Preoperative Neutrophil-to-Lymphocyte Ratio Prognostic Value in Cephalic and Cervical Adenoid Cystic Carcinoma

Abstract

Objective: Preoperative neutrophil-to-lymphocyte ratio (NLR) prognostic value in patients with cephalic and cervical adenoid cystic carcinoma (ACC). Methods: A retrospective analysis was performed on 71 ACC patients that attended the Xuzhou Central Hospital from August 2005 to November 2020. NLR and platelet-to-lymphocyte ratio (PLR) values were collected before treatment. NLR was calculated by dividing the absolute neutrophil count by the absolute lymphocyte count. PLR was calculated by dividing the absolute platelet count by the absolute lymphocyte count. Time-dependent ROC (receiver operating characteristic) curves of NLR and PLR predicting the postoperative survival status of patients at 3 years and 5 years were respectively drawn by the R program and the ideal cutoff value for the preoperative NLR was calculated for grouping. According to NLR >2.071 or NLR ≤2.071, patients were classified into low NLR group (n = 34) and high NLR group (n = 37), and the correlation between clinicopathological features and NLR of ACC patients was analyzed. The relationship between NLR and overall survival (OS) in ACC patients and disease-free survival (DFS) was examined by Cox regression analysis and Kaplan–Meier curves. Results: The area under the curve (AUC) for NLR was 0.743 (3 years) and 0.665 (5 years), and the AUC for PLR was 0.645 (3 years) and 0.512 (5 years). The ideal cutoff value for preoperative NLR was 2.071. Patients were divided into high NLR (NLR >2.071) (n = 37) and low NLR groups (NLR ≤2.071) (n = 34) for survival analysis. The level of preoperative NLR was linked to lymph node metastasis (LNM) and tumor stage. Kaplan–Meier survival analysis revealed that the high level of NLR was associated with a shorter OS but was not associated with DFS (p > 0.05). High age (>54 years) and high NLR (>2.071) were independent risk factors that predicted worse prognosis in ACC patients, as revealed by multivariate Cox regression analysis. Conclusions: This study suggests that the preoperative NLR, with better predictive value than PLR, is an effective biomarker for the prognosis of ACC patients.