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