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International Arab Journal of Dentistry

DOI

https://doi.org/10.70174/iajd.v15i2.1029

Abstract

Aims and Objectives: This study evaluates the hemogram parameters NLR, LMR, and PLR among 90 Patients. They were divided into three groups: Group A consists of 30 patients with histopathological confirmed oral cancer. Group B consists of 30 patients who present acute dental infections. Group C consists of 30 patients with clinically healthy subjects. The hemogram parameters NLR, LMR, and PLR were compared in oral cancer, acute dental infection patients, and healthy subjects and their correlation to clinical prognostic indicators like T stage, presence or absence of lymph node metastasis, and differentiation of cancer.

Methodology: The present study was a cross-sectional observational study, which was carried out on patients reported to the Department of Oral Medicine and Radiology. After obtaining personal informed consent, a thorough examination of the oral cavity and the lesion was conducted with an illuminated light and mouth mirror. Blood tests were performed on all the subjects before treatment. Under aseptic conditions, Venous blood (2 ml) was collected by venipuncture of the median cubital vein in the cubital fossa of the forearm using a disposable syringe with a 24-gauge needle. The withdrawn blood was transferred into an EDTA-containing test tube. Hematological parameters were analyzed using an automated hematology analyzer. NLR, LMR, and PMR were calculated as the ratio of absolute peripheral neutrophil to lymphocyte, lymphocyte to monocyte, and platelet to lymphocyte count, respectively. Result: The present study revealed NLR is elevated in oral carcinoma compared to healthy individuals, and it is significant but lesser than acute dental infections. LMR is higher in oral carcinoma than in acute dental infections and healthy individuals, but no significant elevation exists among the groups. PLR is higher in oral carcinoma than Acute dental infections and healthy individuals, and it is a significant elevation among the groups. There are significant correlations in oral carcinoma between NLR, LMR, and PLR. NLR has a positive correlation with PLR and a negative correlation with LMR, which showed clinical significance as determined by the Spearman correlation coefficient. In Acute dental infections and healthy individuals, there is a significant correlation of NLR with LMR and PLR but no significant correlations between LMR and PLR and vice versa. NLR, LMR, and PLR were correlated to clinical prognostic indicators like T stage, presence or absence of lymph node metastasis, and differentiation of cancer by using ANOVA. There is no significant difference in NLR, LMR, or PLR ratios concerning Clinical T staging since the p-value is greater than 0.05 for NLR, LMR, and PLR (p= 0.072, 0.446, 0.446, respectively). A statistically significant difference is found in LMR to the clinical presence or absence of Lymph node metastasis since the p-value is less than 0.05 only for LMR (p=0.018). The mean values of LMR in N0, N1, and N2 were 9.49, 5.65, and 4.40, respectively; this implies that the mean value of LMR decreases in advanced oral carcinoma as the nodal stage increases with lymph node metastases. A statically significant difference is found in NLR (p=0.011) and PLR (p =0.013) for differentiation of tumor (p-value is less than 0.05), which implies NLR & PLR values are elevated in moderately differentiated oral carcinomas when compared to well-differentiated oral carcinoma.

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