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Correlation of Clinical and Pathological Diagnosis and Inflammatory Markers for Patients Undergoing Laryngeal Microsurgery

  • Author Footnotes
    1 Bayram ŞAHİN, M.D., ORC-ID: 0000-0002-3886-4432
    Bayram ŞAHİN
    Correspondence
    Address correspondence and reprint requests to Bayram ŞAHİN, M.D., Kocaeli Health Sciences University, Derince Training and Research Hospital, Otorhinolaryngology & Head and Neck Surgery, İbni Sina Mah. Lojman Sok. Derince/Kocaeli, Turkey 41090.
    Footnotes
    1 Bayram ŞAHİN, M.D., ORC-ID: 0000-0002-3886-4432
    Affiliations
    Department of Otorhinolaryngology & Head and Neck Surgery, Kocaeli Health Sciences University Derince Training and Research Hospital, Kocaeli, Turkey
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  • Author Footnotes
    2 Merve AKYOL, M.D., ORC-ID: 0000-0003-2787-0527
    Merve AKYOL
    Footnotes
    2 Merve AKYOL, M.D., ORC-ID: 0000-0003-2787-0527
    Affiliations
    Department of Otorhinolaryngology & Head and Neck Surgery, Kocaeli Health Sciences University Derince Training and Research Hospital, Kocaeli, Turkey
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  • Author Footnotes
    3 Halil Erdem ÖZEL, Associate Professor, M.D., ORC-ID: 0000-0002-7235-3433
    Halil Erdem ÖZEL
    Footnotes
    3 Halil Erdem ÖZEL, Associate Professor, M.D., ORC-ID: 0000-0002-7235-3433
    Affiliations
    Department of Otorhinolaryngology & Head and Neck Surgery, Kocaeli Health Sciences University Derince Training and Research Hospital, Kocaeli, Turkey
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  • Author Footnotes
    4 Selahattin GENÇ, Associate Professor, M.D., ORC-ID: 0000-0002-4412-1889
    Selahattin GENÇ
    Footnotes
    4 Selahattin GENÇ, Associate Professor, M.D., ORC-ID: 0000-0002-4412-1889
    Affiliations
    Department of Otorhinolaryngology & Head and Neck Surgery, Kocaeli Health Sciences University Derince Training and Research Hospital, Kocaeli, Turkey
    Search for articles by this author
  • Author Footnotes
    1 Bayram ŞAHİN, M.D., ORC-ID: 0000-0002-3886-4432
    2 Merve AKYOL, M.D., ORC-ID: 0000-0003-2787-0527
    3 Halil Erdem ÖZEL, Associate Professor, M.D., ORC-ID: 0000-0002-7235-3433
    4 Selahattin GENÇ, Associate Professor, M.D., ORC-ID: 0000-0002-4412-1889
Published:November 03, 2020DOI:https://doi.org/10.1016/j.jvoice.2020.10.003

      Summary

      Background

      The purpose of this study was to investigate the rate of concordance between indirect- and direct laryngoscopy and final pathology in patients undergoing laryngeal microsurgery.

      Study Design

      Retrospective case study.

      Methods

      This study was conducted in the Otolaryngology clinic of a tertiary center between January 2017 and June 2020. Archives records of 432 patients, who underwent laryngeal microsurgery because of benign and premalignant lesions or malignancy, were examined. The patients were divided into three subgroups according to pathology results: benign lesions, premalignant lesions, and malignancies.

      Results

      There were 400 laryngeal lesions from 385 patients, that met the inclusion and exclusion criteria, 307 (79.7%) were male and 78 were (20.3%) female. The average age of patients was 52.88 ± 13.21 years. The most common diagnosis was polyp (34.25%) followed by squamous cell carcinoma (27.75%) and Reinke's edema (8.25%) according to final pathology. For the benign laryngeal lesions, a high correlation level was observed regarding the compatibility of the indirect- and direct laryngoscopy diagnosis, and final pathology (P < 0.001). The laryngeal premalignant lesions and malignancies were significantly more common in older age and male gender (P <0.001). Similarly, smoking usage was more frequent in patients with premalignant lesions and malignancy (P <0.001). The neutrophil count, neutrophil to lymphocyte ratio, platelet to lymphocyte ratio, neutrophil to platelet ratio as well as CRP value were significantly higher in malignancy group (P <0.05). On the other hand, lymphocyte ratio was smaller in the malignancy group compared with the benign and premalignant lesions, and this difference was significant (P = 0.016).

      Conclusion

      Our study demonstrated a high rate of agreement between the clinical diagnosis and pathology results in patients with benign laryngeal lesions, in contrast to premalignant lesions and malignancies. Also, the neutrophil to lymphocyte ratio, platelet to lymphocyte ratio, neutrophil to platelet ratio as well as CRP were shown to be increased in patients with laryngeal malignancies.

      Key Words

      Abbreviations:

      NLR (neutrophil to lymphocyte ratio), CBC (complete blood count), CRP (C-reactive protein), SCC (squamous cell carcinoma), WHO (World Health Organization), SIL (squamous intraepithelial neoplasia), WBC (white blood cell), RDW (red cell distribution width), NPR (neutrophil to platelet ratio), NMR (neutrophil to monocyte ratio), PLR (platelet to lymphocyte ratio)
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      References

        • Nunes RB
        • Behlau M
        • Nunes MB
        • et al.
        Clinical diagnosis and histological analysis of vocal nodules and polyps.
        Braz J Otorhinolaryngol. 2013; 79: 434-440
        • Robins CK
        Pathologic Basis of Disease.
        fifth ed. Saunders, Philadelphia1994
        • Zeitels SM
        Premalignant epithelium and microinvasive cancer of the vocal fold: the evolution of phonomicrosurgical management.
        Laryngoscope. 1995; 105: 1-40
        • Devaney KO
        • Rinaldo A
        • Zeitels SM
        • et al.
        Laryngeal dysplasia and other epithelial changes on endoscopic biopsy: what does it all mean to the individual patient?.
        ORL J Otorhinolaryngol Relat Spec. 2004; 66: 1-4
        • Isenberg JS
        • Crozier DL
        • Dailey SH
        Institutional and comprehensive review of laryngeal leukoplakia.
        Ann Otol Rhinol Laryngol. 2008; 117: 74-79
        • Nankivell P
        • Weller M
        • McConkey C
        • Paleri V
        • Mehanna H
        Biomarkers in laryngeal dysplasia: a systematic review.
        Head Neck. 2011; 33: 1170-1176
        • Eskiizmir G
        • Uz U
        • Onur E
        • et al.
        The evaluation of pretreatment neutrophil-lymphocyte ratio and derived neutrophil-lymphocyte ratio in patients with laryngeal neoplasms.
        Braz J Otorhinolaryngol. 2019; 85: 578-587
        • Hsueh C
        • Tao L
        • Zhang M
        • et al.
        The prognostic value of preoperative neutrophils, platelets, lymphocytes, monocytes and calculated ratios in patients with laryngeal squamous cell cancer.
        Oncotarget. 2017; 8: 60514-60527
        • Wang J
        • Wang S
        • Song X
        • et al.
        The prognostic value of systemic and local inflammation in patients with laryngeal squamous cell carcinoma.
        Onco Targets Ther. 2016; 9: 7177-7185
        • Zeng YC
        • Chi F
        • Xing R
        • et al.
        Pretreatment neutrophil-to-lymphocyte ratio predicts prognosis in patients with locoregionally advanced laryngeal carcinoma treated with chemoradiotherapy.
        Jpn J Clin Oncol. 2016; 46: 126-131
        • Wong BY
        • Stafford ND
        • Green VL
        • et al.
        Prognostic value of the neutrophil-to-lymphocyte ratio in patients with laryngeal squamous cell carcinoma.
        Head Neck. 2016; 38: E1903-E1908
        • Roxburgh CS
        • McMillan DC
        Role of systemic inflammatory response in predicting survival in patients with primary operable cancer.
        Future Oncol. 2010; 6: 149-163
        • Kacan T
        • Babacan NA
        • Seker M
        • et al.
        Could the neutrophil to lymphocyte ratio be a poor prognostic factor for non small cell lung cancers?.
        Asian Pac J Cancer Prev. 2014; 15: 2089-2094
        • Karaman H
        • Karaman A
        • Erden A
        • et al.
        Relationship between colonic polyp type and the neutrophil/ lymphocyte ratio as a biomarker.
        Asian Pac J Cancer Prev. 2013; 14: 3159-3161
        • Kemal Y
        • Yucel I
        • Ekiz K
        • et al.
        Elevated serum neutrophil to lymphocyte and platelet to lymphocyte ratios could be useful in lung cancer diagnosis.
        Asian Pac J Cancer Prev. 2014; 15: 2651-2654
        • Thompson L
        World Health Organization classification of tumours: pathology and genetics of head and neck tumours.
        Ear Nose Throat J. 2006; 85: 74
        • Gale N
        • Poljak M
        • Zidar N
        Update from the 4th edition of the World Health Organization Classifcation of head and neck tumours: what is new in the 2017 WHO blue book for tumours of the Hypopharynx, Larynx, Trachea and Parapharyngeal Space.
        Head Neck Pathol. 2017; 11: 23-32
        • Fleskens S
        • Slootweg P
        Grading systems in head and neck dysplasia: their prognostic value, weaknesses and utility.
        Head Neck Oncol. 2009; 11: 1-11
        • Chediak Coelho Mdo N
        • Guimarães Vde C
        • Rodrigues SO
        • et al.
        Correlation between clinical diagnosis and pathological diagnosis in laryngeal lesions.
        J Voice. 2016; 30: 595-599
        • Hantzakos A
        • Remacle M
        • Dikkers FG
        • et al.
        Exudative lesions of Reinke's space: a terminology proposal.
        Eur Arch Otorhinolaryngol. 2009; 266: 869-878
        • Grivennikov SI
        Infammation and colorectal cancer: colitis-associated neoplasia.
        Semin Immunopathol. 2013; 35: 229-244
        • Fox JG
        • Wang TC
        Infammation, atrophy, and gastric cancer.
        J Clin Invest. 2007; 117: 60-69
        • Francescone R
        • Hou V
        • Grivennikov SI
        Microbiome, infammation, and cancer.
        Cancer J. 2014; 20: 181-189
        • Fang Y
        • Yang Y
        • Chen M
        • et al.
        Elevated peripheral inflammatory markers are related with the recurrence and canceration of vocal fold leukoplakia.
        Eur Arch Otorhinolaryngol. 2019; 276: 2857-2864
        • Franklin RA
        • Liao W
        • Sarkar A
        • et al.
        The cellular and molecular origin of tumor-associated macrophages.
        Science. 2014; 344: 921-925
        • Palumbo JS
        • Talmage KE
        • Massari JV
        • et al.
        Platelets and fibrinogen increase metastatic potential by impeding natural killer cell-mediated elimination of tumor cells.
        Blood. 2005; 105: 178-185
        • Wenger FA
        • Jacobi CA
        • Zieren J
        • et al.
        Tumor size and lymph-node status in pancreatic carcinoma-is there a correlation to the preoperative immune function?.
        Langenbecks Arch Surg. 1999; 384: 473-478
        • Teramukai S
        • Kitano T
        • Kishida Y
        • et al.
        Pretreatment neutrophil count as an independent prognostic factor in advanced non-small-cell lung cancer: an analysis of Japan Multinational Trial Organisation LC00-03.
        Eur J Cancer. 2009; 45: 1950-1958
        • Diem S
        • Schmid S
        • Krapf M
        • et al.
        Neutrophil-to-Lymphocyte ratio (NLR) and Platelet-to-Lymphocyte ratio (PLR) as prognostic markers in patients with non-small cell lung cancer (NSCLC) treated with nivolumab.
        Lung Cancer. 2017; 111: 176-181
        • Asaoka T
        • Miyamoto A
        • Maeda S
        • et al.
        Prognostic impact of preoperative NLR and CA19-9 in pancreatic cancer.
        Pancreatology. 2016; 16: 434-440
        • Chen L
        • Zeng H
        • Yang J
        • et al.
        Survival and prognostic analysis of preoperative inflammatory markers in patients undergoing surgical resection for laryngeal squamous cell carcinoma.
        BMC Cancer. 2018; 18: 816
        • Yasumatsu R
        • Wakasaki T
        • Hashimoto K
        • et al.
        Monitoring the neutrophil-to-lymphocyte ratio may be useful for predicting the anticancer effect of nivolumab in recurrent or metastatic head and neck cancer.
        Head Neck. 2019; 41: 2610-2618
        • Seretis C
        • Gourgiotis S
        • Gemenetzis G
        • et al.
        The significance of neutrophil/lymphocyte ratio as a possible marker of underlying papillary microcarcinomas in thyroidal goiters: a pilot study.
        Am J Surg. 2013; 205: 691-696
        • Tsai YD
        • Wang CP
        • Chen CY
        • et al.
        Pretreatment circulating monocyte count associated with poor prognosis in patients with oral cavity cancer.
        Head Neck. 2013; 36: 947-953
        • An X
        • Ding PR
        • Wang FH
        • Jiang WQ
        • Li YH
        Elevated neutrophil to lymphocyte ratio predicts poor prognosis in nasopharyngeal carcinoma.
        Tumour Biol. 2011; 32: 317-324
        • Kum RO
        • Ozcan M
        • Baklaci D
        • et al.
        Elevated neutrophil-to-lymphocyte ratio in squamous cell carcinoma of larynx compared to benign and precancerous laryngeal lesions.
        Asian Pac J Cancer Prev. 2014; 15: 7351-7355