title: Elevated neutrophil-to-lymphocyte ratio in squamous cell carcinoma of larynx compared to benign and precancerous laryngeal lesions.
abstract: BACKGROUND
  Laryngeal carcinogenesis is a multifactorial process that has not been fully elucidated. Despite extensive research, reliable markers with diagnostic and prognostic value are still lacking. It was recently reported that an elevated preoperative neutrophil-to-lymphocyte ratio (NLR) may correlate with an increased risk of recurrence, tumor aggressiveness and poorer prognosis in various malignancies. The aim of this study was to examine whether NLR could be used as an inflammatory marker to differentiate laryngeal squamous cell carcinoma (LSCC) patients from benign laryngeal lesion (BLL) and precancerous laryngeal lesion (PLL) patients.
  
  
  METHODS
  This retrospective study was performed on 209 patients admitted to a tertiary referral center with laryngeal lesions and undergoing biopsies to establish their histopathological diagnosis. We reviewed the patient files for their clinical, histopathological and laboratory data. The patients were divided into three groups according to their histopathological findings, as BLL, PLL and LSCC groups. The patients in the PLL group were also divided into three subgroups as mild, moderate and severe dysplasia/ carcinoma in situ (CIS) subgroups. The groups were compared for NLR and the other laboratory data.
  
  
  RESULTS
  The mean NLRs of the BLL, PLL and the LSCC groups were 2.12 ± 0.86, 2.32 ± 0.68 and 3.46 ± 1.51, respectively, and the difference was statistically significant (p = 0.001). The mean NLRs of the patients with PLL and LSCC were significantly higher than the patients with BLL (p = 0.031 and p = 0.001, respectively). The mean NLRs were similar among mild dysplasia, moderate dysplasia and severe dysplasia / CIS groups (p > 0.05).
  
  
  CONCLUSIONS
  To our knowledge, this is the first study investigating NLR in BLL, PLL and LSCC. NLR is an inexpensive, reproducible and widely available blood test, and could be a useful inflammatory marker to differentiate LSCC from BLL and PLL.
authors.affiliation: Ankara Numune Education and Research Hospital ENT Clinic, Ankara, Turkey E-mail : adigerok@yahoo.com.tr.
authors.forename: Rauf Oguzhan
authors.initials: RO
authors.lastname: Kum
authors.forename: Muge
authors.initials: M
authors.lastname: Ozcan
authors.forename: Deniz
authors.initials: D
authors.lastname: Baklaci
authors.forename: Nurcan Yurtsever
authors.initials: NY
authors.lastname: Kum
authors.forename: Yavuz Fuat
authors.initials: YF
authors.lastname: Yilmaz
authors.forename: Volkan
authors.initials: V
authors.lastname: Gungor
authors.forename: Adnan
authors.initials: A
authors.lastname: Unal
mesh_terms: D000328:Adult; D000368:Aged; D002278:Carcinoma in Situ / Q000097:blood* / Q000175:diagnosis; D002294:Carcinoma, Squamous Cell / Q000097:blood* / Q000175:diagnosis; D005260:Female; D006258:Head and Neck Neoplasms / Q000097:blood* / Q000175:diagnosis; D006801:Humans; D007818:Laryngeal Diseases / Q000097:blood / Q000175:diagnosis; D007822:Laryngeal Neoplasms / Q000097:blood* / Q000175:diagnosis; D007827:Laryngitis / Q000097:blood / Q000175:diagnosis; D018655:Lymphocyte Count; D008214:Lymphocytes / Q000166:cytology*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000097:blood*; D009504:Neutrophils / Q000166:cytology*; D011127:Polyps / Q000097:blood / Q000175:diagnosis; D011230:Precancerous Conditions / Q000097:blood* / Q000175:diagnosis; D011379:Prognosis; D012189:Retrospective Studies; D000077195:Squamous Cell Carcinoma of Head and Neck