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Preoperative Inflammatory Ratios Poorly Discriminate Malignant From Benign Parotid Tumours
Jung Min Kim1, So Young Jeon1, Young Chan Lee1
1Department of Otorhinolaryngology-Head and Neck Surgery, Kyung Hee University School of Medicine, Kyung Hee University Medical Center, Seoul, Republic of Korea.
Objective:
To determine whether preoperative blood inflammatory ratios discriminate malignant from benign parotid tumours.
Methods:
This retrospective single-centre study included 204 patients undergoing parotidectomy (45 malignant, 159 benign); inflammatory-index analyses included 45 malignant and 157 benign cases. The neutrophil-to-lymphocyte and monocyte-to-lymphocyte ratios were the two primary indices. Group differences were tested non-parametrically with multiplicity control, discrimination by receiver operating characteristic analysis and association by multivariable logistic regression.
Results:
Median neutrophil-to-lymphocyte and monocyte-to-lymphocyte ratios were higher in malignant tumours (2.00 vs. 1.81 and 0.203 vs. 0.166), but effect sizes were small. Areas under the curve were 0.608 (95% confidence interval 0.518-0.701) and 0.631 (0.520-0.735), respectively. At the sample-derived neutrophil-to-lymphocyte threshold, sensitivity was 86.7% and specificity 35.7%. Additional inflammatory indices, histological subgroup analyses and sensitivity analyses did not materially improve discrimination.
Conclusions:
Although the two primary ratios were higher in malignant tumours, their distributions overlapped substantially and discrimination was poor. These findings do not support their use as stand-alone markers for preoperative malignancy risk stratification.