The Effect of Neutrophil/Lymphocyte Ratio in Peripheral Blood and Tumor on Prognosis and Survival in Oral Squamous Cell Carcinomas

Objective:The aim of this study was to evaluate the prognostic significance of the neutrophil-to-lymphocyte ratio in peripheral blood (NLR) and in the cancer nest (iNLR) in patients with oral squamous cell carcinoma (OSCC). Methods:A retrospective analysis was performed on 59 OSCC patients who underwent radical surgery at a University Hospital between January 2017 and December 2023.Baseline assessments included routine peripheral blood tests and histopathologic examination of the carcinoma nest.Survival outcomes were analyzed using Kaplan-Meier curves, and univariate and multivariate analyses were performed to identify potential prognostic factors. Results:The median postoperative survival time for patients with low iNLR was 43 months compared to 19.5 months for patients with high iNLR.Although the overall survival difference did not reach statistical significance (P=0.09),patients with high NLR exhibited lower survival times.Furthermore, the median postoperative survival time for patients with low NLR was 38 months, compared to 20 months for patients with high NLR, a statistically significant difference (P=0.013).Univariate analysis identified NLR and tumor-node-metastasis staging as independent prognostic factors for postoperative survival in OSCC patients (P<0.05).Multivariate analysis revealed smoking status, surgical procedure, tumor-nodemetastasis staging, pathological tumor differentiation and NLR/iNLR scores as significant factors affecting postoperative survival (P<0.05). Conclusion:High NLR and iNLR levels are indicative of a worse prognosis in OSCC patients.Integration of NLR and iNLR assessments could potentially inform clinicians in the implementation of more aggressive therapeutic strategies for high-risk individuals.