Prognostic Significance of Peripheral T-Cell Subsets in Laryngeal Squamous Cell Carcinoma

Objectives The role of the immune system in head and neck squamous cell carcinoma is controversial. The aim of our study was to analyze full blood counts and distribution of T cell subsets in patients affected by laryngeal squamous cell cancer (LSCC) and their association with clinical variables and survival. Study design Retrospective study. Methods We analyzed the levels of platelets, lymphocytes, and neutrophils, as well as the CD4(+), CD8(+), and CD3(+) T-cell subpopulations by cytofluorometry in LSCC patients. A cohort of healthy patients was used as control group. The disease-specific survival (DSS) was considered as survival outcome. Results Sixty-five LSCC patients and 48 controls were enrolled. In LSCC patients, neutrophils were higher than in the healthy group (P < .0001). The neutrophil-to-lymphocyte ratio (NLR) and the platelet-to-lymphocyte ratio (PLR) were both higher in LSCC patients (P < .0001). In patients treated for recurrent disease, the CD8(+)/CD3(+) ratio was increased (P = .02), while the CD4(+)/CD8(+) (P = .03) and CD4(+)/CD3(+) (P = .04) ratios were lower. In patients with lymph node metastases, leukocytes (P = .03), CD3(+) (P = .04), and CD4(+) (P = .0098) were all higher. Among Stages III-IV patients, low lymphocyte and low leukocyte count were associated with worse DSS. Conclusion Our data demonstrate that NLR and PLR are significantly increased in LSCC. Lower CD4(+)/CD8(+) and CD3(+)/CD8(+) ratios are related to recurrent disease and a higher level of CD3(+) and CD4(+) is associated with nodal metastasis. Level of Evidence 4