Pretreatment Neutrophil-Lymphocyte Ratio in Salivary Gland Tumors Is Associated with Malignancy

Objective To assess pretreatment levels in the counts and percentages of leukocytes and the neutrophil-lymphocyte ratio (NLR) in benign and malignant salivary gland tumors (SGTs) while investigating whether NLR is an inflammatory marker for distinguishing low- from high-grade parotid gland tumors. Study Design Case series with chart review. Setting Tertiary referral center. Subjects and Methods This study was performed on 182 patients with SGTs (age range: 16-87 years; 93 male and 89 female) who were treated between January 2010 and May 2015. Pretreatment counts and percentages of leukocytes and NLR were measured preoperatively in benign and malignant tumors. Results Mean neutrophil percentage (63.50% ± 12.11% vs 58.76% ± 8.20%, P =.008) and NLR (3.29 ± 3.13 vs 2.13 ± 1.26, P =.008) were significantly higher in patients with malignant SGTs than in patients with benign SGTs. Mean lymphocyte count (2.42 ± 0.72 103/mm3 vs 1.97 ± 0.87 103/mm3, P <.001) and percentage (30.67% ± 7.68% vs 26.86% ± 10.15%, P =.011) were lower in patients with malignant SGTs than in patients with benign SGTs. Mean lymphocyte percentage and NLR were significantly different between low- and high-grade malignant parotid gland tumors (P =.026 and P =.030, respectively). Conclusion Elevated NLR could be an inflammatory marker to distinguish low- from high-grade malignant parotid gland tumors. © Official journal of the American Academy of Otolaryngology-Head and Neck Surgery Foundation

Reliability of SleepStrip as a screening test in obstructive sleep apnea patients

Obstructive sleep apnea syndrome (OSAS) is a common sleep disorder and related to multiple conditions that cause mortality in adults. In the present study, reliability of SleepStrip, a disposable screening device for detection of OSAS, is tested. In this prospective, nonrandomized double-blinded single cohort study at an academic health center, the performance of the SleepStrip in detecting respiratory events and establishing an SleepStrip score (Sscore) in domestic use were compared to the apnea-hypopnea index (AHI) obtained by the standard polysomnography (PSG) recordings in the sleep laboratory. Forty-one patients who have the PSG results participated the study and wore the SleepStrips at home. Test efficiency rate was 75% and there was a positive correlation between PSG-AHI scores and Sscores (r = 0.71, p 30 levels. The SleepStrip has 100% specificity and positive predictive values, but it also has low negative predictive and sensitivity values. The SleepStrip is not a reliable screening test in differential diagnosis among simple snorers, mild, moderate and severe OSAS patients. However, high Sscores highly indicate the presence of moderate-severe OSAS. We can safely send these patients to split-night PSG and continuous, automatic, bi-level positive airway pressure (CPAP/BPAP/APAP) titration at the same night. The SleepStrip may increase the effective use of the sleep laboratories