Clinical Significance Of Preoperative Inflammatory Markers In Predicting The Prognosis Of Laryngeal Carcinoma

Objective To explore the clinical significance of preoperative inflammatory indexes NLR,PLR and MLR in predicting the prognosis of laryngeal carcinoma,and to provide reference basis for postop erative prognosis evaluation of patients with laryngeal carcinoma.Methods From October 1,2010 to November 30,2015,124 patients with laryngeal malignant tumor were admitted to our hospital by otorhinolaryngology head and neck surgery(partial or total laryngect omy).All patients were followed up for 1-120 months,with an average follow-up time of 47 months.74 patients were followed up for five years.Blood routine examination was performed before operation,the absolute values of lymphocytes,neutrophi ls,platelets and monocytes were recorded,and the values of NLR,PLR,MLR,PDW and MPV were calculated.according to the(ROC)curve of the subjects’ working characteristics,the patients were divided into high and low groups according to the end point of death or follow-up,namely,high NLR,PLR,MLR,MPV and PDW group and low NLR,PLR,MLR,MPV and PDW group.To explore the clinical significance of preoperative inflammatory indexes in predicting the prognosis of patients with laryngeal carcinoma.Results 1.Relationship between preoperative inflammatory indexes and clinical data: ROC curve analysis showed that the cutoff values of preoperative inflammatory indexes NLR,PLR,MLR,MPV and PDW were3.19,137,0.36,11.25,14.05 respectively.Compared with the lo w preoperative inflammatory indexes NLR,MLR,MPV and PDW,there was no significant difference in nationality,age and sex between the high preoperative inflammatory indexes group and the low preoperative inflammatory indexes group(all P > 0.05).There wa s no significant difference in nationality and age between high PLR group and low PLR group before operation,but the PLR value of male patients was higher than that of female patients(P < 0.05).2.The relationship between preoperative inflammatory index es and pathological features: there was no significant difference between the two groups in tumor location,differentiation,T stage,N stage and clinical stage(all P > 0.05).There was no significant difference in PLR,MPV and PDW in tumor location,diff erentiati on degree,T stage,N stage and clinical stage between the two groups.There was no significant difference in tumor location,differentiation degree and N stage between the two groups,but there were significant differences in T stage and clinical stage between the two groups(all P < 0 05).There was no significant difference in NLR and MLR between the two groups in tumor location,differentiation and N stage.The higher the preoperative NLR and MLR,the higher the T stage and the later the clinic al stage.3.Univariate analysis of the prognosis of patients with laryngeal carcinoma: there was no significant difference in the level of preoperative inflammatory indexes MPV and PDW,nationality,age,sex and differentiation with the five-year survival rate of patients with laryngeal carcinoma(all P >0.05).There were significant differences in preoperative NLR,PLR and MLR levels,tumor location,T stage,N stage and clinical stage with the five-year survival rate of patients with laryngeal carcinoma(all P >0.05).The higher the preoperative NLR,PLR and MLR,the lower the five-year survival rate of patients with laryngeal carcinoma.The five-year survival rate of glottic carcinoma group was higher than that of supraglottic and subglottic carcinoma gr oup,the five-year survival rate of T1+T2 stage group was higher than that of T3+T4 stage group,and the five-year survival rate of patients without lymph node metastasis was higher than that of lymph node metastasis group.the five-year survival rate of patients with early laryngeal carcinoma was higher than that of patients with middle and advanced laryngeal carcinoma.4.Multivariate analysis of the prognosis of patients with laryngeal carcinoma: preoperative NLR level,N stage and clinical stage were independent risk factors affecting the prognosis of laryngeal carcinoma(all P < 0.05).Conclusion 1.Preoperative NLR,PLR and MLR levels may be related factors affecting the prognosis of patients with laryngeal carcinoma.2.Preoperative NLR level may be an independent predictor of prognosis of laryngeal carcinoma,and the prognosis of patients with laryngeal carcinoma with preoperative NLR ≥ 3.19 is relatively poor.