Background/Objectives: Oral cavity carcinomas (OCCs) represent roughly 50% of all head and neck cancers. The risk of occult neck metastases for early-stage OCCs ranges from 15 to 35%, thus the need to develop tools that can support the diagnosis detecting these neck metastases. Inflammatory biomarkers and perineural and lympho-vascular invasion are emerging as effective in this field. The aim of this study is to demonstrate the effectiveness of these parameters to detect occult neck metastases in early-stage (T1-T2/N0) OCCs. Methods: A retrospective analysis was conducted on 81 patients surgically treated for early-stage OCC. For all patients, data regarding TNM, pN status after the histopathological examination, inflammatory biomarkers, and perineural and lympho-vascular invasion have been obtained. A statistical analysis was performed using the receiver operating characteristic (ROC) curve to calculate the optimal cutoff values for SII, SIRI, PLR, and NLR. Results: Fifty-eight patients confirmed N0 status after surgery, while twenty-three resulted pN+. The best cut-off to detect occult neck metastases were PLR 249.30, NLR 13.10, MLR 0.439, SII 1043.12, and SIRI 1.85. The accuracy to detect occult neck metastases was PLR 75%, NLR 81%, MLR 74%, SII 73%, SIRI 70%, perineural invasion 70%, and lympho-vascular invasion 83%. Conclusions: Our results confirm that inflammatory biomarkers and perineural and lympho-vascular invasion are effective in detecting occult neck metastases in early-stage OCCs. The clinical relevance of this study is that these parameters could be used routinely as preoperative tools to support diagnosis and to help surgeons in the decision-making process, particularly regarding surgical indications for neck lymph nodes treatment.
背景/目的：口腔癌约占所有头颈部肿瘤的50%。早期口腔癌发生隐匿性颈部转移的风险约为15%至35%，因此亟需开发能够辅助诊断此类颈部转移的工具。炎症生物标志物以及神经周围和淋巴血管侵犯在该领域正显示出诊断价值。本研究旨在验证这些参数在检测早期（T1-T2/N0期）口腔癌隐匿性颈部转移中的有效性。方法：对81例接受手术治疗的早期口腔癌患者进行回顾性分析。收集所有患者的TNM分期、术后病理pN状态、炎症生物标志物及神经周围与淋巴血管侵犯数据。采用受试者工作特征曲线进行统计分析，计算SII、SIRI、PLR和NLR的最佳截断值。结果：58例患者术后确认为N0状态，23例为pN+状态。检测隐匿性颈部转移的最佳截断值为：PLR 249.30、NLR 13.10、MLR 0.439、SII 1043.12、SIRI 1.85。各参数检测隐匿性颈部转移的准确率分别为：PLR 75%、NLR 81%、MLR 74%、SII 73%、SIRI 70%、神经周围侵犯70%、淋巴血管侵犯83%。结论：本研究证实炎症生物标志物及神经周围与淋巴血管侵犯能有效检测早期口腔癌的隐匿性颈部转移。其临床意义在于，这些参数可作为常规术前诊断工具辅助临床决策，特别是在颈部淋巴结治疗的手术指征判断方面，为外科医生提供重要参考。
肿瘤(癌症)患者之家