- Volume 16 Issue 9
DOI QR Code
May the Neutrophil/Lymphocyte Ratio Be a Predictor in the Differentiation of Different Thyroid Disorders?
- Kocer, Derya (Clinical Biochemistry, Training and Research Hospital) ;
- Karakukcu, Cigdem (Clinical Biochemistry, Training and Research Hospital) ;
- Karaman, Hatice (Clinical Pathology, Training and Research Hospital) ;
- Gokay, Ferhat (Endocrinology and Metabolism, Training and Research Hospital) ;
- Bayram, Fahri (Endocrinology and Metabolism, Erciyes University, Faculty of Medicine)
- Published : 2015.05.18
Background: The neutrophil/lymphocyte ratio (NLR) is a simple index of systemic inflammatory response, and has been shown to be a prognostic indicator in some types of cancer. Inflammation has been implicated in the initiation and progression of thyroid cancer. The aim of this study was to examine the relationship of NLR with papillary thyroid cancer (PTC) and different benign thyroid pathologies like multinodular goiter (MNG) and lymphocytic thyroiditis (LT). Materials and Methods: We retrospectively evaluated the neutrophil, lymphocyte counts and NLR calculated from these parameters of 232 patients with histologically confirmed as multinodular goiter (group MNG) (n=70), lymphocytic thyroiditis (group LT) (n=97), LT with PTC (group LT-PTC) (n=25) and PTC (group PTC) (n=40). The optimal cut-off value for NLR was determined. Results: NLR level was significantly higher in groups LT-PTC and PTC as compared to groups MNG and LT (p<0.05). NLR of LT subgroups according to TSH levels were not different (p>0.05). When we grouped the patients as benign and malignant according to PTC presence, the optimum NLR cut-off point obtained from ROC analysis was 1.91 (sensitivity 89.0% and specificity 54.5%). Conclusions: Since NLR was significantly elevated in group LT-PTC and group PTC, NLR value may give an opinion as a potential marker in differentiation of benign and malign thyroid disorders. For this purpose a cut-off value of 1.91 for NLR may be accepted.
- Avanzas P, Quiles J, Lopez de Sa E, et al (2004). Neutrophil count and infarct size in patients with acute myocardial infarction. Int J Cardiol, 97, 155-6. https://doi.org/10.1016/j.ijcard.2003.06.028
- Baykan H, Cihan YB, Ozyurt K (2015). Roles of white blood cells and subtypes as inflammatory markers in skin cancer. Asian Pac J Cancer Prev, 16, 2303-6. https://doi.org/10.7314/APJCP.2015.16.6.2303
- Cipolla C, Sandonato L, Graceffa G, et al (2005). Hashimoto thyroiditis coexistent with papillary thyroid carcinoma. Am Surg, 71, 874-8.
- Coussens LM, Werb Z (2002). Inflammation and cancer. Nature, 420, 860-7. https://doi.org/10.1038/nature01322
- Cunha LL, Ferreira RC, Marcello MA, Vassallo J, Ward LS (2011). Clinical and pathological implications of concurrent autoimmune thyroid disorders and papillary thyroid cancer. J Thyroid Res, 1, 1-13.
- DeVita VT, Hellman JS, Rosenberg SA (2008). Cancer: Principles and Practice of Oncology. Philadelphia, Pa: Lippincott Williams and Wilkins, pp. 1674-99.
- Duzlu M, Karamert R, Tutar H, et al (2015). Neutrophil-lymphocyte ratio findings and larynx carcinoma: a preliminary study in Turkey. Asian Pac J Cancer Prev, 16, 351-4. https://doi.org/10.7314/APJCP.2015.16.1.351
- Gandolfi PP, Frisina A, Raffa M, et al (2004). The incidence of thyroid carcinoma in multinodular goiter: retrospective analysis. Acta Biomed, 75, 114-7.
- Guzel AI, Kokanali MK, Erkilinc S, et al (2014). Predictive role of the neutrophil lymphocyte ratio for invasion with gestational trophoblastic disease. Asian Pac J Cancer Prev, 15, 4203-6. https://doi.org/10.7314/APJCP.2014.15.10.4203
- He WZ, Jiang C, Yin CX, et al (2014). Prognostic model built on blood-based biomarkers in patients with metastatic colorectal cancer. Asian Pac J Cancer Prev, 15, 7327-31. https://doi.org/10.7314/APJCP.2014.15.17.7327
- Karaman H, Karaman A, Erden A, et al (2013). Relationship between colonic polyp type and the neutrophil/ lymphocyte ratio as a biomarker. Asian Pac J Cancer Prev, 14, 3159-61. https://doi.org/10.7314/APJCP.2013.14.5.3159
- Kum RO, Ozcan M, Baklaci D, et al (2014). Elevated neutrophil-to-lymphocyte ratio in squamous cell carcinoma of larynx compared to benign and precancerous laryngeal lesions. Asian Pac J Cancer Prev, 15, 7351-5. https://doi.org/10.7314/APJCP.2014.15.17.7351
- Liu CL, Lee JJ, Liu TP, et al (2013). Blood neutrophil-to-lymphocyte ratio correlates with tumor size in patients with differentiated thyroid cancer. J Surg Oncol, 107, 493-7. https://doi.org/10.1002/jso.23270
- Lloyd RV, Buehler D, Khanafshar E (2011). Papillary thyroid carcinoma variants. Head Neck Pathol, 5, 51-6. https://doi.org/10.1007/s12105-010-0236-9
- Luo J, McManus C, Chen H, Sippel RS (2012). Are there predictors of malignancy in patients with multinodular goiter? J Surg Res, 174, 207-10. https://doi.org/10.1016/j.jss.2011.11.1035
- Ommen SR, Hodge DO, Rodeheffer RJ, et al (1998). Predictive power of the relative lymphocyte concentration in patients with advanced heart failure. Circulation, 97, 19-22. https://doi.org/10.1161/01.CIR.97.1.19
- Ozaksit G, Tokmak A, Kalkan H, Yesilyurt H (2015). Value of the platelet to lymphocyte ratio in the diagnosis of ovarian neoplasms in adolescents. Asian Pac J Cancer Prev, 16, 2037-41. https://doi.org/10.7314/APJCP.2015.16.5.2037
- Ozyalvacli G, Yesil C, Kargi E, Kizildag B, Kilitci A, Yilmaz F (2014). Diagnostic and prognostic importance of the neutrophil lymphocyte ratio in breast cancer. Asian Pac J Cancer Prev, 15, 10363-6.
- Pinchera A, Aghini-Lombardi F, Antonangeli L, Vitti P (1996). Multinodular goiter. Epidemiology and prevention. Ann Ital Chir, 67, 317-25.
- Polyzos SA, Kita M, Avramidis A (2007). Thyroid nodules-stepwise diagnosis and management. Hormones 6, 101-19. https://doi.org/10.14310/horm.2002.111107
- Rios A, Rodriguez JM, Galindo PJ, et al (2004). Utility of fine-needle aspiration for diagnosis of carcinoma associated with multinodular goitre. Clin Endocrinol (Oxf), 61, 732-7. https://doi.org/10.1111/j.1365-2265.2004.02157.x
- Singh B, Shaha AR, Trivedi H, Carew JF, Poluri A, Shah JP (1999). Coexistent Hashimoto's thyroiditis with papillary thyroid carcinoma: impact on presentation, management, and outcome. Surgery, 126, 1070-6. https://doi.org/10.1067/msy.2099.101431
- Tamimi DM (2002). The association between chronic lymphocytic thyroiditis and thyroid tumors. Int J Surg Pathol, 10, 141-6. https://doi.org/10.1177/106689690201000207
- Ugolini C, Basolo F, Proietti A, et al (2007). Lymphocyte and immature dendritic cell infiltrates in differentiated, poorly differentiated, and undifferentiated thyroid carcinoma. Thyroid, 17, 389-93. https://doi.org/10.1089/thy.2006.0306
- Vassilatou E, Fisfis M, Morphopoulos G, et al (2006). Papillary thyroid carcinoma producing granulocyte-macrophage colony-stimulating factor is associated with neutrophilia and eosinophilia. Hormones (Athens), 5, 303-9. https://doi.org/10.14310/horm.2002.11196
- Wenger FA, Jacohi CA, Zieren J, et al (1999). Tumor size and lymph-node status in pancreatic carcinoma is there a correlation to the preoperative immune function? Langenbecks Arch Surg, 384, 473-8. https://doi.org/10.1007/s004230050233
- Yildirim MA, Seckin KD, Togrul C, et al (2014). Roles of neutrophil/lymphocyte and platelet/lymphocyte ratios in the early diagnosis of malignant ovarian masses. Asian Pac J Cancer Prev, 15, 6881-5. https://doi.org/10.7314/APJCP.2014.15.16.6881
- Lack of Variation in Inflammatory Hematological Parameters between Benign Nodular Goiter and Papillary Thyroid Cancer vol.17, pp.4, 2016, https://doi.org/10.7314/APJCP.2016.17.4.2321
- Association between neutrophil-to-lymphocyte ratio and differentiated thyroid cancer: a meta-analysis vol.6, pp.1, 2016, https://doi.org/10.1038/srep38551
- Association of Baseline Neutrophil-to-Lymphocyte Ratio with Clinicopathological Characteristics of Papillary Thyroid Carcinoma vol.2017, pp.1687-8345, 2017, https://doi.org/10.1155/2017/8471235
- Trends in white blood cell and platelet indices in a comparison of patients with papillary thyroid carcinoma and multinodular goiter do not permit differentiation between the conditions vol.42, pp.4, 2017, https://doi.org/10.1080/07435800.2017.1319859
- Association of the preoperative neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios with lymph node metastasis and recurrence in patients with medullary thyroid carcinoma vol.95, pp.40, 2016, https://doi.org/10.1097/MD.0000000000005079
- Evaluation of Hemocytometer Parameters as Potential Biomarkers in Benign Multinodular Goiter and Papillary Thyroid Carcinoma vol.19, pp.12, 2017, https://doi.org/10.5812/ircmj.58295
- Assessment of clinical and pathological features of patients who underwent thyroid surgery: A retrospective clinical study vol.6, pp.3, 2018, https://doi.org/10.12998/wjcc.v6.i3.20
- Diagnostic Accuracy of Preoperative Neutrophil-to-Lymphocyte and Platelet-to-Lymphocyte Ratios in Detecting Occult Papillary Thyroid Microcarcinomas in Benign Multinodular Goitres vol.2018, pp.2042-0072, 2018, https://doi.org/10.1155/2018/3470429
- CD58; leucocyte function adhesion-3 (LFA-3) could be used as a differentiating marker between immune and non-immune thyroid disorders vol.27, pp.3, 2018, https://doi.org/10.1007/s00580-018-2657-x