• Adrian Nicoară, Ciprian Roi, Alexandra Roi, Alexandru Cătălin Motofelea, Marina Rakitovan, Flavia Zară, and Mircea Riviș.
• Department of Anesthesiology and Oral Surgery, "Victor Babes" University of Medicine and Pharmacy, Eftimie Murgu Sq. No. 2, 300041 Timisoara, Romania.
• Medicina (Kaunas). 2024 Nov 8; 60 (11).

AbstractBackground and Objectives: With the greatest rate of morbidity and death, OSCC is one of the world's most critical public health problems. Being a complex pathology, the management process that includes diagnostic, surgical, and adjuvant treatments must as well take into account the involvement of the immune system. This study aims to evaluate various biomarkers such as neutrophils, lymphocytes, platelets, SII, and NLR in the different stages of OSCC treatment and in correlation with TNM stages, in order to observe the inflammatory response of the host. Materials and Methods: A total of 154 patients diagnosed with OSCC were included in the present retrospective study. Routine blood samples were collected from all patients both before and after surgery. Using the detected values of platelets, neutrophils, and lymphocyte count, the systemic immune-inflammation index (SII) and neutrophil-to-lymphocyte ratio (NLR) were calculated. Based on the oncologist's recommendation, 46 patients underwent adjuvant radiotherapy as part of their oncologic treatment plan. For these patients, additional blood samples were collected before the first and after the last radiotherapy session for determining the values of platelets, neutrophils, and lymphocyte count, and SII and NLR calculation. Results: Prior to the first radiotherapy session, neutrophils decreased slightly to 4.35, lymphocytes increased to 2.23, and platelets rose to 258.62. The SII and NLR were 641.02 and 2.19, respectively. Following the last radiotherapy session, neutrophils increased substantially to 10.30, while lymphocytes decreased to 1.21. Platelets showed a slight reduction to 227.08. Notably, the SII rose dramatically to 3084.19, and the NLR increased significantly to 15.49, suggesting an important immune and inflammatory response of the host. Conclusions: The host's immunological and inflammatory responses are impacted by both surgery and adjuvant radiation administered following surgery. The parameters assessed-neutrophils, lymphocytes, platelets, SII, and NLR-qualify as significant variables that need to be monitored before, during, and following OSCC therapy. This study's findings validated significant changes in immunological and inflammatory markers in the management of OSCC.

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