%)	70 (19.39%)	11 (3.05%)	2.45	7
Song et al.⁸8 Song S, Chen H, Dong W, Zhou H. The prognostic value of preoperative derived neutrophil-to-lymphocyte ratio in patients undergoing total laryngectomy with laryngeal carcinoma. Acta Otolaryngol. 2019;139:294-298.	2019	China	Asia	137 (133/4)	62 (40-84)	OS RFS	47 (2-111)	Glottic: 61 (44.5%) supraglottic and subglottic: 76 (55.4%)			2.96	8
Tu et al.¹⁰10 Tu XP, Qiu QH, Chen LS, Luo XN, Lu ZM, Zhang SY, et al. Preoperative neutrophil-to-lymphocyte ratio is an independent prognostic marker in patients with laryngeal squamous cell carcinoma. BMC Cancer. 2015;15:743.	2015	China	Asia	141 (137/4)	59 (36-87)	OS DFS	51 (5−102)	24 (17%)	113 (80.2%)	4 (2.8%)	2.17	8
Zhou et al.¹¹11 Zhou T, Yu ST, Chen WZ, Xie R, Yu JC. Pretreatment albumin globulin ratio has a superior prognostic value in laryngeal squamous cell carcinoma patients: a comparison study. J Cancer. 2019;10:594-601.	2019	China	Asia	232 (192/40)	63 (39−81)	OS DFS	27.3 ± 18.6	68 (29.3%)	152 (65.2%)	12 (5.2%)	2.38	7
Fu et al.¹²12 Fu Y, Liu W, OuYang D, Yang A, Zhang Q. Preoperative neutrophil-to-lymphocyte ratio predicts long-term survival in patients undergoing total laryngectomy with advanced laryngeal squamous cell carcinoma: a single-center retrospective Study. Medicine (Baltimore) 2016;95:e2689.	2016	China	Asia	420 (413/7)	60 ± 9.1 (33−84)	OS CSS		198 (47.14%)	206 (49.04%)	16 (3.82%)	2.59	8
Wong et al.¹³13 Wong BY, Stafford ND, Green VL, Greenman J. Prognostic value of the neutrophil-to-lymphocyte ratio in patients with laryngeal squamous cell carcinoma. Head Neck. 2016;38 Suppl 1:E1903-E1908.	2016	United Kingdom	Europe	140 (121/19)	66 (36−92)	OS DFS	41.5 (2−103)				＜1.78 2.41 3.10 ＞3.10	5
Wang et al.¹⁴14 Wang J, Wang S, Song X, Zeng W, Wang S, Chen F, et al. The prognostic value of systemic and local inflammation in patients with laryngeal squamous cell carcinoma. Onco Targets Ther. 2016;9:7177-7185.	2016	China	Asia	120 (118/2)	60.6 ± 8.6 (40−81)	OS PFS	40.1 ± 14.9	52 (43.33%)	63 (52.50%)	5 (4.17%)	2.79	6
Aires et al.¹⁵15 Aires FT, Dedivitis RA, Kulcsar M.AV, Ramos DM, Cernea CR. Neutrophil-to-lymphocyte ratio as a prognostic factor for pharyngocutaneous fistula after total laryngectomy. Acta Otorhinolaryngol Ital. 2018;38:31-37.	2018	Turkey	Asia	229 (221/8)	59 (31−88)	OS DFS PFS	39.5 (1-107)	79 (40.97%)	82 (50.93%)		4	6

Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Sede da Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico Facial, Av. Indianópolia, 1287, 04063-002 São Paulo/SP Brasil, Tel.: (0xx11) 5053-7500, Fax: (0xx11) 5053-7512 - São Paulo - SP - Brazil
E-mail: revista@aborlccf.org.br

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[1] * Corresponding author. 2292534784@qq.com (J. Qin).

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Prognostic role of neutrophil-to-lymphocyte ratio to laryngeal squamous cell carcinoma: a meta-analysis☆ ☆ Peer Review under the responsibility of Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial.

Abstract

Introduction

Objective

Methods

Results

Conclusion

Prognostic role of neutrophil-to-lymphocyte ratio to laryngeal squamous cell carcinoma: a meta-analysis^☆ ☆ Peer Review under the responsibility of Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial.