This study aims to evaluate the clinical significance of preoperative blood test indicators in diagnosing cervical lymph node metastasis in patients with head and neck squamous cell carcinoma (HNSCC).

A total of 97 HNSCC patients who underwent surgical treatment at the Affiliated Hospital of Xuzhou Medical University between October 2023 and January 2025 were included in the study. Based on postoperative pathological results, the patients were categorized into two groups: those with cervical lymph node metastasis and those without. Preoperative blood routine examination indicators, including neutrophils, platelets, and lymphocytes, as well as biochemical examination indicators such as aspartate aminotransferase and albumin, were collected. The neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and aspartate aminotransferase-to-albumin ratio (AAR) were calculated. The diagnostic value of preoperative NLR, PLR and AAR for cervical lymph node metastasis in HNSCC patients was subsequently analyzed.

The NLR and AAR values in the cervical lymph node metastasis group were significantly higher than those in the non-cervical lymph node metastasis group. The optimal cut-off values and areas under the curve for NLR and AAR in diagnosing cervical lymph node metastasis among patients with HNSCC were 0.687 and 0.682 for NLR, and 3.3433 and 0.6338 for AAR, respectively. Results from multivariate logistic regression analysis indicated that AAR may serve as a potential blood indicator for evaluating cervical lymph node metastasis in HNSCC patients.

Preoperative NLR, PLR and AAR have significant clinical value for the initial screening and diagnosis of lymph node metastasis in HNSCC.