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. 2022 May 15;14(5):3017-3027.
eCollection 2022.

NLR, PLR, LMR and MWR as diagnostic and prognostic markers for laryngeal carcinoma

Pingdong Li  1 , Haiyang Li  2 , Shuo Ding  1 , Jing Zhou  1
Affiliations

NLR, PLR, LMR and MWR as diagnostic and prognostic markers for laryngeal carcinoma

Pingdong Li et al. Am J Transl Res. .

Abstract

Objective: To evaluate whether neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte to monocyte ratio (LMR) and monocyte-to-white blood cell ratio (MWR) can be used as diagnostic and prognostic markers for laryngeal carcinoma (LC).

Methods: In this retrospective study, 50 patients with LC treated in the Department of Otolaryngology, Head and Neck Surgery of Beijing Tongren Hospital from August 2014 to August 2015 were enrolled in research group. In addition, 40 healthy volunteers from the same period were selected as control group. The counts of white blood cells, neutrophils, lymphocytes, monocytes and platelets in the peripheral blood of participants were measured with a blood counting instrument (Sysmex XE-2100, Sysmex Corporation, Japan), and the NLR, PLR, LMR and MWR were calculated. After that, the survival rate of patients was observed through a 5-year follow-up. The prognostic value of the above four indexes and their combination was discussed in patients with different clinical characteristics.

Results: Compared with the control group, the NLR, PLR and MWR were higher and the LMR was lower in the research group. In terms of survival, patients with higher NLR, PLR and MWR and lower LMR showed a higher 5-year mortality than those with lower NLR, PLR and MWR and higher LMR, indicating that NLR, PLR and MWR were higher and LMR was lower in the survival group than in the death group. Subsequent analysis identified that NLR, PLR, LMR and MWR were closely correlated with age, alcohol drinking, smoking, clinical staging and T-staging. Clinical staging, T-staging, NLR, PLR, LMR, and MWR were confirmed as influencing factors for LC.

Conclusions: NLR, PLR, LMR, and MWR can be used as diagnostic and prognostic markers for LC and their combination has a superior diagnostic performance.

Keywords: LMR; MWR; NLR; PLR; laryngeal carcinoma; tumor.

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Conflict of interest statement

None.

Figures

Figure 1
Figure 1
Comparison of NLR, PLR, LMR and MWR between the research group and the control group. (A-D) The NLR (A), PLR (B), LMR (C) and MWR (D) in the research group were higher than those in the control group. NLR: neutrophil-to-lymphocyte ratio, PLR: platelet-to-lymphocyte ratio, LMR: lymphocyte to monocyte ratio, MWR: monocyte-to-white blood cell ratio. *P<0.05 vs. the control group.
Figure 2
Figure 2
Effects of NLR (A), PLR (B), LMR (C) and MWR (D) on the survival rate of patients with laryngeal carcinoma. NLR: neutrophil-to-lymphocyte ratio, PLR: platelet-to-lymphocyte ratio, LMR: lymphocyte to monocyte ratio, MWR: monocyte-to-white blood cell ratio.
Figure 3
Figure 3
Predictive value of NLR, PLR, LMR and MWR for the prognosis of patients with laryngeal carcinoma. (A, B, D) The NLR (A), PLR (B) and MWR (D) in the death group were significantly higher than those in the survival group (P<0.05); (C) The LMR in the death group was significantly lower than that in the survival group (P<0.05); (E-I) The ROC of NLR (E), PLR (F), LMR (G), MWR (H) and NLR+PLR+LMR+MWR (I) for the prognosis of the patients. NLR: neutrophil-to-lymphocyte ratio, PLR: platelet-to-lymphocyte ratio, LMR: lymphocyte to monocyte ratio, MWR: monocyte-to-white blood cell ratio, ROC: receiver operating characteristic. *P<0.05 vs. the survival group.
Figure 4
Figure 4
NLR in patients with different clinical features. A. Sex: There was no difference in the NLR between males and females (P>0.05); B. Age: the NLR in patients aged 63 or less was significantly lower than that in patients over 63 years old (P<0.05); C. Drinking: the NLR in patients with a drinking history was significantly higher than that in non-drinkers (P<0.05); D. Smoking: the NLR in patients with a smoking history was significantly higher than that in non-smokers (P<0.05); E. Clinical staging: the NLR of patients in stage I-II was significantly lower than that of patients in stage III-IV (P<0.05); F. T-staging: the NLR of patients in stage T1-T2 was significantly lower than that of patients in stage T3-T4 (P<0.05). NLR: neutrophil-to-lymphocyte ratio. *P<0.05.
Figure 5
Figure 5
PLR in patients with different clinical features. A. Sex: there was no difference in the PLR between males and females (P>0.05); B. Age: the PLR in patients aged 63 or less was significantly lower than that in patients over 63 years old (P<0.05); C. Drinking: the PLR in patients with a drinking history was significantly higher than that in non-drinkers (P<0.05); D. Smoking: the PLR in patients with a smoking history was significantly higher than that in non-smokers (P<0.05); E. Clinical staging: the PLR of patients in stage I-II was significantly lower than that of patients in stage III-IV (P<0.05); F. T-staging: the PLR of patients in stage T1-T2 was significantly lower than that of patients in stage T3-T4 (P<0.05). PLR: platelet-to-lymphocyte ratio. *P<0.05.
Figure 6
Figure 6
LMR patients with different clinical features. A. Sex: there was no difference in the LMR between males and females (P>0.05); B. Age: the LMR in patients aged 63 or less was significantly higher than that in patients over 63 years old (P<0.05); C. Drinking: the LMR in patients with a drinking history was significantly lower than that in non-drinkers (P<0.05); D. Smoking: the LMR in patients with a smoking history was significantly lower than that in non-smokers (P<0.05); E. Clinical staging: the LMR of patients in stage I-II was significantly higher than that of patients in stage III-IV (P<0.05); F. T-staging: the LMR of patients in stage T1-T2 was significantly higher than that of patients in stage T3-T4 (P<0.05). LMR: lymphocyte to monocyte ratio. *P<0.05.
Figure 7
Figure 7
MWR in patients with different clinical features. A. Sex: there was no difference in the MWR between males and females (P>0.05); B. Age: the MWR in patients aged 63 or less was significantly lower than that in patients over 63 years old (P<0.05); C. Drinking: the MWR in patients with a drinking history was significantly higher than that in non-drinkers (P<0.05); D. Smoking: The MWR in patients with a smoking history was significantly higher than that in non-smokers (P<0.05); E. Clinical staging: the MWR of patients in stage I-II was significantly lower than that of patients in stage III-IV (P<0.05); F. T-staging: the MWR of patients in stage T1-T2 was significantly lower than that of patients in stage T3-T4 (P<0.05). MWR: monocyte-to-white blood cell ratio. *P<0.05.
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