Abstract
This study assessed the significance of the neutrophil-to-lymphocyte ratio (NLR) in head and neck squamous cell carcinoma (HNSCC), and the relationships of the NLR with the aldehyde dehydrogenase 1 (ALDH1) level in tumors and the proportion of myeloid-derived suppressor cells (MDSCs) in the peripheral circulation. In total, 227 HNSCC patients who had received curative treatment at our hospital were enrolled into the present study. The NLR of each HNSCC patient before treatment was calculated. The associations of NLR with various clinicopathological parameters and prognoses were then examined. In addition, correlations between the proportion of MDSCs and level of ALDH1 with the NLR were assessed. Our data revealed that an elevated NLR was significantly correlated with the risk of developing locoregional recurrence and with a reduced overall survival in HNSCC patients. Multivariate analyses revealed that the NLR pretreatment and surgical resection were significantly correlated with the rate of treatment failure and the overall survival rate in HNSCC patients. Furthermore, the levels of ALDH1 in tumors and MDSCs in the peripheral circulation were significantly correlated with the prognosis of HNSCC, and the NLR was positively correlated with MDSC levels in the circulation and ALDH1 staining intensity in tumor specimens. In conclusion, the NLR has power in predicting the expression of ALDH1 in tumors, the circulating level of MDSCs, and the prognosis in HNSCC. We suggest that the NLR is an important biomarker that can assist the clinician and patient in making informed decisions regarding treatment options for HNSCC patients.
Highlights
Head and neck squamous cell carcinoma (HNSCC) is a heterogeneous disease occurring in various sites, including the oral cavity, oropharynx, and hypopharynx [1]
We previously reported that positive aldehyde dehydrogenase 1 (ALDH1) staining was significantly related to a poor treatment response and higher disease failure rate in oral squamous cell carcinoma (SCC) [21]
We suggest that positive staining of ALDH1 is an independent and a high pretreatment neutrophil-to-lymphocyte ratio (NLR) plays a role in predicting ALDH1 expression levels and subsequently predictor of shorter survival and a higher rate of disease failure, and a high pretreatment NLR plays a a poor prognosis in head and neck squamous cell carcinoma (HNSCC)
Summary
Head and neck squamous cell carcinoma (HNSCC) is a heterogeneous disease occurring in various sites, including the oral cavity, oropharynx, and hypopharynx [1]. Treatment failure and locoregional recurrence are common and account for the majority of deaths [2]. Identification of potential molecular markers predicting aggressive tumor growth and treatment response is important for the effective management and prognosis of HNSCC. Abundant epidemiological data have revealed a strong correlation between inflammation and cancer incidence. Systemic inflammation is a recognized characteristic of malignancy, and numerous inflammatory markers have been investigated as prognostic indicators for cancer patients [3,4]. Host inflammatory responses were reported to play an important role in tumor development and progression [5]
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