Elevated densities of TANs, particularly CD15<sup>+</sup> and CXCR4<sup>+</sup> subsets, were linked to poorer cancer-specific survival and OS, respectively.<h4>Conclusion</h4>This meta-analysis indicates that elevated pretreatment NLR, particularly above four, may serve as a significant prognostic marker of poor survival outcomes in patients with HNSCC. This evidence concerns the gene CXCR4 and head and neck squamous cell carcinoma.