Inflammation Markers Have Important Value in Predicting Relapse in Patients with papillary thyroid carcinoma: A Long-Term Follow-Up Retrospective Study

Abstract

Purpose Many markers of inflammation are increasingly found to have prognostic significance in some cancers. This study investigated the prognostic value of albumin/globulin (AGR), lymphocyte/monocyte ratio (LMR), and other inflammatory markers, including neutrophil/lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR), in patients with papillary thyroid carcinoma (PTC). Methods We retrospectively analyzed the data of 764 patients newly diagnosed with PTC (608 women, 156 men) aged 10-83 years. Univariate and multivariate analyses were used to analyze recurrence rates and assess potential prognostic factors. Furthermore, we used random survival forests to construct a random survival forest score (RSFscore). The correlations between various inflammatory factors and traditional prognostic factors were analyzed. We also compared the areas under the curve (AUCs) of the RSFscore and 4 inflammation-based markers. Results AGR, NLR, PLR, and LMR were strongly associated with invasive clinicopathological features (tumor size, lesions, lymph node metastasis, and lymph node metastasis rate) and postoperative recurrence. In the multivariate analysis, AGR and LMR were independent prognostic markers for recurrent PTC. Higher NLR and PLR values indicated a higher risk of recurrence, while higher LMR and AGR values suggested a lower recurrence risk. The predictive power of the combined indicators was stronger than that of single indicators alone. Conclusion Compared to the analysis of a single indicator, the combination of inflammatory markers was more helpful in determining the risk of PTC recurrence, which has an important impact on predicting patients’ cancer-free survival and quality of life.

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

“…Several previous research reports also confirmed our similar conclusion. 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.…”

Androgen Receptor Activation Induces Senescence in Thyroid Cancer Cells

“…Inflammation is a well-established risk factor for many malignancies, and there are sex differences in thyroid inflammation that begin around puberty [ 78 ]. Thyroid inflammation due to autoimmune disorders is more common in women, and several studies have demonstrated that women with these disorders have an increased risk of thyroid cancer [ 79 , 80 ]. With that, investigations into the role of sex hormones in inflammation and the role of AR activation have uncovered mechanisms, including the inhibition of NFKB activation, and the suppression of T cells, macrophages, neutrophils, and natural killer cells, and hence, a reduction in inflammatory cytokine production [ 81 , 82 , 83 , 84 ].…”

Role of Inflammatory Biomarkers (NLR, LMR, PLR) in the Prognostication of Malignancy in Indeterminate Thyroid Nodules

“…Because of the factors related to malignancy, the host immune system may be tightly involved in tumorigenesis, so suppressing the immune response is required to stop the development of the neoplasm. Recently, several systemic inflammatory markers, such as the neutrophil-to-lymphocyte ratio (NLR), the platelet-to-lymphocyte ratio (PLR) and the lymphocyte-to-monocyte ratio (LMR), have been considered predictive and prognostic factors for lung cancer, colorectal cancer, pancreatic cancer, breast cancer and, at least partially, for thyroid cancer [ 10 , 11 ]. In PTC, the predictive value of NLR has not yet been fully investigated.…”

“…In PTC, the predictive value of NLR has not yet been fully investigated. Therefore, the incorporation of the NLR into a prognostic and predictive model might improve the stratification and management of indeterminate risk patients [ 10 , 11 ].…”