Usefulness of pre-thyroidectomy neutrophil–lymphocyte, platelet–lymphocyte, and monocyte–lymphocyte ratios for discriminating lymph node and distant metastases in differentiated thyroid cancer

Abstract

This study aimed to analyze the relationship of neutrophil-lymphocyte ratio (NLR), plateletlymphocyte ratio (PLR), and monocyte-lymphocyte ratio (MLR) with clinicopathological characteristics of patients with differentiated thyroid cancer (DTC). METHODS: This retrospective study included 390 patients with DTC who had complete blood cell counts available at the time of surgery. NLR, PLR, and MLR were calculated, and the risk of cancer-related death, structural recurrence, and response to therapy were assessed using the eighth edition of the tumor-nodemetastasis classification, American Thyroid Association (ATA) Risk Stratification System, and ATA Response to Therapy Reclassification, respectively. RESULTS: PLR was higher in patients with distant metastasis than in those without (133.15 ± 43.95 versus 119.24 ± 45.69, p=0.0345) and lower in patients with disease-free status (117.72±44.70 versus 131.07±47.85, p=0.0089) than in those who experienced persistent disease or death. Patients aged X55 years had a higher MLR than those aged o55 years (0.26 ± 0.10 versus 0.24 ± 0.12, p=0.0379). Higher MLR (odds ratio [OR]: 8.775, 95% confidence interval [CI]: 1.532-50.273, p=0.0147), intermediate ATA risk (OR: 4.892, 95% CI: 2.492-9.605, pp0.0001), and high ATA risk (OR: 5.998, 95% CI: 3.126-11.505, pp0.0001) were risk factors associated with active disease. NLR was not significantly different among the studied variables. Receiver operating characteristic curve cut-off values for NLR, PLR, and MLR were able to differentiate distant metastasis from lymph node metastasis (NLR41.93: 73.3% sensitivity and 58.7% specificity, PLR4124.34: 86.7% sensitivity and 69.2% specificity, MLR40.21: 80% sensitivity and 45.2% specificity). CONCLUSION: Cut-off values of NLR, PLR, and MLR differentiated distant metastasis from lymph node metastasis with good sensitivity and accuracy. PLR was associated with disease-free status and it was higher in DTC patients with distant metastasis, persistent disease, and disease-related death. MLR was a risk factor for active disease.

Construction and validation of a novel prognostic model for thyroid cancer based on N7-methylguanosine modification-related lncRNAs

“…A higher relative ratio of monocytes in THCA patients tends to be associated with a higher risk of postoperative recurrence, [ 45 ] and the relative ratio is also higher in THCA patients with lymph node and distant metastases. [ 46 ] Gogali F et al [ 47 ] found higher NK cell infiltration levels in papillary thyroid carcinoma (PTC) tissues, and NK cell infiltration levels were positively correlated with PTC clinical stage. In addition, vascular endothelial growth factor (VEGF) produced by tumor cells can effectively stimulate endothelial cell proliferation and angiogenesis, and plays a key role in the pathophysiology of THCA.…”

Association between Posttreatment Serum Platelet-to-Lymphocyte Ratio and Distant Metastases in Patients with Hepatocellular Carcinoma Receiving Curative Radiation Therapy

“…In the present study, the highest Post-PLR (Post-PLR-H) was the significant parameter associated with DM and an independent prognostic factor of DC rates. The association between a high PLR and poor prognosis has been demonstrated in several types of solid tumors [ 20 , 22 , 25 , 29 , 30 , 31 , 32 , 33 , 35 , 36 , 54 ]. However, treatment types, including immunotherapy, chemotherapy, RT, or surgery, varied among studies, and the majority of the studies focused on the pretreatment value of PLR.…”

“…However, treatment types, including immunotherapy, chemotherapy, RT, or surgery, varied among studies, and the majority of the studies focused on the pretreatment value of PLR. Very recently, a relationship between high PLR and distant organ metastasis in various types of cancers including breast, esophageal, hepatocellular, prostate, and thyroid cancer has been reported [ 32 , 33 , 34 , 35 , 55 ]. Our study results also support this theory of a robust role of PLR in the development of DM.…”

“…Recent evidence suggests that a high PLR may be related to early distant recurrence, poor overall survival, and tumor aggressiveness [ 20 , 25 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 ]. Here, we investigated whether serum markers are useful for the prediction of clinical outcomes (especially for DM) in patients with unresectable HCC receiving curative RT in the contemporary era.…”

Multi-Omics and Management of Follicular Carcinoma of the Thyroid

“…The histological subtype, tumour differentiation of the tumour, immunohistochemistry, genomics, epigenomics, metabolomics and the changes in the micro-environment of the tumour also have an influence on the prognosis of WDTC and therefore guide of appropriate treatment [ 26 , 27 , 28 , 41 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 ]. Additional markers that have been found to be useful in the risk stratification of patients with TC include serum Vitamin D and the neutrophil-to-lymphocyte ratio (NLR) [ 52 , 53 ].…”