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目的:探讨术前外周血淋巴细胞单核细胞比值(LMR)在区分喉鳞状细胞癌(LSCC)、喉癌前病变(LPL)以及喉良性病变(LBL)中的作用。方法:收集405例经病理确诊的喉部病变患者(LSCC组154例,LPL组83例,LBL组168例),LSCC组按T分期进一步分为T1组、T2组和T3~4组,检测各组术前外周血中性粒细胞、淋巴细胞、单核细胞、血红蛋白和血小板等计数,并比较各组中LMR、中性粒细胞淋巴细胞比值(NLR)及其他指标。结果:LBL、LPL、LSCC各组中LMR和NLR值分别为4.88±1.65和4.61±1.59、3.92±1.77和2.11±0.79、2.08±0.77和2.63±1.69,LSCC组LMR较LBL组和LPL组小,且差异有统计学意义(P<0.01),而NLR较LBL组和LPL组大(P<0.05),LBL组和LPL组之间LMR和NLR差异均无统计学意义(P>0.05)。LSCC组中局部晚期(T3~4期)患者较局部早、中期(T1、T2期)患者LMR小,而NLR值大且差别具有统计学意义(P<0.05)。LBL、LPL、LSCC三组的血小板、白细胞、中性粒细胞数之间差异无统计学意义(P>0.05)。结论:本研究首次比较不同喉部病变中的LMR,并发现LMR、NLR作为全身性的炎症指标对区分LSCC和LPL及LBL具有一定的参考价值。
Objective: To investigate the role of preoperative peripheral blood lymphocyte monocyte ratio (LMR) in differentiating laryngeal squamous cell carcinoma (LSCC), laryngeal precancerous lesions (LPL) and benign laryngeal lesions (LBL). Methods: A total of 405 patients with pathologically confirmed laryngeal lesions (LSCC, 154 LPL and 168 LBL) were collected and divided into T1 group, T2 group and T3-4 group according to T stage. Peripheral blood neutrophil, lymphocyte, monocyte, hemoglobin and platelet were counted before operation and the LMR, neutrophil lymphocyte ratio (NLR) and other indexes in each group were compared. Results: The LMR and NLR values in LBL, LPL and LSCC groups were 4.88 ± 1.65 and 4.61 ± 1.59, 3.92 ± 1.77 and 2.11 ± 0.79, 2.08 ± 0.77 and 2.63 ± 1.69, respectively. The LMR in LSCC group was smaller than that in LBL group and LPL group (P <0.01), while NLR was significantly higher in LBL group than in LPL group (P <0.05). There was no significant difference in LMR and NLR between LBL group and LPL group (P> 0.05). The patients with locally advanced stage (stage T3 ~ 4) in LSCC had smaller LMR than those with local early stage and intermediate stage (stage T1 and T2), while the NLR values were large and the difference was statistically significant (P <0.05). LBL, LPL, LSCC three groups of platelet, leukocyte, neutrophil number difference was not statistically significant (P> 0.05). CONCLUSIONS: This study, for the first time, compared LMR in different laryngeal lesions and found that LMR and NLR as systemic inflammation markers are useful for distinguishing between LSCC, LPL and LBL.