Based on Peripheral Blood TLR4 and NLR Levels,A Nomogram Model was Constructed to Predict Lymph Node Metastasis in Patients with Laryngeal Cancer
Objective To construct a nomogram model for predicting lymph node metastasis in patients with laryngeal cancer based on Toll-like receptor 4(TLR4)and neutrophil/lymphocyte ratio(NLR)levels in peripheral blood.Methods A total of 100 patients with laryngeal cancer were selected as the research objects.According to whether lymph node metastasis occurred or not,the patients were divided into the lymph node metastasis group(37 cases)and the lymph node metastasis group(63 cases).The levels of TLR4 and NLR in peripheral blood were compared between the two groups,and the risk factors of lymph node metas-tasis in patients with laryngeal cancer were analyzed by multi-factor stepby-step Logistic regression analysis.R3.5.3 software was used to draw the nomogram model of lymph node metastasis in patients with laryngeal cancer,and the area under receiver operat-ing curve(ROC)was used to test the prediction efficiency of the risk nomogram model,and the accuracy of the model was tested by Bootstrap method.Results The levels of TLR4 and NLR in peripheral blood of the group with lymph node metastasis were higher than those of the group without lymph node metastasis,and the differences were statistically significant(P＜0.05).Univa-riate analysis showed that there were significant differences in tumor location,differentiation,clinical stage and treatment mode be-tween the group with lymph node metastasis and the group without lymph node metastasis(P＜0.05).Multivariate Logisticregres-sion analysis showed that tumor location,differentiation degree,clinical stage,treatment style,TLR4 and NLR levels in peripheral blood were all influence factors for lymph node metastasis in laryngeal cancer patients(P＜0.05).The above factors were used as predictive variables to construct a nomogram model for lymph node metastasis in laryngeal cancer patients.The internal verifica-tion result of Bootstrap method showed that the C-index was 0.809(95%CI:0.743～0.858),indicating good differentiation.The ROC curve results showed that the area,sensitivity and specificity under the ROC curve were 0.824,82.63%and 78.95%,re-spectively,indicating that the prediction efficiency of the model was good.Conclusion TLR4 and NLR levels in peripheral blood are correlated with lymph node metastasis in patients with laryngeal cancer.The nomogram model based on TLR4 and NLR levels in peripheral blood is effective in predicting lymph node metastasis in patients with laryngeal cancer.
TLR4NLRLaryngeal cancerLymph node metastasisNomogram model
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