Evaluation of Inflammatory Biomarkers in Parotid Tumors

BACKGROUND Salivary gland neoplasms present a diagnostic challenge due to their heterogeneous nature and varying histological subtypes. Recent studies have highlighted the potential role of inflammatory biomarkers, such as neutrophil to lymphocyte ratio (NLR) and systemic immune inflammation index (SII), in enhancing diagnostic accuracy for distinguishing between benign and malignant parotid gland tumors. This study aimed to evaluate the use of inflammatory biomarkers - NLR, platelet-to-lymphocyte ratio (PLR), SII, and systemic inflammation response index (SIRI) - in the differential diagnosis of parotid gland tumors. MATERIAL AND METHODS Patients who underwent parotidectomy in a single center between 2019 and 2023 were included. Inflammatory biomarkers (NLR, PLR, SII, SIRI) were calculated and compared according to histopathological features (benign vs malignant) and subgroups (benign: pleomorphic adenoma, Warthin, and others; and malignant: high grade, low grade, and lymphoma. RESULTS A total of 206 patients were included in the study (benign: 177, malignant: 29). No significant difference was detected in NLR, PLR, SII and SIRI values between benign and malignant tumor groups. While all inflammatory markers were found to be elevated, only PLR exhibited a statistically significant difference among high-grade, low-grade, and benign tumor groups (P=0.05). Patients with Warthin tumor revealed significantly lower PLR and higher SIRI values than those with pleomorphic adenoma (P=0.02 and P<0.001, respectively). CONCLUSIONS Evaluation of inflammatory biomarkers seems to play a promising role in diagnosing parotid tumors, especially Warthin tumor and high-grade malignancies. Due to their accessibility and cost-effectiveness, further studies are warranted to determine their accuracy and optimal use in clinical practice.