Association of albumin–globulin ratio, neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio with TNM stage and histopathological grade in oral squamous cell carcinoma: a cross-sectional study

Oral Squamous Cell Carcinoma (OSCC) is a common malignancy associated with high morbidity and mortality. Systemic inflammatory and nutritional biomarkers such as Albumin–Globulin Ratio (AGR), Neutrophil-to-Lymphocyte Ratio (NLR), and Platelet-to-Lymphocyte Ratio (PLR) have emerged as potential indicators of tumor progression. To evaluate the association of AGR, NLR, and PLR with TNM stage and histopathological grade in patients with OSCC. This prospective cross-sectional study included 120 histopathologically confirmed OSCC patients. Demographic, clinicopathological, hematological, and biochemical data were recorded. AGR, NLR, and PLR were calculated from routine laboratory investigations. Associations with TNM stage and histopathological grade were analyzed using appropriate statistical tests, and correlations were assessed using Spearman’s rank correlation coefficient. Lower AGR and higher NLR and PLR were significantly associated with advanced TNM stage. Across histopathological grades, AGR decreased progressively, whereas NLR and PLR increased significantly with poorer differentiation. Spearman correlation analysis showed significant inverse correlations of AGR with TNM stage ( r = − 0.52, p = 0.030) and histopathological grade ( r = − 0.47, p = 0.010), while NLR and PLR showed significant positive correlations with both TNM stage and histopathological grade. In multivariable analysis, NLR remained significantly associated with advanced TNM stage (adjusted OR = 1.745, 95% CI: 1.163–2.619, p = 0.007). AGR, NLR, and PLR are inexpensive and readily available biomarkers associated with disease severity in OSCC. These markers may serve as useful adjuncts for pretreatment risk assessment and association with disease severity. However, owing to the cross-sectional design, their causal, prognostic or predictive utility cannot be established from the present study.