The Role Of Systemic Immune-Inflammation Index And Prognostic Nutrition Index In The Prognosis Of Laryngeal Carcinoma:A Correlation Study

Objective:Increasing evidence suggests that systemic inflammatory response and malnutrition are associated with the survival rate of some types of solid tumors.However,the relationship between prognosis and laryngeal cancer is still not very clear.The purpose of this study was to investigate the correlation between systemic immune inflammation index(SⅡ)and prognostic nutrition index(PNI)and the degree of laryngeal cancer lesion,to evaluate the relationship between SⅡ and PNI and overall survival rate(OS)in patients with laryngeal cancer after surgery,and to compare their predictive efficacy for the prognosis of laryngeal cancer patients.Methods:A retrospective study was conducted on patients with laryngeal squamous cell carcinoma who underwent radical surgery from February 1,2014 to February 28,2016 in the Department of Otolaryngology,Head and Neck Surgery,First Hospital of Shanxi Medical University.After screening according to the prescribed inclusion and exclusion criteria,104 patients with laryngeal squamous cell carcinoma were finally collected,and 104 patients with laryngeal benign tumors were enrolled in the control group.They were treated surgically in the Department of Otolaryngology,Head and Neck Surgery,the First Hospital of Shanxi Medical University at the same time.SPSS24.0 software was used for statistical analysis.The differences of NLR,PLR,SⅡ and PNI between laryngeal squamous cell carcinoma and benign laryngeal mass were analyzed.The best cut-off values of SⅡ,NLR,PLR and PNI were determined by theworking characteristic curve of the subjects.Chi-square test was used to evaluate the relationship between NLR,PLR,SⅡ,PNI and clinicopathological features in laryngeal cancer patients.Survival rate was analyzed by Kaplan-Meier method,logarithmic rank test,and then multivariate Cox proportional hazard model.Finally,the area under ROC curve was used to evaluate the predictive effect of NLR,PLR,SⅡ and PNI on the prognosis of laryngeal cancer patients.Results:1.The NLR,PLR and SⅡ values of laryngeal squamous cell carcinoma group were significantly higher than those of benign laryngeal mass control group,while PNI values were significantly lower(P < 0.05).2.In laryngeal squamous cell carcinoma group,NLR and PLR were correlated with TNM staging,tumor differentiation and tumor typing.3.Univariate regression analysis showed that SⅡ(p=0.003),NLR(p=0.018),PLR(p=0.014)and P NI(p=0.007)were all prognostic factors for 3-year survival rate of laryngeal squamous cell carcinoma patients.Multivariate regression analysis showed that SⅡ(P=0.037)and PNI(P=0.026)were independent risk factors for3-year survival rate of laryngeal squamous cell carcinoma patients.4.ROC curve analysis showed that the AUCs of NLR,PLR,SⅡ,PNI and COSⅡ-PNI were 0.578(95% confidence interval,0.541-0.628),0.592(95%confidence interval,0.545-0.646),0.598(95% confidence interval,0.550-0.667),0.602(95% confidence interval,0.566-0.648)and 0.644(95% confidence interval,0.613-0.711).The prognostic efficacy of COSⅡ-PNI was better than that of SⅡ and PNI(P < 0.05).Conclusions:The increase of SⅡ and the decrease of PNI may indicate the progress of laryngeal cancer.SⅡ and PNI can be used as indicators to reflect the severity of laryngeal cancer patients.Preoperative high SⅡ and low PNI are powerful indicators of Invasive Biology and poor prognosis in patients with esophageal squamous cell carcinoma.The combination of SⅡ and PNI can improve the accuracy of prognosis.