Objective:To study the prognostic value of preoperative neutrophil to lymphocyte ratio(NLR) and postoperative NLR in patients with oral squamous cell carcinoma(OSCC). Methods:One hundred and twenty-three patients with primary OSCC undergoing radical operation of oral cancer in our hospital from October 2012 to January 2020 were selected. The data of blood routine of all the patients last time before operation and 3 months after operation were collected. The effects of preoperative and postoperative NLR on overall survival(OS) and disease-free survival(DFS) of OSCC patients were analyzed by Cox regression analysis and Kaplan-Meier(K-M) survival curve. Results:The area under the curve(AUC) of preoperative NLR was 0.670(0.570-0.770), and the best cutoff value was 2.74. The AUC of postoperative NLR was 0.643(0.544-0.743), and the best cutoff value was 3.13. The rate of postoperative wound infection and chemoradiotherapy in patients with NLR ≥ 3.13 group was higher than that in patients with NLR<3.13 group, and postoperative Hb was lower than that in patients with NLR<3.13 group, the differences being statistically significant(all P<0.05). The median of OS and DFS in the low preoperative NLR group was higher than that in the high preoperative NLR group, and the differences between the two groups were statistically significant(P<0.05). The median of OS of low NLR group was higher than that of high NLR group(P<0.05). The median of DFS of low NLR group was higher than that of high NLR group(P>0.05). Cox regression analysis showed that tumor size(T3-T4/T1-T2), clinical stage(Ⅲ-Ⅳ/Ⅰ-Ⅱ), pathological stage(Ⅱ-Ⅲ/Ⅰ), preoperative NLR ≥ 2.74 and postoperative NLR ≥ 3.13 were independent prognostic factors of OS, and their HR values were 2.706, 2.949, 2.219, 2.015 and 1.985, respectively. Clinical stage(Ⅲ-Ⅳ/Ⅰ-Ⅱ), pathological stage(Ⅱ-Ⅲ/Ⅰ), cervical lymph node metastasis, radiotherapy or chemotherapy, preoperative NLR ≥ 2.74 were independent influencing factors of DFS, and their HR values were 1.687, 2.451, 1.912, 0.696 and 1.830, respectively. Conclusion:Preoperative and postoperative NLRs have certain predictive value for poor prognosis. Preoperative NLR ≥ 2.74 is an independent influencing factor for OS and DFS in patients with OSCC after radical resection, and postoperative NLR ≥ 3.13 is an independent influencing factor for OS after radical operation.
 CHINN S B,MYERS J N.Oral cavity carcinoma:current management,controversies,and future directions[J].J Clin Oncol,2015,33(29):3269-3276.
 WONG L,BOZHILOV K,HERNANDEZ B,et al.Underlying liver disease and advanced stage liver cancer are associated with elevated neutrophil-lymphocyte ratio[J].Clin Mol Hepatol,2019,25(3):305-316.
 GAO J,WANG Y,LI F,et al.Prognostic nutritional index and neutrophil-to-lymphocyte ratio are respectively associated with prognosis of gastric cancer with liver metastasis undergoing and without hepatectomy[J].Biomed Res Int,2019:4213623.
 SCHILLING C,STOECKLI S J,VIGILI M G,et al.Surgical consensus guidelines on sentinel node biopsy(SNB) in patients with oral cancer[J].Head & Neck,2019,41(8):2655-2664.
 YANG J,WAN S Q,HUANG L,et al.Analysis of hospitalization costs and length of stay for oral cancer patients undergoing surgery:evidence from Hunan,China[J].Oral Oncol,2021,119:105363.
 HIRAHARA T,ARIGAMI T,YANAGITA S,et al.Combined neutrophil-lymphocyte ratio and platelet-lymphocyte ratio predicts chemotherapy response and prognosis in patients with advanced gastric cancer[J].BMC Cancer,2019,19(1):672.
 KANG J,CHANG Y,JAHN J,et al.Neutrophil-to-lymphocyte ratio and risk of lung cancer mortality in a low-risk population:a cohort study[J].Int J Cancer,2019,145(12):3267-3275.
 YU W,DOU Y,WANG K,et al.Preoperative neutrophil lymphocyte ratio but not platelet lymphocyte ratio predicts survival and early relapse in patients with oral,pharyngeal,and lip cancer[J].Head & Neck,2019,41(5):1468-1474.
 DIAO P,WU Y,GE H,et al.Preoperative circulating platelet,neutrophil,and lymphocyte counts predict survival in oral cancer[J].Oral Dis,2019,25(4):1057-1066.
 CHEN S,GUO J,FENG C,et al.The preoperative platelet lymphocyte ratio versus neutrophil-lymphocyte ratio:which is better as a prognostic factor in oral squamous cell carcinoma?[J].Ther Adv Med Oncol,2016,8(3):160-167.
 GRANDIS J R,SNYDERMAN C H,JOHNSON J T,et al.Postoperative wound infection.A poor prognostic sign for patients with head and neck cancer[J].Cancer,1992,70(8):2166-2170.
 JACKSON R M,RICE D H.Wound infections and recurrence in head and neck cancer[J].Otolaryng Head Neck,1990,102:331-333.
 DE ALMEIDA J R,YAO C M K L,ZIAI H,et al.Postoperative wound infections,neutrophil-to-lymphocyte ratio,and cancer recurrence in patients with oral cavity cancer undergoing surgical resection[J].Oral Oncol,2019,97:23-30.