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O papel prognóstico do rácio neutrófilos-linfócitos em doentes com carcinoma pavimento-celular da cabeça e pescoço
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Resumo(s)
O Carcinoma Pavimento-Celular da Cabeça e Pescoço (CPCCP) é o sexto cancro mais frequente a nível mundial. Apesar dos desenvolvimentos no tratamento do CPCCP, a sobrevivência a 5 anos continua abaixo dos 50%, causando mais de 200.000 mortes anualmente. Atualmente, os fatores de prognóstico mais usados neste cancro são o sistema TNM e o status HPV. No entanto, estão a surgir inúmeros estudos que apontam para que o Rácio Neutrófilos-Linfócitos (RNL) poderá complementar estes fatores na predição do prognóstico em doentes com CPCCP. Pensa-se que o RNL, um parâmetro facilmente calculado a partir de resultados de exames de sangue de rotina, poderá refletir o estado inflamatório do hospedeiro. Este trabalho procura rever a evidência científica disponível sobre o CPCCP e o RNL. Inúmeras revisões sistemáticas com meta-análise concluíram que um RNL aumentado se associa a um pior prognóstico em doentes com CPCCP. Em adição, parece haver evidência que aponta para outras utilidades do RNL, como previsão da resposta a terapêutica, de complicações ou da malignidade de lesões. Assim, o RNL é uma ferramenta com grande potencial de utilidade na prática clínica em doentes com CPCCP.
Head and neck squamous cell carcinoma (HNSCC) is the sixth cause of cancer worldwide. Although there are many developments in the treatment of HNSCC, the 5-year survival rate is still bellow 50%, causing more than 200.000 death every year. Nowadays, the TNM system and HPV status are the main prognostic markers used. However, there is building evidence that the Neutrophil to Lymphocyte Ratio (NLR) could complement the other markers in predicting the prognosis in HNSCC patients. It is thought that the NLR, which is easily calculated from routine blood works, could reflect the inflammatory status of the host. This work intends to review the existing scientific evidence available about HNSCC and NLR. Various systematic reviews with meta-analysis have concluded that a high NLR is associated with a poorer prognosis in patients with HNSCC. In addition, there looks to be evidence that points to other uses of the NLR, like predicting the response to therapy, complications after therapy or the malignancy of lesions. Concluding, the NLR is a tool with a great potential to be used in practice with patients with HNSCC.
Head and neck squamous cell carcinoma (HNSCC) is the sixth cause of cancer worldwide. Although there are many developments in the treatment of HNSCC, the 5-year survival rate is still bellow 50%, causing more than 200.000 death every year. Nowadays, the TNM system and HPV status are the main prognostic markers used. However, there is building evidence that the Neutrophil to Lymphocyte Ratio (NLR) could complement the other markers in predicting the prognosis in HNSCC patients. It is thought that the NLR, which is easily calculated from routine blood works, could reflect the inflammatory status of the host. This work intends to review the existing scientific evidence available about HNSCC and NLR. Various systematic reviews with meta-analysis have concluded that a high NLR is associated with a poorer prognosis in patients with HNSCC. In addition, there looks to be evidence that points to other uses of the NLR, like predicting the response to therapy, complications after therapy or the malignancy of lesions. Concluding, the NLR is a tool with a great potential to be used in practice with patients with HNSCC.
Descrição
Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2020
Palavras-chave
Carcinoma pavimento-celular da cabeça e pescoço Rácio neutrófilos-linfócitos Prognóstico Otorrinolaringologia