Introduction: Oral squamous cell carcinoma (OSCC) remains a significant public health concern. The variables utilized to determine appropriate treatment for this disease also represent its most unfavorable prognostic factors, with these parameters solely determined by the neoplasm and its behavior. However, a lack of well-established indices is evident in the literature that specifically relate to the patient and indicate a worse prognosis. Objective: To assess the prognostic impact of hematological indices in patients with OSCC. Methods: This retrospective cohort study included patients with oral squamous cell carcinoma (OSCC) who underwent curative-intent treatment. Treatment encompassed surgery, followed by adjuvant therapy, as necessary. Laboratory tests were conducted immediately prior to surgery, and demographic information was obtained from medical records. Results: The cohort comprised 600 patients, with 73.5% being male subjects. Adjuvant treatment was recommended for 60.3% of patients. Throughout the follow-up period, 48.8% of participants died. Univariate analysis indicated that perineural invasion, angiolymphatic invasion, pT4 tumors, lymph node metastases, extranodal extravasation, RDW > 14.3%, NLR (neutrophil–lymphocyte ratio) > 3.38, PLR (platelet–lymphocyte ratio) > 167.3, and SII (systemic inflammatory/immune response index) > 416.1 were factors associated with increased mortality. These threshold values were established through ROC curve analysis. In the multivariate analysis, angiolymphatic invasion (HR = 1.43; 95% CI: 1.076–1.925;p= 0.014), pT4a/b tumors (HR = 1.761; 95% CI: 1.327–2.337;p< 0.001), extranodal extravasation (HR = 1.420; 95% CI: 1.047–1.926;p= 0.024), and RDW (HR = 1.541; 95% CI: 1.153–2.056;p= 0.003) were identified as independent risk factors for decreased overall survival. Conclusions: RDW > 14.3% was proven to be a reliable parameter for assessing overall survival in patients with OSCC. Further studies are required to evaluate the clinical applicability of other hematological indices.
引言：口腔鳞状细胞癌（OSCC）仍是重要的公共卫生问题。目前用于确定该疾病适宜治疗方案的变量也代表了其最不利的预后因素，而这些参数仅由肿瘤及其生物学行为决定。然而，文献中明显缺乏专门针对患者且提示预后不良的成熟指标。目的：评估血液学指标对OSCC患者预后的影响。方法：本回顾性队列研究纳入接受根治性治疗的口腔鳞状细胞癌患者。治疗方案包括手术及必要的辅助治疗。实验室检测于术前即刻进行，人口统计学信息从医疗记录中获取。结果：队列共纳入600例患者，其中男性占73.5%。60.3%的患者接受了辅助治疗建议。随访期间总死亡率为48.8%。单因素分析显示：神经侵犯、脉管侵犯、pT4分期肿瘤、淋巴结转移、结外浸润、RDW（红细胞分布宽度）>14.3%、NLR（中性粒细胞-淋巴细胞比值）>3.38、PLR（血小板-淋巴细胞比值）>167.3及SII（全身炎症/免疫反应指数）>416.1与死亡率升高相关，这些阈值通过ROC曲线分析确定。多因素分析表明：脉管侵犯（HR=1.43；95%CI：1.076-1.925；p=0.014）、pT4a/b分期肿瘤（HR=1.761；95%CI：1.327-2.337；p<0.001）、结外浸润（HR=1.420；95%CI：1.047-1.926；p=0.024）及RDW（HR=1.541；95%CI：1.153-2.056；p=0.003）是降低总生存期的独立危险因素。结论：RDW>14.3%被证实是评估OSCC患者总生存期的可靠参数，其他血液学指标的临床应用价值仍需进一步研究验证。
Prognostic Value of Hematological Parameters in Oral Squamous Cell Carcinoma
肿瘤(癌症)患者之家