Preoperative platelet lymphocyte ratio is superior to neutrophil lymphocyte ratio to be used as predictive marker for lymph node metastasis in oral squamous cell carcinoma.

OBJECTIVE: To assess whether the neutophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) before complete surgical staging will provide information on lymph node metastasis (LNM) in oral squamous cell carcinoma (OSCC) patients and to evaluate the relation of NLR and PLR with the various clinicopathologic characteristics.

METHODS: The clinicopathological data and the preoperative complete blood investigation details were obtained from 68 OSCC patients who underwent surgical treatment. Receiver operating characteristics (ROC) curve analysis was used to evaluate cut-off, sensitivity, and specificity values for preoperative NLR and PLR in order to predict LNM.

RESULTS: Lymph node involvement was detected in 24 (35%) patients. The best cut-off value for predicting LNM was 128.5 for the PLR, with 75% sensitivity and 70.45% specificity (P < 0.05). Fifty-five percent of patients had PLR ≤ 128.5 and 45% had PLR > 128.5. The PLR was higher in the lymph-node-positive group than in the negative group (147.63 ± 35.49 vs. 120.51 ± 42.5) (P < 0.05). There was an association between PLR cut-off and tumor stage. The best cut-off value for predicting LNM was 1.77 for NLR, with sensitivity of 87.5% and 25% specificity (P = 0.92).

CONCLUSION: Preoperative PLR is directly associated with nodal involvement status of OSCC. Preoperative PLR is superior to NLR for predicting LNM in OSCC.