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The aim of this study is to evaluate the levels of systemic inflammatory markers such as PIV, SII, and NPAR in patients with benign and premalignant laryngeal lesions and to determine the diagnostic accuracy of these values using ROC analysis.
Benign laryngeal lesions are generally nodules, polyps, or cysts that form due to overuse of the voice or vocal cord trauma. Reinke's edema, also within this group, is a benign laryngeal condition characterized by the accumulation of gelatinous fluid in the superficial lamina propria of the vocal cords. It is usually associated with chronic irritation, particularly smoking, and is frequently seen in middle-aged individuals with a long history of tobacco use. Previous experimental studies have shown that cigarette smoke triggers inflammatory responses in vocal cord fibroblasts and increases the production of inflammatory mediators. The cellular and systemic inflammatory processes triggered by irritation due to chronic smoking are still not fully understood. In recent years, systemic inflammation markers derived from routine hemogram parameters have attracted attention as low-cost and reliable potential biomarkers in various inflammatory and neoplastic diseases. Neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), hemoglobin-eosinophil ratio (HEO), systemic immune-inflammation index (SII), and pan-immune-inflammation value (PIV), as well as more comprehensive indices reflecting both inflammatory and nutritional status such as Neutrophil-Albumin Ratio (NPAR) and HALP (Hemoglobin, Albumin, Platelet Ratio), are inexpensive and readily available indicators of systemic inflammation. However, a review of the literature reveals a lack of studies examining the relationship between benign and malignant laryngeal lesions and systemic inflammation through these comprehensive indices (PIV and NPAR). The aim of this study is to evaluate the levels of systemic inflammatory markers such as PIV, SII, and NPAR in patients with benign and premalignant laryngeal lesions and to determine the diagnostic accuracy of these values using ROC analysis.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Laryngeal polyps |
| ||
| Laryngeal nodules |
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| Laryngeal cysts |
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| Reinke's edema |
| ||
| Papillomas |
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| Dysplasia |
| ||
| High-risk premalignant lesions |
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| Malignant vocal cord lesions |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Laryngeal polyps | Other | Bening laryngeal lesions |
| |
| Laryngeal nodules |
| Measure | Description | Time Frame |
|---|---|---|
| Determining the diagnostic accuracy of PIV | PIV (pan-immune-inflammation value) | Postoperative 1 month |
| Measure | Description | Time Frame |
|---|---|---|
| Determining the diagnostic accuracy of NLR | NLR (neutrophil-lymphocyte ratio) | Postoperative 1 month |
| Determining the diagnostic accuracy of PLR | PLR (platelet-lymphocyte ratio) |
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Inclusion Criteria:
Exclusion Criteria:
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Inclusion was planned for patients aged 18 and over, with a diagnosis of vocal cord lesion via endoscopic or surgical means, and with complete blood count and albumin data in hospital records.
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Nuray Ensari | Contact | +905055025177 | nurayakmese@yahoo.com |
| Name | Affiliation | Role |
|---|---|---|
| Nuray Ensari | University of Health Sciences, Antalya Training and Research Hospital | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University of Health Sciences, Antalya Training and Research Hospital | Antalya | Muratpaşa | Turkey (Türkiye) |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 40086488 | Background | Pan L, Yu Z, Xiang WX, Sun SR, Li JX, Deng YK, Wang MC, Zhong JX, Huang K, Gao PS, Zhu LP, Yao Y, Liu Z. Cigarette smoke-induced epithelial cell ferroptosis promotes neutrophilic inflammation in patients with nasal polyps. J Allergy Clin Immunol. 2025 Jun;155(6):1882-1897. doi: 10.1016/j.jaci.2025.02.034. Epub 2025 Mar 12. | |
| 36565325 |
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| Control |
|
| Other |
Bening laryngeal lesions |
|
| Laryngeal cysts | Other | Bening laryngeal lesions |
|
| Reinke's edema | Other | Bening laryngeal lesions |
|
| Papillomas | Other | Premalign laryngeal lesions |
|
| Dysplasia | Other | Premalign laryngeal lesions |
|
| High-risk premalignant lesions | Other | Premalign laryngeal lesions |
|
| Malignant vocal cord lesions | Other | Malign laryngeal lesions |
|
| Asymptomatic smokers without vocal cord lesions | Other | None laryngeal lesions |
|
| Postoperative 1 month |
| Determining the diagnostic accuracy of HEO | HEO (hemoglobin-eosinophil ratio) | Postoperative 1 month |
| Determining the diagnostic accuracy of SII | SII (systemic immune-inflammation index) | Postoperative 1 month |
| Determining the diagnostic accuracy of NPAR | NPAR (neutrophil-albumin ratio) | Postoperative 1 month |
| Determining the diagnostic accuracy of HALP | HALP (hemoglobin, albumin, platelet ratio) | Postoperative 1 month |
| Guven DC, Erul E, Yilmaz F, Yasar S, Yildirim HC, Ercan F, Kaygusuz Y, Cayiroz K, Ucdal MT, Yesil F, Yazici G, Cengiz M, Gullu I, Aksoy S. The association between pan-immune-inflammation value and survival in head and neck squamous cell carcinoma. Eur Arch Otorhinolaryngol. 2023 May;280(5):2471-2478. doi: 10.1007/s00405-022-07804-x. Epub 2022 Dec 24. |