Clinical Significance Of Preoperative Peripheral Blood Inflammation Index In Predicting The Prognosis Of Oral Squamous Cell Carcinoma

Objective: To investigate the associations between various blood test parameters including neutrophil-to-lymphocyte ratio(NLR),lymphocytes-to-monocyte ratio(LMR)、systemic immune-inflammation index(SII)and prognosis in post-operative oral squamous cell carcinoma(OSCC)patient.Methods: A total of 373 patients with surgically treated oral squamous cell carcinoma who were treated in the Department of Stomatology,Affiliated Hospital of Yanbian University from from 2000 to 2021 were collected.A total of 73 patients were followed up according to the inclusion and exclusion criteria.Collect the values of neutrophils,lymphocytes,monocytes and platelets in peripheral blood before operation.The relationship between NLR,LMR,SII,Clinicopathological data such as gender,age,ethnic group and prognosis were analyzed.According to receiver operating characteristic curve(ROC),the optimal cut off value of NLR、LMR、SII were determined and the patients were divided into high and low two groups.Kaplan-Meier survival curve and log-rank test methods were used to compare the cancer specific survival(CSS)between the two groups.Cox proportional hazards regression model was used for univariate and multivariate prognostic analysis,with P<0.05 as the statistical criterion.Results:1.According to the clinical data of 73 patients with oral cancer,the ROC curve was drawn.The cut-off values of NLR,LMR and SII were 2.24,4.17 and 333.96,respectively,and the area under the curve(AUC)were 0.593,0.621 and 0.600,respectively.2.The relationship between preoperative inflammatory indexes and clinical data2.1 The number of cases with drinking history in the high NLR group was significantly less than that in the low NLR group(P<0.05).There was no significant difference in sex,age,ethnic group,smoking history,p T,p N,p TNM,differentiation,tumor location and postoperative adjuvant therapy history between the two groups(P>0.05).2.2 The number of cases with drinking history in the high LMR group was significantly more than that in the low LMR group(P<0.05).There was no significant difference in sex,age,ethnic group,smoking history,p T,p N,p TNM,differentiation,tumor location and postoperative adjuvant therapy history between the two groups(P>0.05).2.3 There was no significant difference between high SII group and low SII group in sex,age,ethnic group,smoking history,drinking history,p T,p N,p TNM,differentiation,tumor location and postoperative adjuvant therapy history(P>0.05).3.The analysis of the Kaplan-Meier survival curve3.1 The 1、3、5-year CSS of the high NLR and low NLR group were 61.90%、52.38%、52.38% and 92.31%、82.69%、78.85%.The survival rate of low NLR group was significantly better than that of high NLR group,and the differences were statistically significant according to the Kaplan-Meier survival curve(P<0.05).3.2 The 1、3、5-year CSS of the high LMR and low LMR group were 88.89%、84.44%、82.22% and 75.00%、57.14%、53.57%.The survival rate of low LMR group was significantly better than that of high LMR group,and the differences were statistically significant according to the Kaplan-Meier survival curve(P<0.05).3.3 The 1、3、5-year CSS of the high SII and low SII group were 75.61%、63.41%、60.98% and 93.75%、87.50%、84.38%.The survival rate of low SII group was significantly better than that of high SII group,and the differences were statistically significant according to the Kaplan-Meier survival curve(P<0.05).3.4 The 1、3、5-year CSS of Korean and Han group were 91.30%、84.78%、84.78% and 70.37%、55.56%、48.15%.The survival rate of Korean was significantly better than that of Han,and the differences were statistically significant(P<0.05).4.Univariate Cox analysis showed that ethnic group,NLR,LMR and SII were the risk factors of CSS in OSCC patients(P<0.05),and multivariate Cox analysis showed that LMR was an independent risk factor for CSS in OSCC patients among NLR,LMR and SII(P=0.019);and ethnic group was also an independent prognostic factor for CSS in OSCC patients(P=0.001).Conclusion:1.Preoperative NLR,LMR and SII can predict postoperative CSS of OSCC patients.Low preoperative LMR level is an independent prognostic factor of poor CSS of OSCC patients,and its evaluation value may be better than NLR and SII.2.The prognosis of CSS in Korean OSCC patients in Yanbian area may better than that of Han,and ethnicity may be an independent prognostic factor of CSS of OSCC patients after operation.