Predictive utility of systemic inflammatory markers in differentiating laryngeal lesions

Abstract

Purpose Laryngeal lesions encompass both benign and malignant pathologies and present with symptoms ranging from hoarseness to throat pain. This study aimed to evaluate the predictive value of systemic inflammatory markers, including neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammatory index (SII), systemic inflammatory response index (SIRI) and haemoglobin-albumin-lymphocyteplatelet (HALP) score, for distinguishing malignant from benign laryngeal lesions. Study design Single-center retrospective cross-sectional analysis. Setting Tertiary medical institution. Methods This single-centre retrospective cross-sectional study analysed 442 patients presenting with hoarseness at a tertiary centre between 2020 and 2023. Based on their biopsy results, the patients were classified into four groups: benign lesions, low-grade dysplasia, high-grade dysplasia, and squamous cell carcinoma (SCC). Preoperative blood tests were used to calculate inflammatory markers. Statistical analyses included Kruskal–Wallis tests and post-hoc pairwise comparisons, with significance set at p<0.05. Results The SCC group demonstrated significantly higher median NLR, SII and SIRI values and lower LMR and HALP scores than the benign and dysplastic groups (p<0.001). Among the indices, SIRI exhibited the highest predictive accuracy for SCC, with an AUC of 0.7, followed by NLR (0.681) and SII (0.672). HALP showed predictive value but was significant only between SCC and benign lesions. Multivariate logistic regression identified SII and LMR as predictive factors. Conclusion Systemic inflammatory markers, particularly SIRI, SII and LMR, hold promise as adjunctive diagnostic tools for assessing malignancy risk in laryngeal lesions. Although their standalone prognostic utility remains limited, these indices may improve clinical decision-making by identifying high-risk patients for earlier biopsy appointments.