Journal of the Chinese Medical Association : JCMA · 2026
Clinical utility of preoperative lymphocyte-albumin-neutrophil ratio for prognostication in patients with oral cancer undergoing surgery.
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Chen Hung-Hua, Lin Yu-Tsai, Chuang Hui-Ching, Chien Chih-Yen, Yang Chao-Hui, Fang Fu-Min, Lu Hui, Tsai Ming-Hsien
Аннотация
BACKGROUND: Systemic inflammation and nutritional status are key determinants of prognosis in oral squamous cell carcinoma (OSCC). The neutrophil-to-lymphocyte ratio and serum albumin in peripheral blood are established markers reflecting host immune response and nutritional condition, respectively. The lymphocyte-albumin-neutrophil ratio (LANR), a composite index integrating these parameters, has emerged as a potential prognostic biomarker in several cancers; however, its role in OSCC remains unclear. This study aimed to evaluate the prognostic value of preoperative LANR in OSCC.
METHODS: We retrospectively analyzed OSCC patients who underwent radical surgery between 2007 and 2017, randomly dividing them into training and validation cohorts by a 2:1 ratio. LANR was calculated by multiplying the absolute lymphocyte count by the serum albumin level and dividing by the absolute neutrophil count. The primary outcomes were 5-year overall survival (OS) and disease-free survival (DFS). Survival-associated factors were identified through univariate and multivariate Cox regression analyses, serving as the foundation for constructing a predictive nomogram model.
RESULTS: This study included a total of 660 patients, with 440 assigned to the training cohort and 220 to the validation cohort. A LANR cutoff value of 18.7 effectively stratified patients into distinct prognostic groups, demonstrating significant differences in survival outcomes. A low LANR independently predicted worse OS (hazard ratio [HR]: 1.54, 95% CI: 1.04-2.28; p = 0.03) and DFS (HR: 1.54, 95% CI: 1.08-2.19; p = 0.017). The LANR-based nomogram demonstrated strong predictive performance, with concordance indices of 0.75 and 0.71 in the training and validation cohorts, respectively.
CONCLUSION: Preoperative LANR serves as an independent prognostic marker in patients with OSCC. Incorporating LANR into risk models may enhance patient stratification and guide treatment strategies.
METHODS: We retrospectively analyzed OSCC patients who underwent radical surgery between 2007 and 2017, randomly dividing them into training and validation cohorts by a 2:1 ratio. LANR was calculated by multiplying the absolute lymphocyte count by the serum albumin level and dividing by the absolute neutrophil count. The primary outcomes were 5-year overall survival (OS) and disease-free survival (DFS). Survival-associated factors were identified through univariate and multivariate Cox regression analyses, serving as the foundation for constructing a predictive nomogram model.
RESULTS: This study included a total of 660 patients, with 440 assigned to the training cohort and 220 to the validation cohort. A LANR cutoff value of 18.7 effectively stratified patients into distinct prognostic groups, demonstrating significant differences in survival outcomes. A low LANR independently predicted worse OS (hazard ratio [HR]: 1.54, 95% CI: 1.04-2.28; p = 0.03) and DFS (HR: 1.54, 95% CI: 1.08-2.19; p = 0.017). The LANR-based nomogram demonstrated strong predictive performance, with concordance indices of 0.75 and 0.71 in the training and validation cohorts, respectively.
CONCLUSION: Preoperative LANR serves as an independent prognostic marker in patients with OSCC. Incorporating LANR into risk models may enhance patient stratification and guide treatment strategies.