Abstract：
The aim of this study was to investigate the correlation between pre-treatment inflammatory biomarkers and the post-operative depth of invasion (DOI) and worst pattern of invasion (WPOI) in early-stage oral tongue squamous cell carcinoma (OTSCC) by means of positive sentinel lymph node biopsy (SLNB). A retrospective analysis of patients affected by cN0 T1-T2 OTSCC who had undergone an SLNB at the National Cancer Institute of Naples was performed. The patients were studied using an evaluation of the pre-treatment neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammatory index (SII), and a histopathological analysis of the DOI and WPOI. The statistical analysis showed that among the prognostic biomarkers, the NLR was a significant predictor of high WPOI values (p = 0.002). The cut-off NLR value was 2.52 with a probability of developing a positive sentinel lymph node biopsy (SLNB) of 30.3%. In contrast, the DOI value was 5.20 with a probability of developing a positive SLNB of 31.82%. Regarding the WPOI, increasing the WPOI class increased the likelihood of a positive SLNB occurrence, and a positive significant correlation was found between the WPOI and SLNB (Csp = 0.342; p < 0.001). Pre-treatment NLR, together with post-surgical DOI and WPOI, can be a reliable predictor of occult neck metastasis in patients affected by early-stage OTSCC with a clinically negative neck. Further prospective studies with a larger series will be needed to confirm the results obtained and to better define the NLR, WPOI and DOI cut-off values in order for elective neck dissection to be recommended in relation to a clinically negative neck.
摘要：
本研究的目的是通过前哨淋巴结活检（SLNB）阳性，探讨早期口腔舌鳞状细胞癌（OTSCC）治疗前炎症生物标志物与术后浸润深度（DOI）和最差浸润方式（WPOI）的相关性。对那不勒斯国家癌症研究所接受SLNB的cN0T1-T2OTSCC患者进行了回顾性分析。使用治疗前中性粒细胞与淋巴细胞比率（NLR）的评估对患者进行了研究，血小板与淋巴细胞比率（PLR），全身免疫炎症指数（SII），以及DOI和WPOI的组织病理学分析。统计学分析表明,在预后标志物中,NLR是高WPOI值的显著预测因子(p=0.002)。截止NLR值为2.52，前哨淋巴结活检（SLNB）阳性的可能性为30.3％。相比之下,DOI值为5.20，出现SLNB阳性的概率为31.82%。关于WPOI,增加WPOI等级增加了SLNB阳性发生的可能性，WPOI与SLNB呈显著正相关(Csp=0.342;p<0.001)。预处理NLR,连同手术后DOI和WPOI，在临床上颈部阴性的早期OTSCC患者中，可以可靠地预测隐匿性颈部转移。需要进行更大系列的进一步前瞻性研究，以确认获得的结果并更好地定义NLR，WPOI和DOI截止值，以便推荐与临床阴性颈部相关的选择性颈部解剖。
