The diagnostic predictive value of neutrophil-to-lymphocyte ratio in thyroid cancer adjusted for tumor size

PLoS One. 2021 May 11;16(5):e0251446. doi: 10.1371/journal.pone.0251446. eCollection 2021.

Abstract

The role of systemic inflammation has not been clearly defined in thyroid cancers. There have been conflicting reports on whether systemic inflammatory markers have predictive value for thyroid cancers. We aimed to evaluate the association between systemic inflammatory markers and clinicopathological factors in thyroid cancers and to assess their predictive value for thyroid cancers in detail. Five hundred thirty-one patients who underwent surgery for thyroid nodules were included. The patient population consisted of 99 individuals (18.6%) with benign thyroid nodules and 432 individuals (81.4%) with thyroid cancers. In 432 patients with thyroid cancers, neutrophil-to-lymphocyte ratio (NLR) was significantly higher in the cases with tumors greater than 2 cm than in those with tumors less than 2 cm. (p = 0.027). NLR and platelet-to-lymphocyte ratio (PLR) were significantly higher in cases with lateral lymph node metastasis (LNM) than in those without LNM (p = 0.007 and 0.090, respectively). The nodule size was significantly higher in benign thyroid nodules than in thyroid cancers (p < 0.001). When the cases were stratified by tumor size, NLR was a significant predictor of thyroid cancers in cases with nodules greater than 2 cm (Exp(B) = 1.85, 95% CI = 1.15-2.97, p = 0.011), but not in those with nodules less than 2 cm. In thyroid cancers, preoperative NLR was associated with pathological prognosticators such as tumor size and lateral lymph node metastasis. When the size difference between thyroid cancers and benign thyroid nodules was adjusted, NLR could be a significant predictor of thyroid cancers.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adenocarcinoma, Follicular / blood
  • Adenocarcinoma, Follicular / diagnosis*
  • Adenocarcinoma, Follicular / immunology
  • Adenocarcinoma, Follicular / pathology
  • Adult
  • Carcinoma, Papillary / blood
  • Carcinoma, Papillary / diagnosis*
  • Carcinoma, Papillary / immunology
  • Carcinoma, Papillary / pathology
  • Diagnosis, Differential
  • Female
  • Humans
  • Inflammation
  • Leukocyte Count*
  • Lymphatic Metastasis
  • Lymphocyte Count
  • Male
  • Middle Aged
  • Neutrophils
  • Platelet Count
  • Predictive Value of Tests
  • Prognosis
  • Retrospective Studies
  • Selection Bias
  • Thyroid Neoplasms / blood
  • Thyroid Neoplasms / diagnosis*
  • Thyroid Neoplasms / immunology
  • Thyroid Neoplasms / pathology
  • Thyroid Nodule / pathology
  • Thyroid Nodule / surgery
  • Thyroiditis / blood
  • Tumor Burden

Grants and funding

This work was supported by the 2019 Inje University research grant. (No.20190051).