Predictive values of the selected inflammatory index in elderly patients with papillary thyroid cancer

Abstract

BackgroundThe American Joint Committee on Cancer has recently revised the tumor-node-metastasis (TNM) staging system on thyroid cancer, which illustrated that the cut-off age for predicting mortality has elevated from 45 to 55 years old. We aimed to investigate the inflammation index based on hematological parameters to predict the clinical characteristics of elderly papillary thyroid cancer (PTC) patients with an inferior prognosis.MethodsWe retrospectively analyzed 558 patients newly diagnosed with PTC from January 2013 to December 2017, and 82 out of the 558 patients were over 55 years old. Receiver operating characteristic (ROC) study and univariate and multivariate logistic analysis was conducted to evaluate the diagnostic value of these preoperative inflammation indexes in PTC patients ≥ 55 years of age.ResultsElevated neutrophils were prognostic of bilaterality (area under the ROC curve (AUC) = 0.673, p = 0.023) and lymph node metastasis (AUC = 0.649, p = 0·020). Decreased mean platelet volume (MPV) and platelet distribution width (PDW) were prognostic of coexistence with Hashimoto’s thyroiditis (AUC = 0.736, p = 0.016; AUC = 0.721, p = 0.024). Elevated lymphocyte and lymphocyte-to-monocyte ratio (LMR) were prognostic of advanced TNM stage (AUC = 0.691, p = 0.029; AUC = 0.680, p = 0.040). Meanwhile, the logistic regression model further revealed that LMR ≥ 5.45 was an independent risk factor for the advanced TNM stage (odds ratio (OR) = 7.306, p = 0.036).ConclusionsThe preoperative neutrophils, lymphocytes, MPV, PDW, LMR were all prognostic. More importantly, the increased in LMR independently contributed to the advanced TNM stage of PTC patients ≥ 55 years.Electronic supplementary materialThe online version of this article (10.1186/s12967-018-1636-y) contains supplementary material, which is available to authorized users.

Diagnostic value of modified systemic inflammation score for prediction of malignancy in patients with indeterminate thyroid nodules

“…Benign However, in contrast to this study, another report revealed an independent relationship between increased LMR levels and advanced TNM stages in elderly patients (!55 years). 18 Although many studies confirm the association of low ALB levels with TC, the existence of contradictory results related to other biomarkers of inflammation emphasizes that the role of inflammation in cancer development is more complicated than we anticipate. The present study has several limitations.…”

The systemic immune-inflammation index-based model is an effective biomarker on predicting central lymph node metastasis in clinically nodal-negative papillary thyroid carcinoma

“…There were also some studies showing that PTC patients with a lower LMR had a poorer prognosis and a higher risk of recurrence (19)(20)(21). Besides, advanced tumor stage of PTC was found to be associated with a higher NLR and a lower LMR (22)(23)(24). However, few studies investigated the associations between these biomarkers and CLNM in cN0 PTC patients.…”

Immune cell confrontation in the papillary thyroid carcinoma microenvironment

“…The proportion of immune cells in the TME was further tilted towards tumor-promoting immune cells. Previous mainstream studies have shown that TAMs, DCs, MCs, neutrophils, and Tregs are positively correlated with PTC progression [23,32,33,[36][37][38][41][42][43][44][45][46][47][48][49][50][51][52][53], and B cells, CD8 + T cells, NK cells, and iDCs are negatively correlated with PTC progression [49,50,[54][55][56][57][58][59]. Unlike previous studies, our research found that both the abundance and proportion of tumor-promoting immune cells were positively correlated with PTC progression, while the proportion of antitumor immune cells during the progression of PTC decreased (CIBERSORT), and the abundance increased (ssGSEA) or did not signi cantly change (immune cell marker).…”