Association of preoperative peripheral blood SOD and NLR with laryngeal squamous cell carcinoma

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Methods: The clinical data of 96 patients with laryngeal squamous cell carcinoma (laryngeal carcinoma group), 68 cases of vocal cord leukoplakia(laryngeal precancerous lesion group) and 209 cases of vocal cord polyps (vocal cord polyp group) treated surgically at the Affiliated Hospital of Jining Medical College from 2018.01.01 to 2022.12.30 were retrospectively analyzed. Results: The differences in peripheral blood NLR and SOD were compared between the groups, and the value of these indicators in the diagnosis of laryngeal cancer was evaluated by applying the receiver operator characteristic (ROC) curve. The differences were statistically significant (all P<0.05). The areas under the ROC curves of SOD and NLR were 0.892, 0.670 and 0.737 for the differentiation of laryngeal squamous cell carcinoma and vocal cord polyps, respectively. We found that NLR was not associated with lymph node metastasis. SOD was associated with TNM stage of laryngeal cancer, but NLR was not. Conclusion: SOD and NLR are valuable for the diagnosis of laryngeal cancer, but not for the prediction of lymph node metastasis. superoxide dismutase neutrophile to lymphocyte rate prognostic nutritional index laryngeal carcinoma lymph node metastasis Figures Figure 1 Introduction Laryngeal cancer is a common malignant tumor of the head and neck and has a high incidence in clinical practice. In recent years, with the deterioration of living environment and continuous change of living habits, the incidence of laryngeal cancer is increasing year by year. The five-year survival rate is approximately 75% in patients with localized disease; however, a remarkable decrease in survival is observed when there is regional and distant disease (44% and 35%) [1] . Therefore, early detection of laryngeal cancer, and assessment of regional and distant metastasis are crucial for clinical staging, treatment selection, locoregional control, and survival. Accordingly, we hope to find a simple, non-invasive and easily accessible index to assist in the diagnosis of laryngeal cancer. NLR is an index that can be derived from simple calculations of routine blood parameters, and recent studies have shown that they can be used as new inflammatory markers in inflammation, cardiovascular system diseases and malignancies for the diagnosis and prognostic assessment of diseases [2−3] . Studies have pointed out that there is a significant correlation between SOD and malignant tumor [4−5] , but the diagnostic value of SOD in liver function test for cancer has not been reported. This study is intended to investigate the diagnostic value of preoperative peripheral blood NLR and SOD in the diagnosis of laryngeal cancer. We also found that SOD was correlated with the stage of laryngeal cancer, but there is no correlation was found between NLR, SOD and lymph node metastasis. Information and Methods 1.1 General data The clinical and pathological data of 96 patients with laryngeal squamous cell carcinoma (laryngeal cancer group), 68 patients with vocal cord leukoplakia (vocal cord leukoplakia group), and 209 patients with vocal cord polyps (vocal cord polyp group) who underwent surgical resection at the Affiliated Hospital of Jining Medical College from 2018.01-2022.12 were selected (the enrolled cases were divided into laryngeal cancer group, vocal cord leukoplakia group, and vocal cord polyp group according to pathological diagnosis). Inclusion criteria: patients who underwent surgical treatment at the Department of Otolaryngology, Affiliated Hospital of Jining Medical College from 2018.01 to 2022.12 and had postoperative pathology confirmed as laryngeal squamous cell carcinoma, vocal cord leukoplakia (postoperative pathology report conforming to the WHO Blue Book pathological diagnosis classification in 2017) and vocal cord polyps. Exclusion criteria: history of laryngeal surgery; history of malignant tumors; diseases of the heart, brain, and other vital organs that cannot tolerate surgical treatment; and psychiatric disorders. Those with hematological system diseases, immune system diseases, which might affect the results of blood tests; those who had received radiotherapy, chemotherapy, immunotherapy or other adjuvant treatments before surgery; those with incomplete or missing clinical data, which could not be analyzed and followed up with data. 1.2 Study methods General and disease-related data such as age, gender, clinical stage. The following pretreatment hematological parameters were collected within 1 weeks before the initial treatment: neutrophil count, lymphocyte count, and albumin. (NLR = N/L ; N is the absolute number of neutrophils, L is the absolute number of lymphocytes). SOD is an index that can examine the liver function. Further receiver operating characteristic (ROC) curves were established for comparisons between the laryngeal cancer group and vocal cord polyp groups. The disease-related clinical information of laryngeal cancer patients was collected to investigate the correlation between SOD and NLR and clinical stage and lymph node metastasis of laryngeal cancer patients. Intraoperative resection specimens were sent to the pathology department for routine pathological examination. This study was a retrospective study, and this study was approved by the Medical Ethics Committee of the Affiliated Hospital of Jining Medical College. 1.3 Statistical analysis The data were analyzed using Empower ( www.empowerstats.com ) and R software. Continuous variables with a normal distribution are presented as mean ± SD, while values without a normal distribution are presented as median (25–75th percentiles).. Categorical variables are presented as numbers and percentages. Independent samples t-test and Mann-Whitney U test were used to determine differential risk factors between the two groups. The χ2 test and Fisher’s exact test were used to compare the categorical data, as appropriate. Furthermore, to evaluate the optimal cut-off value of the platelet, NLR and SOD ROC (receiver operating characteristic) curves were generated and the area under ROC curve (AUC) was measured and compared. Differences were considered statistically significant at P < 0.05. Results 2.1 Comparison of general clinical data A total of 96 cases of laryngeal cancer were included in this study, with an average age of (62.79 ± 9.29) years old, 94 cases were male, accounting for 97.92%. There were 68 cases of vocal cord leukoplakia with an average age of (52.91 ± 13.32) years and 209 cases of vocal cord polyps with an average age of (45.00 ± 10.68) years. The differences in NLR and SOD between the laryngeal cancer group and the vocal cord leukoplakia and vocal cord polyp groups were statistically significant (all P < 0.05) (Table 1). The NLR values in the laryngeal cancer group were significantly higher than those in the vocal fold white spots and vocal fold polyps groups, and the differences were statistically significant. The SOD values in the laryngeal cancer group was lower than those in the vocal fold leukoplakia and vocal fold polyp groups, and the differences was statistically significant. 2.2 ROC curve analysis of the diagnostic value of SOD and NLR for laryngeal squamous cell carcinoma ROC curve analysis of NLR and SOD for laryngeal squamous cell carcinoma showed that the sensitivity of NLR and SOD were 0.6603 and 0.7778, respectively. The specificity of NLR and SOD were 0.6042 and 0.8646 respectively. The optimum cut-off values of NLR and SOD were determined according to ROC curve. As shown in Fig. 1, the optimal cut-off value for NLR is 1.8628 and the AUC value is 67.033%(95% CI: 60.5189%-73.5471%) (Table 2 ). The optimal cut-off value of SOD was 204.5, and the AUC was 89.211%(95%CI: 85.562%-92.8547%). NLR and SOD have some significance in the differential diagnosis of laryngeal cancer, among which SOD have better diagnostic efficacy and specificity. Table 2 NLR and SOD to assess the diagnostic validity of laryngeal squamous cell carcinoma Variables AUC youden threshold sensitivity specificity accuracy AUC(95%CI) NLR 67.033% 1.265 1.8628 0.6603 0.6042 0.6426 (60.5189%-73.5471%) SOD 89.211% 1.642 204.5 0.7778 0.8646 0.8053 (85.5672%-92.8547%) 2.3 Relationship between NLR and SOD clinicopathological characteristics of laryngeal cancer patients Table 3 shows the relationship between the clinicopathological characteristics of patients with laryngeal cancer by NLR and SOD. Among the 96 patients, 2 (2.1%) were female and 94 (97.9% ) were male. In this study, on the one hand, patients were divided into low NLR group (NLR < 1.86, n = 38) and high NLR group (NLR ≥ 1.86, n = 58), on the other hand, patients were divided into Low SOD group (SOD < 204.5, n = 83) and high SOD group (SOD ≥ 204.5, n = 13), according to the best cut-off values of NLR and SOD(by explicitly tested (variables)). SOD was related to laryngeal cancer stage. NLR was related to drinking. NLR and SOD were associated with age and were significant at P < 0.05. But the differences between SOD, NLR, and lymph node metastasis, smoking and incisal margin were not statistically significant. Table 3 Relationship between NLR, SOD and clinicopathological characteristics of laryngeal cancer Variables NLR SOD <1.86(n = 38) ≥ 1.86(n = 58) P value <204.5(n = 83) ≥ 204.5(n = 13) P value Age(years) 64.47 ± 9.57 60.24 ± 8.34 0.028 55.77 ± 11.19 63.89 ± 8.52 0.003 Sex 0.247 0.572 Male 96.6 100.0 100.0 97.6 Female 3.4 0.0 0.0 2.4 Smoke 0.977 0.729 Yes 89.7 89.5 92.3 89.2 No 10.3 10.5 7.7 10.8 Drink 0.006 0.532 Yes 80.0 100.0 83.3 89.6 No 20.0 0.0 16.7 10.4 Incisal margin 0.503 0.445 positive 5.7 2.7 0.0 5.1 negative 94.3 97.3 100.0 94.9 TNM Stage 0.125 0.041 I 32.8 39.5 69.2 30.1 II 20.7 36.8 15.4 28.9 III 27.6 13.2 15.4 22.9 IV 19.0 10.5 0.0 18.1 Lymphatic invasion 0.638 0.119 Yes 19.6 24.1 0.0 23.9 No 80.4 75.9 100.0 76.1 Discussion Laryngeal cancer ranks second in incidence and mortality of head and neck cancer, accounting for 1% of systemic malignant tumors, and the main pathological type is squamous cell carcinoma (96%-98%) [ 6 ] . 2020 epidemiological data in China show that the incidence of laryngeal cancer is 1.84 /100000 and mortality rate is 1.0 /100000, ranking 21st in both tumor incidence and mortality [ 7 ] . Vocal cord leukoplakia is a lamellar keratotic hyperplastic lesion on the mucosal surface of the vocal cords. The main pathological changes are mucosal epithelial hyperplasia with incomplete keratinization and mild hyperplasia of submucosal tissue [ 8 ] . Vocal cord leukoplakia manifests as white spots or patchy changes in the vocal cord mucosa, making epithelial-like changes such as hyperplasia, chemosis and atypical hyperplasia, with a malignant rate of about 6%-22%. It is one of the precancerous lesions of cancer. 2017 WHO latest revised classification of head and neck tumors classifies the pathological types of vocal cord leukoplakia into low-grade heterogeneous hyperplasia and high-grade heterogeneous hyperplasia [ 9 ] . It has been found that a high inflammatory response and low nutritional status can promote the progression of cancer cells, which is one of the main manifestations in patients with laryngeal squamous cell carcinoma. The inflammatory response stimulates the release of multiple inflammatory mediators, vascular endothelial growth factor, which contributes to cardiovascular production to promote tumor growth. Inflammation can participate in tumor occurrence and development by accelerating tumor cell proliferation, migration, angiogenesis, and suppressing the body's anti-tumor immunity, etc. The nutritional and inflammatory immune status of the body is related to the clinicopathological characteristics of malignant tumors and affects the clinical treatment outcome and prognosis. In recent years, NLR which reflect the nutritional changes of tumor-related inflammation, have become the focus of new research. NLR is a systemic inflammatory biomarker based on neutrophils and lymphocytes, reflecting the balance between inflammatory and immune responses to malignant tumors, and is a biological indicator closely related to the immune response of the body. Neutrophils and lymphocytes, as major cellular components of the immune system, neutrophils reflect inflammatory status, lymphocytes represent immune regulatory pathways, and NLR may reflect the degree of systemic inflammatory response. Reactive oxygen species (ROS) are increasingly recognized as critical determinants of cellular signaling and a strict balance of ROS levels must be maintained to ensure proper cellular function and survival. Notably, ROS is increased in cancer cells. The superoxide dismutase family plays an essential physiological role in mitigating deleterious effects of ROS [ 10 ] . SOD is capable of converting superoxide anions into hydrogen peroxide and belongs to one of many defensive mechanisms, which prevent from cell oxidative damage, leading to apoptosis [ 11 ] . A large volume of evidence suggests that malignant cells increase their antioxidant capacities to prevent tissue damage when ROS levels are increased [ 12 − 13 ] ,while SOD is an efficient and powerful antioxidant enzyme that acts to decrease the levels of oxidative stress in an organism [ 14 − 15 ] ,so this can support our view that SOD is associated with laryngeal squamous cell carcinoma. Our study found that SOD levels in patients with laryngeal cancer were lower than those in patients with vocal cord leukoplakia and vocal cord polyps, and the ROC curve showed that SOD was more sensitive than NLR and PIN. In addition, some studies have found that lower lip cancer is positively correlated with the Khmer expression of Mn-SOD [ 16 ] , which may be due to the different SOD response mechanisms of squamous cell carcinoma in different organs. In 2017, the Department of Otolaryngology-Head and Neck Surgery, Zhongshan Hospital, Fudan University, reported for the first time the diagnostic value of LMR, NLR in benign laryngeal lesions, precancerous laryngeal lesions, and laryngeal squamous cell carcinoma [ 17 ] . However, ROC statistical analysis was not performed, and the specific accuracy and specificity were not calculated. NLR and PNI have diagnostic value for many tumors such as lung, colorectal, liver, breast and kidney cancers [ 18 − 19 ] . Many scholars have examined the predictive value of NLR and PNI on the prognosis of laryngeal cancer [ 20 − 21 ] , but few scholars have examined the diagnostic value of NLR and PNI on laryngeal cancer. Meanwhile, SOD is an index that is often overlooked in the hematological examination of liver function. No scholars have examined the diagnostic value of SOD in laryngeal cancer. Lianyuan Tao found that NLR, CA125 and CA19-9 are associated significantly with lymph node metastasis independently in a multivariate analyses of 159 pancreatic ductal adenocarcinoma patients [ 22 ] . Toshiyuki Kosuga [ 23 ] thought that preoperative NLR may be a useful complementary diagnostic tool for predicting pathological lymph node metastasis in gastric cancer because of its higher sensitivity and negative predictive value than conventional modalities. Bo Zhou [ 24 ] reviewed 101 patients and found that preoperative NLR ≥ 1.80 is independently associated with lymph node metastases for patients undergoing resection of nonfunctioning pancreatic neuroendocrine tumors. Gorkem Eskiizmir [ 25 ] retrospectively analyzed the medical records of patients with benign laryngeal tumors, precancerous lesions, and malignant tumors, and found that there was no significant difference in NLR between the three groups, but NLR was a predictor of stage, lymph node metastasis, and distant metastasis. Therefore, they proposed that pretreatment NLR is a useful and reliable marker for predicting lymph node metastasis and prognosis. We did not detect the significance of NLR and SOD in predicting preoperative lymph node metastasis of laryngeal cancer. Maybe it has something to do with our low caseloads. Conclusion NLR and SOD are simple, inexpensive, and easily detectable indicators. In this study, we systematically evaluated the preoperative levels of NLR and SOD in laryngeal leision patients and confirmed their clinical diagnostic value for laryngeal cancer. We discovered the diagnostic value of SOD. To the best of our knowledge, this is the first time it has been attempted. The diagnostic value of SOD for laryngeal cancer is greater than that of NLR. In addition, we found that NLR was not associated with lymph node metastasis. SOD was associated with TNM stage of laryngeal cancer, but NLR was not. These hematological indicators can be combined with other inflammatory markers to assist in the diagnosis when laryngeal cancer is clinically suspected. However, this study has some shortcomings, as it is a single-center retrospective study with a small number of included cases, and more multicenter, large-sample prospective studies are needed to provide a higher level of evidence to support the study. In addition, NLR is an indicator of inflammation, which is easily affected by other inflammatory diseases, drugs, etc., and the basic conditions of patients should be comprehensively analysed when using this type of indicator for clinical analysis. This readily-available serum biomarker may, thus, help guide additional treatment strategies. Abbreviations SOD superoxide dismutase NLR neutrophil-to-lymphocyte ROC receiver operator characteristic AUC the area under curve PNI prognostic nutritional index Declarations Author Contributions: Conception and design: YG-W, H-Z, DT-D, T-L; Collection and assembly of data: Q-A, JQ-X, X-M, DM-L; Data analysis and interpretation: J-Z,X-Z; Manuscript writing:K-W, YF-Z, J-Z; Final approval of manuscript: All authors have read and agreed to the published version of the manuscript. Funding This study was financially supported by grants from Jining City key research and development project of Jining Science and Technology Bureau (No. 2023YXNS208), Research Fund project of Academician Helinw New Medical Clinical Transformation Workstation(No. JYHL2022FMS11) and Special research plan of attending physician team in Affiliated Hospital of Jining Medical College(No. ZZTD-2022-007). The funders make no contributions to the study design, data collection and analysis, decision to publish,or preparation of the manuscript. Availability of data and materials Data available on request due to data sharing restrictions. The data presented in this study are available on request from the corresponding author. Ethics approval and consent to participate All data were collected in accordance with the World Medical Association Declaration of Helsinki. The study protocol was approved by the Ethics Committee of Affiliated Hospital of Jining Medical College(2023-03-C032). Patient consent was waived for the retrospective data evaluation by the Ethics Committee of Affiliated Hospital of Jining Medical College. Consent for publication Authors declare that informed consent was obtained from all subjects and/or their legal guardians Competing interests The authors declare that they have no competing interests to disclose References Eskiizmir G, Uz U, Onur E, et al. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-4063436","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":283168406,"identity":"83a72155-725d-4939-acb7-b370168ec15a","order_by":0,"name":"Ke Wu","email":"","orcid":"","institution":"Jining Medical College","correspondingAuthor":false,"prefix":"","firstName":"Ke","middleName":"","lastName":"Wu","suffix":""},{"id":283168407,"identity":"5010aa49-bf93-49e6-a3bf-d5d257f86fe7","order_by":1,"name":"Yufeng Zhao","email":"","orcid":"","institution":"Affiliated Hospital of Jining Medical 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University","correspondingAuthor":false,"prefix":"","firstName":"Hui","middleName":"","lastName":"Zhang","suffix":""},{"id":283168422,"identity":"57d00e1e-9a69-4d1b-a4d2-3f0fe7722be1","order_by":11,"name":"Yungang Wu","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAuklEQVRIiWNgGAWjYJCCAx8M/suxsbcfIFoH48MZFczGfDxnEojWwmzMcYY5cZ6EgwFx6g1upF+TZmxjS2+TYEhg+FGxjRgtOWXShW08uW3SjQcYe87cJqzF7EZOmvTMNoncNpkDCcyMbcRq4W0zSGeTSDAgVkv6YWNgYCUQr8X+zBtQIB8wbAPqO0iUXyTb0x8Ao/KAvHx7+8EHPyqI0MIgkIOIjgNEqAcC/uMPiFM4CkbBKBgFIxcAADZPQNhMt1YSAAAAAElFTkSuQmCC","orcid":"","institution":"Affiliated Hospital of Jining Medical University","correspondingAuthor":true,"prefix":"","firstName":"Yungang","middleName":"","lastName":"Wu","suffix":""}],"badges":[],"createdAt":"2024-03-10 09:00:15","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-4063436/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-4063436/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":53412175,"identity":"dded9008-14ba-495e-803f-e0f36ad211ab","added_by":"auto","created_at":"2024-03-25 16:46:30","extension":"jpeg","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":186483,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eROC curves of NLR and SOD for laryngeal cancer assessment\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"floatimage1.jpeg","url":"https://assets-eu.researchsquare.com/files/rs-4063436/v1/fd8384495a25befabe9540da.jpeg"},{"id":68755580,"identity":"88efa7ef-5a8d-4b41-ac53-62cee95f610d","added_by":"auto","created_at":"2024-11-11 16:53:43","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":738045,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4063436/v1/1dd479bb-4b09-4c04-98ca-babe646bf942.pdf"},{"id":53412174,"identity":"e7253f84-5a97-409f-88da-8b0b8afb9a6e","added_by":"auto","created_at":"2024-03-25 16:46:30","extension":"docx","order_by":4,"title":"","display":"","copyAsset":false,"role":"supplement","size":30434,"visible":true,"origin":"","legend":"","description":"","filename":"STROBEchecklistv4combinedPlosMedicine.docx","url":"https://assets-eu.researchsquare.com/files/rs-4063436/v1/dc540e23606fb8649a5cb90a.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"Association of preoperative peripheral blood SOD and NLR with laryngeal squamous cell carcinoma","fulltext":[{"header":"Introduction","content":"\u003cp\u003eLaryngeal cancer is a common malignant tumor of the head and neck and has a high incidence in clinical practice. In recent years, with the deterioration of living environment and continuous change of living habits, the incidence of laryngeal cancer is increasing year by year. The five-year survival rate is approximately 75% in patients with localized disease; however, a remarkable decrease in survival is observed when there is regional and distant disease (44% and 35%)\u003csup\u003e[1]\u003c/sup\u003e. Therefore, early detection of laryngeal cancer, and assessment of regional and distant metastasis are crucial for clinical staging, treatment selection, locoregional control, and survival. Accordingly, we hope to find a simple, non-invasive and easily accessible index to assist in the diagnosis of laryngeal cancer. NLR is an index that can be derived from simple calculations of routine blood parameters, and recent studies have shown that they can be used as new inflammatory markers in inflammation, cardiovascular system diseases and malignancies for the diagnosis and prognostic assessment of diseases\u003csup\u003e[2\u0026minus;3]\u003c/sup\u003e. Studies have pointed out that there is a significant correlation between SOD and malignant tumor\u003csup\u003e[4\u0026minus;5]\u003c/sup\u003e, but the diagnostic value of SOD in liver function test for cancer has not been reported. This study is intended to investigate the diagnostic value of preoperative peripheral blood NLR and SOD in the diagnosis of laryngeal cancer. We also found that SOD was correlated with the stage of laryngeal cancer, but there is no correlation was found between NLR, SOD and lymph node metastasis.\u003c/p\u003e"},{"header":"Information and Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003e1.1 General data\u003c/h2\u003e \u003cp\u003e The clinical and pathological data of 96 patients with laryngeal squamous cell carcinoma (laryngeal cancer group), 68 patients with vocal cord leukoplakia (vocal cord leukoplakia group), and 209 patients with vocal cord polyps (vocal cord polyp group) who underwent surgical resection at the Affiliated Hospital of Jining Medical College from 2018.01-2022.12 were selected (the enrolled cases were divided into laryngeal cancer group, vocal cord leukoplakia group, and vocal cord polyp group according to pathological diagnosis).\u003c/p\u003e \u003cp\u003eInclusion criteria: patients who underwent surgical treatment at the Department of Otolaryngology, Affiliated Hospital of Jining Medical College from 2018.01 to 2022.12 and had postoperative pathology confirmed as laryngeal squamous cell carcinoma, vocal cord leukoplakia (postoperative pathology report conforming to the WHO Blue Book pathological diagnosis classification in 2017) and vocal cord polyps.\u003c/p\u003e \u003cp\u003eExclusion criteria: history of laryngeal surgery; history of malignant tumors; diseases of the heart, brain, and other vital organs that cannot tolerate surgical treatment; and psychiatric disorders. Those with hematological system diseases, immune system diseases, which might affect the results of blood tests; those who had received radiotherapy, chemotherapy, immunotherapy or other adjuvant treatments before surgery; those with incomplete or missing clinical data, which could not be analyzed and followed up with data.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003e1.2 Study methods\u003c/h2\u003e \u003cp\u003eGeneral and disease-related data such as age, gender, clinical stage. The following pretreatment hematological parameters were collected within 1 weeks before the initial treatment: neutrophil count, lymphocyte count, and albumin. (NLR\u0026thinsp;=\u0026thinsp;N/L ; N is the absolute number of neutrophils, L is the absolute number of lymphocytes). SOD is an index that can examine the liver function. Further receiver operating characteristic (ROC) curves were established for comparisons between the laryngeal cancer group and vocal cord polyp groups.\u003c/p\u003e \u003cp\u003eThe disease-related clinical information of laryngeal cancer patients was collected to investigate the correlation between SOD and NLR and clinical stage and lymph node metastasis of laryngeal cancer patients.\u003c/p\u003e \u003cp\u003eIntraoperative resection specimens were sent to the pathology department for routine pathological examination. This study was a retrospective study, and this study was approved by the Medical Ethics Committee of the Affiliated Hospital of Jining Medical College.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003e1.3 Statistical analysis\u003c/h2\u003e \u003cp\u003eThe data were analyzed using Empower (\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e\u003ca href=\"10.1016/j.bjorl.2018.04.013\" target=\"_blank\"\u003ewww.empowerstats.com\u003c/a\u003e\u003c/span\u003e\u003cspan address=\"http://www.empowerstats.com\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e) and R software. Continuous variables with a normal distribution are presented as mean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD, while values without a normal distribution are presented as median (25\u0026ndash;75th percentiles).. Categorical variables are presented as numbers and percentages. Independent samples t-test and Mann-Whitney U test were used to determine differential risk factors between the two groups. The χ2 test and Fisher\u0026rsquo;s exact test were used to compare the categorical data, as appropriate. Furthermore, to evaluate the optimal cut-off value of the platelet, NLR and SOD ROC (receiver operating characteristic) curves were generated and the area under ROC curve (AUC) was measured and compared. Differences were considered statistically significant at P\u0026thinsp;\u0026lt;\u0026thinsp;0.05.\u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cdiv id=\"Sec7\" class=\"Section2\"\u003e \u003ch2\u003e2.1 Comparison of general clinical data\u003c/h2\u003e \u003cp\u003eA total of 96 cases of laryngeal cancer were included in this study, with an average age of (62.79\u0026thinsp;\u0026plusmn;\u0026thinsp;9.29) years old, 94 cases were male, accounting for 97.92%. There were 68 cases of vocal cord leukoplakia with an average age of (52.91\u0026thinsp;\u0026plusmn;\u0026thinsp;13.32) years and 209 cases of vocal cord polyps with an average age of (45.00\u0026thinsp;\u0026plusmn;\u0026thinsp;10.68) years. The differences in NLR and SOD between the laryngeal cancer group and the vocal cord leukoplakia and vocal cord polyp groups were statistically significant (all P\u0026thinsp;\u0026lt;\u0026thinsp;0.05) (Table\u0026nbsp;1).\u003c/p\u003e \u003cp\u003eThe NLR values in the laryngeal cancer group were significantly higher than those in the vocal fold white spots and vocal fold polyps groups, and the differences were statistically significant. The SOD values in the laryngeal cancer group was lower than those in the vocal fold leukoplakia and vocal fold polyp groups, and the differences was statistically significant.\u003c/p\u003e \u003cp\u003e \u003cb\u003e2.2 ROC curve analysis of the diagnostic value of SOD and NLR for laryngeal squamous cell carcinoma\u003c/b\u003e \u003c/p\u003e \u003cp\u003eROC curve analysis of NLR and SOD for laryngeal squamous cell carcinoma showed that the sensitivity of NLR and SOD were 0.6603 and 0.7778, respectively. The specificity of NLR and SOD were 0.6042 and 0.8646 respectively. The optimum cut-off values of NLR and SOD were determined according to ROC curve. As shown in Fig.\u0026nbsp;1, the optimal cut-off value for NLR is 1.8628 and the AUC value is 67.033%(95% CI: 60.5189%-73.5471%) (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e2\u003c/span\u003e). The optimal cut-off value of SOD was 204.5, and the AUC was 89.211%(95%CI: 85.562%-92.8547%). NLR and SOD have some significance in the differential diagnosis of laryngeal cancer, among which SOD have better diagnostic efficacy and specificity.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003e NLR and SOD to assess the diagnostic validity of laryngeal squamous cell carcinoma\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"8\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\"\u0026minus;\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAUC\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eyouden\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003ethreshold\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003esensitivity\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003especificity\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eaccuracy\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003eAUC(95%CI)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNLR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e67.033%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.265\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.8628\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.6603\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.6042\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.6426\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026minus;\" colname=\"c8\"\u003e \u003cp\u003e(60.5189%-73.5471%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSOD\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e89.211%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.642\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e204.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.7778\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.8646\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.8053\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026minus;\" colname=\"c8\"\u003e \u003cp\u003e(85.5672%-92.8547%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003e2.3 Relationship between NLR and SOD clinicopathological characteristics of laryngeal cancer patients\u003c/h2\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e3\u003c/span\u003e shows the relationship between the clinicopathological characteristics of patients with laryngeal cancer by NLR and SOD. Among the 96 patients, 2 (2.1%) were female and 94 (97.9% ) were male. In this study, on the one hand, patients were divided into low NLR group (NLR\u0026thinsp;\u0026lt;\u0026thinsp;1.86, n\u0026thinsp;=\u0026thinsp;38) and high NLR group (NLR\u0026thinsp;\u0026ge;\u0026thinsp;1.86, n\u0026thinsp;=\u0026thinsp;58), on the other hand, patients were divided into Low SOD group (SOD\u0026thinsp;\u0026lt;\u0026thinsp;204.5, n\u0026thinsp;=\u0026thinsp;83) and high SOD group (SOD\u0026thinsp;\u0026ge;\u0026thinsp;204.5, n\u0026thinsp;=\u0026thinsp;13), according to the best cut-off values of NLR and SOD(by explicitly tested (variables)). SOD was related to laryngeal cancer stage. NLR was related to drinking. NLR and SOD were associated with age and were significant at P\u0026thinsp;\u0026lt;\u0026thinsp;0.05. But the differences between SOD, NLR, and lymph node metastasis, smoking and incisal margin were not statistically significant.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eRelationship between NLR, SOD and clinicopathological characteristics of laryngeal cancer\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"7\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e \u003cp\u003eNLR\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c7\" namest=\"c5\"\u003e \u003cp\u003eSOD\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026lt;1.86(n\u0026thinsp;=\u0026thinsp;38)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u0026ge;\u0026thinsp;1.86(n\u0026thinsp;=\u0026thinsp;58)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eP value\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;204.5(n\u0026thinsp;=\u0026thinsp;83)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026ge;\u0026thinsp;204.5(n\u0026thinsp;=\u0026thinsp;13)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eP value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge(years)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e64.47\u0026thinsp;\u0026plusmn;\u0026thinsp;9.57\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e60.24\u0026thinsp;\u0026plusmn;\u0026thinsp;8.34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.028\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e55.77\u0026thinsp;\u0026plusmn;\u0026thinsp;11.19\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e63.89\u0026thinsp;\u0026plusmn;\u0026thinsp;8.52\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.003\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSex\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.247\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.572\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e96.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e100.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e100.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e97.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSmoke\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.977\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.729\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e89.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e89.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e92.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e89.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e10.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e7.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e10.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDrink\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.006\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.532\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e80.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e100.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e83.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e89.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e20.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e16.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e10.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIncisal margin\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.503\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.445\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003epositive\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e5.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e5.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003enegative\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e94.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e97.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e100.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e94.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTNM Stage\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.125\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.041\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eI\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e32.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e39.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e69.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e30.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eII\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e20.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e36.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e15.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e28.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIII\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e27.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e13.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e15.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e22.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIV\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e19.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e18.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLymphatic invasion\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.638\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.119\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e19.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e24.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e23.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e80.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e75.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e100.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e76.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e "},{"header":"Discussion","content":"\u003cp\u003eLaryngeal cancer ranks second in incidence and mortality of head and neck cancer, accounting for 1% of systemic malignant tumors, and the main pathological type is squamous cell carcinoma (96%-98%)\u003csup\u003e[\u003c/sup\u003e\u003csup\u003e6\u003c/sup\u003e\u003csup\u003e]\u003c/sup\u003e. 2020 epidemiological data in China show that the incidence of laryngeal cancer is 1.84 /100000 and mortality rate is 1.0 /100000, ranking 21st in both tumor incidence and mortality\u003csup\u003e[\u003c/sup\u003e\u003csup\u003e7\u003c/sup\u003e\u003csup\u003e]\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eVocal cord leukoplakia is a lamellar keratotic hyperplastic lesion on the mucosal surface of the vocal cords. The main pathological changes are mucosal epithelial hyperplasia with incomplete keratinization and mild hyperplasia of submucosal tissue\u003csup\u003e[\u003c/sup\u003e\u003csup\u003e8\u003c/sup\u003e\u003csup\u003e]\u003c/sup\u003e. Vocal cord leukoplakia manifests as white spots or patchy changes in the vocal cord mucosa, making epithelial-like changes such as hyperplasia, chemosis and atypical hyperplasia, with a malignant rate of about 6%-22%. It is one of the precancerous lesions of cancer. 2017 WHO latest revised classification of head and neck tumors classifies the pathological types of vocal cord leukoplakia into low-grade heterogeneous hyperplasia and high-grade heterogeneous hyperplasia\u003csup\u003e[\u003c/sup\u003e\u003csup\u003e9\u003c/sup\u003e\u003csup\u003e]\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eIt has been found that a high inflammatory response and low nutritional status can promote the progression of cancer cells, which is one of the main manifestations in patients with laryngeal squamous cell carcinoma. The inflammatory response stimulates the release of multiple inflammatory mediators, vascular endothelial growth factor, which contributes to cardiovascular production to promote tumor growth. Inflammation can participate in tumor occurrence and development by accelerating tumor cell proliferation, migration, angiogenesis, and suppressing the body's anti-tumor immunity, etc. The nutritional and inflammatory immune status of the body is related to the clinicopathological characteristics of malignant tumors and affects the clinical treatment outcome and prognosis.\u003c/p\u003e \u003cp\u003eIn recent years, NLR which reflect the nutritional changes of tumor-related inflammation, have become the focus of new research. NLR is a systemic inflammatory biomarker based on neutrophils and lymphocytes, reflecting the balance between inflammatory and immune responses to malignant tumors, and is a biological indicator closely related to the immune response of the body. Neutrophils and lymphocytes, as major cellular components of the immune system, neutrophils reflect inflammatory status, lymphocytes represent immune regulatory pathways, and NLR may reflect the degree of systemic inflammatory response.\u003c/p\u003e \u003cp\u003eReactive oxygen species (ROS) are increasingly recognized as critical determinants of cellular signaling and a strict balance of ROS levels must be maintained to ensure proper cellular function and survival. Notably, ROS is increased in cancer cells. The superoxide dismutase family plays an essential physiological role in mitigating deleterious effects of ROS\u003csup\u003e[\u003c/sup\u003e\u003csup\u003e10\u003c/sup\u003e\u003csup\u003e]\u003c/sup\u003e. SOD is capable of converting superoxide anions into hydrogen peroxide and belongs to one of many defensive mechanisms, which prevent from cell oxidative damage, leading to apoptosis\u003csup\u003e[\u003c/sup\u003e\u003csup\u003e11\u003c/sup\u003e\u003csup\u003e]\u003c/sup\u003e. A large volume of evidence suggests that malignant cells increase their antioxidant capacities to prevent tissue damage when ROS levels are increased\u003csup\u003e[\u003c/sup\u003e\u003csup\u003e12\u003c/sup\u003e\u003csup\u003e\u0026minus;\u003c/sup\u003e\u003csup\u003e13\u003c/sup\u003e\u003csup\u003e]\u003c/sup\u003e,while SOD is an efficient and powerful antioxidant enzyme that acts to decrease the levels of oxidative stress in an organism\u003csup\u003e[\u003c/sup\u003e\u003csup\u003e14\u003c/sup\u003e\u003csup\u003e\u0026minus;\u003c/sup\u003e\u003csup\u003e15\u003c/sup\u003e\u003csup\u003e]\u003c/sup\u003e,so this can support our view that SOD is associated with laryngeal squamous cell carcinoma. Our study found that SOD levels in patients with laryngeal cancer were lower than those in patients with vocal cord leukoplakia and vocal cord polyps, and the ROC curve showed that SOD was more sensitive than NLR and PIN. In addition, some studies have found that lower lip cancer is positively correlated with the Khmer expression of Mn-SOD\u003csup\u003e[\u003c/sup\u003e\u003csup\u003e16\u003c/sup\u003e\u003csup\u003e]\u003c/sup\u003e, which may be due to the different SOD response mechanisms of squamous cell carcinoma in different organs.\u003c/p\u003e \u003cp\u003eIn 2017, the Department of Otolaryngology-Head and Neck Surgery, Zhongshan Hospital, Fudan University, reported for the first time the diagnostic value of LMR, NLR in benign laryngeal lesions, precancerous laryngeal lesions, and laryngeal squamous cell carcinoma\u003csup\u003e[\u003c/sup\u003e\u003csup\u003e17\u003c/sup\u003e\u003csup\u003e]\u003c/sup\u003e. However, ROC statistical analysis was not performed, and the specific accuracy and specificity were not calculated. NLR and PNI have diagnostic value for many tumors such as lung, colorectal, liver, breast and kidney cancers\u003csup\u003e[\u003c/sup\u003e\u003csup\u003e18\u003c/sup\u003e\u003csup\u003e\u0026minus;\u003c/sup\u003e\u003csup\u003e19\u003c/sup\u003e\u003csup\u003e]\u003c/sup\u003e. Many scholars have examined the predictive value of NLR and PNI on the prognosis of laryngeal cancer\u003csup\u003e[\u003c/sup\u003e\u003csup\u003e20\u003c/sup\u003e\u003csup\u003e\u0026minus;\u003c/sup\u003e\u003csup\u003e21\u003c/sup\u003e\u003csup\u003e]\u003c/sup\u003e, but few scholars have examined the diagnostic value of NLR and PNI on laryngeal cancer. Meanwhile, SOD is an index that is often overlooked in the hematological examination of liver function. No scholars have examined the diagnostic value of SOD in laryngeal cancer.\u003c/p\u003e \u003cp\u003eLianyuan Tao found that NLR, CA125 and CA19-9 are associated significantly with lymph node metastasis independently in a multivariate analyses of 159 pancreatic ductal adenocarcinoma patients\u003csup\u003e[\u003c/sup\u003e\u003csup\u003e22\u003c/sup\u003e\u003csup\u003e]\u003c/sup\u003e. Toshiyuki Kosuga\u003csup\u003e[\u003c/sup\u003e\u003csup\u003e23\u003c/sup\u003e\u003csup\u003e]\u003c/sup\u003e thought that preoperative NLR may be a useful complementary diagnostic tool for predicting pathological lymph node metastasis in gastric cancer because of its higher sensitivity and negative predictive value than conventional modalities. Bo Zhou\u003csup\u003e[\u003c/sup\u003e\u003csup\u003e24\u003c/sup\u003e\u003csup\u003e]\u003c/sup\u003e reviewed 101 patients and found that preoperative NLR\u0026thinsp;\u0026ge;\u0026thinsp;1.80 is independently associated with lymph node metastases for patients undergoing resection of nonfunctioning pancreatic neuroendocrine tumors. Gorkem Eskiizmir\u003csup\u003e[\u003c/sup\u003e\u003csup\u003e25\u003c/sup\u003e\u003csup\u003e]\u003c/sup\u003e retrospectively analyzed the medical records of patients with benign laryngeal tumors, precancerous lesions, and malignant tumors, and found that there was no significant difference in NLR between the three groups, but NLR was a predictor of stage, lymph node metastasis, and distant metastasis. Therefore, they proposed that pretreatment NLR is a useful and reliable marker for predicting lymph node metastasis and prognosis. We did not detect the significance of NLR and SOD in predicting preoperative lymph node metastasis of laryngeal cancer. Maybe it has something to do with our low caseloads.\u003c/p\u003e "},{"header":"Conclusion","content":"\u003cp\u003eNLR and SOD are simple, inexpensive, and easily detectable indicators. In this study, we systematically evaluated the preoperative levels of NLR and SOD in laryngeal leision patients and confirmed their clinical diagnostic value for laryngeal cancer. We discovered the diagnostic value of SOD. To the best of our knowledge, this is the first time it has been attempted. The diagnostic value of SOD for laryngeal cancer is greater than that of NLR. In addition, we found that NLR was not associated with lymph node metastasis. SOD was associated with TNM stage of laryngeal cancer, but NLR was not. These hematological indicators can be combined with other inflammatory markers to assist in the diagnosis when laryngeal cancer is clinically suspected.\u003c/p\u003e \u003cp\u003eHowever, this study has some shortcomings, as it is a single-center retrospective study with a small number of included cases, and more multicenter, large-sample prospective studies are needed to provide a higher level of evidence to support the study. In addition, NLR is an indicator of inflammation, which is easily affected by other inflammatory diseases, drugs, etc., and the basic conditions of patients should be comprehensively analysed when using this type of indicator for clinical analysis. This readily-available serum biomarker may, thus, help guide additional treatment strategies.\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e"},{"header":"Abbreviations","content":"\u003cdiv class=\"DefinitionList\"\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eSOD\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003esuperoxide dismutase\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eNLR\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eneutrophil-to-lymphocyte\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eROC\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003ereceiver operator characteristic\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eAUC\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003ethe area under curve\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003ePNI\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eprognostic nutritional index\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003c/div\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAuthor Contributions:\u003c/strong\u003e Conception and design: YG-W, H-Z, DT-D, T-L; Collection and assembly of data: Q-A, JQ-X, X-M, DM-L; Data analysis and interpretation: J-Z,X-Z; Manuscript writing:K-W, YF-Z, J-Z; Final approval of manuscript: All authors have read and agreed to the published version of the manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was financially supported by grants from Jining City key research and development project of Jining Science and Technology Bureau (No. 2023YXNS208), Research Fund project of Academician Helinw New Medical Clinical Transformation Workstation(No. JYHL2022FMS11) and Special research plan of attending physician team in Affiliated Hospital of Jining Medical College(No. ZZTD-2022-007). The funders make no contributions to the study design, data collection and analysis, decision to publish,or preparation of the manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;Data available on request due to data sharing restrictions. The data presented in this study are available on request from the corresponding author.\u003c/p\u003e\n\n\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll data were collected in accordance with the World Medical Association Declaration of Helsinki. The study protocol was approved by the Ethics Committee of Affiliated Hospital of Jining Medical College(2023-03-C032).\u0026nbsp;Patient consent was waived for the retrospective data evaluation\u0026nbsp;by the Ethics Committee of Affiliated Hospital of Jining Medical College.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAuthors declare that informed consent was obtained from all subjects and/or their legal guardians\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;The authors declare that they have no competing interests to disclose\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eEskiizmir G, Uz U, Onur E, et al. 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Correlating intraepithelial papillary capillary loops of vocal cord leukoplakia with histopathology.\u0026nbsp;Acta Otolaryngol. 2022;142(1):106-111. doi:10.1080/00016489.2021.2019828\u003c/li\u003e\n\u003cli\u003eGale N, Poljak M, Zidar N. Update from the 4th Edition of the World Health Organization Classification of Head and Neck Tumours: What is New in the 2017 WHO Blue Book for Tumours of the Hypopharynx, Larynx, Trachea and Parapharyngeal Space.\u0026nbsp;Head Neck Pathol. 2017;11(1):23-32. doi:10.1007/s12105-017-0788-z\u003c/li\u003e\n\u003cli\u003eGriess B, Tom E, Domann F, Teoh-Fitzgerald M. Extracellular superoxide dismutase and its role in cancer.\u0026nbsp;Free Radic Biol Med. 2017;112:464-479. doi:10.1016/j.freeradbiomed.2017.08.013\u003c/li\u003e\n\u003cli\u003ede Melo AD, Freire VAF, Diogo \u0026Iacute;L, et al. Antioxidant Therapy Reduces Oxidative Stress, Restores Na,K-ATPase Function and Induces Neuroprotection in Rodent Models of Seizure and Epilepsy: A Systematic Review and Meta-Analysis.\u0026nbsp;Antioxidants (Basel). 2023;12(7):1397. Published 2023 Jul 7. doi:10.3390/antiox12071397\u003c/li\u003e\n\u003cli\u003eYANG C, TAN Y X, YANG G Z, et al. Gankyrin has an antioxidative role through the feedback regulation of Nrf2 in hepatocellular carcinoma [J]. J Exp Med, 2016, 213(5): 859-75.\u003c/li\u003e\n\u003cli\u003eBAO L, FESTA F, FREET C S, et al. The Human Transient Receptor Potential Melastatin 2 Ion Channel Modulates ROS Through Nrf2 [J]. Sci Rep, 2019, 9(1): 14132.\u003c/li\u003e\n\u003cli\u003eYOKOE H, NOMURA H, YAMANO Y, et al. Alteration of extracellular superoxide dismutase expression is associated with an aggressive phenotype of oral squamous-cell carcinoma [J]. Exp Ther Med, 2010, 1(4): 585-90.\u003c/li\u003e\n\u003cli\u003eBLOKHINA O, VIROLAINEN E, FAGERSTEDT K V. Antioxidants, oxidative damage and oxygen deprivation stress: a review [J]. Ann Bot, 2003, 91 Spec No(2): 179-94.\u003c/li\u003e\n\u003cli\u003eTSENG H W, TSENG H H, LIOU H H, et al. The association between immunoexpression levels of oxidant and antioxidant enzymes and lip squamous cell carcinoma [J]. Apmis, 2018, 126(5): 403-12.\u003c/li\u003e\n\u003cli\u003eWu DQ, Huang XS. [The significance of lymphocyte to monocyte ratio in peripheral blood of patients with benign and malignant laryngeal lesions]. Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2017 Jun 5;31(11):835-838. Chinese. doi: 10.13201/j.issn.1001-1781.2017.11.005.\u003c/li\u003e\n\u003cli\u003eLv X, Xu B, Zou Q, et al. Clinical application of common inflammatory and nutritional indicators before treatment in prognosis evaluation of non-small cell lung cancer: a retrospective real-world study.\u0026nbsp;Front Med (Lausanne). 2023;10:1183886. Published 2023 Jul 13. doi:10.3389/fmed.2023.1183886\u003c/li\u003e\n\u003cli\u003eWang Y, Jiang Y, Luo Y, et al. Prognostic Nutritional Index with Postoperative Complications and 2-year Mortality in Hip Fracture Patients: An Observational Cohort Study [published online ahead of print, 2023 Aug 1].\u0026nbsp;Int J Surg. 2023;10.1097/JS9.0000000000000614. doi:10.1097/JS9.0000000000000614\u003c/li\u003e\n\u003cli\u003eCai H, Zhang ZH, Zhou YJ, et al. The Prognostic Value of Preoperative Plasma Fibrinogen and Neutrophil-to-Lymphocyte Ratio in Patients With Laryngeal Squamous Cell Carcinoma. Ear Nose Throat J. 2021 Dec;100(10):731-736. doi: 10.1177/0145561320920746.\u003c/li\u003e\n\u003cli\u003eFerrandino RM, Roof S, Garneau J, et al. Neutrophil-to-lymphocyte ratio as a prognostic indicator for overall and cancer-specific survival in squamous cell carcinoma of the head and neck. Head Neck. 2020 Oct;42(10):2830-2840. doi: 10.1002/hed.26329. Epub 2020 Jun 27. PMID: 32592262.\u003c/li\u003e\n\u003cli\u003eLi Z, Qu Y, Yang Y, et al. Prognostic value of the neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio and systemic immune-inflammation index in patients with laryngeal squamous cell carcinoma. Clin Otolaryngol. 2021 Mar;46(2):395-405. doi: 10.1111/coa.13689. Epub 2020 Dec 27. PMID: 33321001.\u003c/li\u003e\n\u003cli\u003eTao L, Zhang L, Peng Y, et al. Preoperative neutrophil-to-lymphocyte ratio and tumor-related factors to predict lymph node metastasis in patients with pancreatic ductal adenocarcinoma (PDAC).\u0026nbsp;Oncotarget. 2016;7(45):74314-74324. doi:10.18632/oncotarget.11031\u003c/li\u003e\n\u003cli\u003eKosuga T, Konishi T, Kubota T, et al. Clinical significance of neutrophil-to-lymphocyte ratio as a predictor of lymph node metastasis in gastric cancer.\u0026nbsp;BMC Cancer. 2019;19(1):1187. Published 2019 Dec 5. doi:10.1186/s12885-019-6404-8\u003c/li\u003e\n\u003cli\u003eZhou B, Deng J, Chen L, et al. Preoperative neutrophil-to-lymphocyte ratio and tumor-related factors to predict lymph node metastasis in nonfunctioning pancreatic neuroendocrine tumors.\u0026nbsp;Sci Rep. 2017;7(1):17506. Published 2017 Dec 13. doi:10.1038/s41598-017-17885-y\u003c/li\u003e\n\u003cli\u003eESKIIZMIR G, UZ U, ONUR E, et al. The evaluation of pretreatment neutrophil-lymphocyte ratio and derived neutrophil-lymphocyte ratio in patients with laryngeal neoplasms [J]. Braz J Otorhinolaryngol, 2019, 85(5): 578-87.\u003cbr /\u003e \u003cbr /\u003e \u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"superoxide dismutase, neutrophile to lymphocyte rate, prognostic nutritional index, laryngeal carcinoma, lymph node metastasis","lastPublishedDoi":"10.21203/rs.3.rs-4063436/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4063436/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eObjective:\u003c/strong\u003e To investigate the diagnostic value of preoperative superoxide dismutase (SOD) and peripheral blood neutrophil-to-lymphocyte ratio (NLR) in the diagnosis of squamous cell carcinoma of the larynx.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods: \u003c/strong\u003eThe clinical data of 96 patients with laryngeal squamous cell carcinoma (laryngeal carcinoma group), 68 cases of vocal cord leukoplakia(laryngeal precancerous lesion group) and 209 cases of vocal cord polyps (vocal cord polyp group) treated surgically at the Affiliated Hospital of Jining Medical College from 2018.01.01 to 2022.12.30 were retrospectively analyzed.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults:\u003c/strong\u003e The differences in peripheral blood NLR and SOD were compared between the groups, and the value of these indicators in the diagnosis of laryngeal cancer was evaluated by applying the receiver operator characteristic (ROC) curve. The differences were statistically significant (all P\u0026lt;0.05). The areas under the ROC curves of SOD and NLR were 0.892, 0.670 and 0.737 for the differentiation of laryngeal squamous cell carcinoma and vocal cord polyps, respectively. We found that NLR was not associated with lymph node metastasis. SOD was associated with TNM stage of laryngeal cancer, but NLR was not.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion:\u003c/strong\u003e SOD and NLR are valuable for the diagnosis of laryngeal cancer, but not for the prediction of lymph node metastasis.\u003c/p\u003e","manuscriptTitle":"Association of preoperative peripheral blood SOD and NLR with laryngeal squamous cell carcinoma","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-03-25 16:46:26","doi":"10.21203/rs.3.rs-4063436/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"6777b85c-2bea-4d3f-b985-d2be39c5c76f","owner":[],"postedDate":"March 25th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2024-11-11T16:53:21+00:00","versionOfRecord":[],"versionCreatedAt":"2024-03-25 16:46:26","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-4063436","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4063436","identity":"rs-4063436","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}