Elevated Neutrophil-To-Lymphocyte Ratio as a Predictive Tool for Laryngeal Squamous Cell Carcinoma

Abstract

Objective: To determine the mean value of Neutrophil-to-Lymphocyte Ratio (NLR) in laryngeal squamous cell carcinoma, premalignant laryngeal lesions, and benign laryngeal lesions.
Material and Methods: A cross-sectional study spanning over 6 months 12th July 2016 to 11th January 2017 at Department of ENT (Ear, Nose and Throat), Benazir Bhutto Hospital (BBH), Rawalpindi. A total of 30 patients with age 15-60 years having hoarseness of voice were included via convenience sampling for the study. Patients with vocal cord paralysis, acute infection, cardiovascular disease and unfit for GA (General anesthesia) were excluded. Complete Blood count with peripheral smear was done for NLR (Neutrophil-To- Lymphocyte Ratio). Informed consent for direct laryngoscope (DL) with biopsy under GA was obtained. Patient was prepared for GA. DL (Direct Laryngoscopy) was done under GA and sample was sent in formalin to the Department of Pathology Benazir Bhutto Hospital for histopathology.
Results: The mean age was 43.37±10.40 years. Out of these 30 patients, 20(66.67%) were male and 10 (33.33%) were females with male to female ratio of 2:1. Mean neutrophil-to-lymphocytic ratio was 2.79 ± 0.82. Mean value of NLR in laryngeal squamous cell carcinoma, premalignant laryngeal lesions and benign laryngeal lesions was 3.80 ± 0.26, 2.42±0.09 and 2.04 ± 0.13 respectively.
Conclusion: This study concluded that NLR can help to predict the likelihood of laryngeal squamous cell carcinoma in a patient presenting with hoarseness of voice and any laryngeal lesion on indirect laryngoscopy prior to direct laryngoscopy and biopsy.
Keywords: Hoarseness of Voice, Laryngeal Squamous Cell Carcinoma, Neutrophil-to-Lymphocytic Ratio.