Predictive value of neutrophil to lymphocyte ratio, platelet to lymphocyte ratio, and systemic inflammatory index for detection of recurrence of pleomorphic adenoma of the major salivary glands: a multicenter study

Giovanni Salzano; Simona Barone; Pietro De Luca; Gerardo Borriello; Luigi Angelo Vaira; Stefania Troise; Vincenza Granata; Umberto Committeri; Francesco Perri; Maria Esposito; Fabio di Blasi; Marzia Petrocelli; Franco Ionna; Luigi Califano; Giovanni Dell'Aversana Orabona; Arianna Di Stadio

doi:10.1016/j.oooo.2024.08.014

Predictive value of neutrophil to lymphocyte ratio, platelet to lymphocyte ratio, and systemic inflammatory index for detection of recurrence of pleomorphic adenoma of the major salivary glands: a multicenter study

Oral Surg Oral Med Oral Pathol Oral Radiol. 2024 Sep 6:S2212-4403(24)00448-6. doi: 10.1016/j.oooo.2024.08.014. Online ahead of print.

Authors

Giovanni Salzano¹, Simona Barone¹, Pietro De Luca², Gerardo Borriello¹, Luigi Angelo Vaira³, Stefania Troise¹, Vincenza Granata⁴, Umberto Committeri¹, Francesco Perri⁵, Maria Esposito¹, Fabio di Blasi¹, Marzia Petrocelli⁶, Franco Ionna⁵, Luigi Califano¹, Giovanni Dell'Aversana Orabona¹, Arianna Di Stadio⁷

Affiliations

¹ Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples Federico II, Naples, Italy.
² Otolaryngology Department, Isola Tiberina-Gemelli Isola Hospital, Rome, Italy. Electronic address: dr.dlp@hotmail.it.
³ Maxillofacial Surgery Operative Unit, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy.
⁴ Division of Radiology, Istituto Nazionale Tumori IRCCS Fondazione Pascale - IRCCS di Napoli, Naples, Italy.
⁵ Otolaryngology and Maxillo-Facial Surgery Unit, Istituto Nazionale Tumori-IRCCS Fondazione G. Pascale, Naples, Italy.
⁶ Oral and Maxillo-Facial Unit AUSL Bologna Bellaria-Maggiore Hospital, Bologna, Italy.
⁷ Department GF Ingrassia, Otolaryngology Unit, University of Catania, Catania, Italy. Electronic address: ariannadistadio@hotmail.com.

PMID: 39438185
DOI: 10.1016/j.oooo.2024.08.014

Abstract

Objective: The aim of this study was to investigate the correlation among inflammatory biomarkers, such as the systemic immune-inflammation index (SII), the neutrophil-to-lymphocyte ratio (NLR) and the platelet-to-lymphocyte ratio (PLR), and the recurrence of pleomorphic adenomas (PAs).

Study design: This was a retrospective multicenter study. Six hundred eight patients diagnosed with PA and treated by tumor enucleation were included in the analyses. The patients were extracted from a 20-year database of 2 referral centers (January 2000 to January 2020). Data about age, gender, voluntary habits, tumor characteristics, tumor treatment, and values of NLR, PLR, and SII were collected. A receiver operating characteristic (ROC) curve was used to calculate the optimal cutoff values for SII, PLR, and NLR. A linear regression model (LRM) and a nonlinear logistic regression model (NLRM) were implemented for NLR, PLR, and SII.

Results: All 3 inflammatory parameters were statistically significant correlated to the recurrence of the tumor. The best performance was achieved by NLR (cutoff of 2.960) with area under the ROC curve (AUC) = 0.91, accuracy of 96.1%, sensitivity of 78.4% and specificity of 97.2%, PPV = 64.4%, and NPV = 98.6%. LRM and NLRM including all hematological parameters did not improve performance in terms of recurrence detection.

Conclusions: The use of 3 inflammatory biomarkers could be a useful tool to predict recurrence of tumor in case of PA ≤ 3 cm. NLR in particular could be sensitive with a cutoff of 2.960. The use of NLR, PLR, and SII could be a good reference point for surgical decision making and follow-up in clinical practice. (Oral Surg Oral Med Oral Pathol Oral Radiol YEAR;VOL:page range).