Prognostic importance of baseline neutrophil to lymphocyte ratio in patients with advanced papillary thyroid carcinomas

Abstract

Inflammation is associated with several tumor development and progression. However, these associations are not clear in well-differentiated thyroid carcinomas. We assessed whether NLR is a useful prognostic marker in patients with papillary thyroid carcinomas (PTC). The medical records of all patients who underwent thyroid surgery at a single institution between March 2005 and September 2012 were retrospectively evaluated; as a control group, patients who underwent routine health examinations in 2012 were also evaluated. Differences in mean NLR among patient groups were assessed, and clinical characteristics according to NLR quartile were evaluated in patients with PTC. The association between NLR and disease-free survival (DFS) in PTC patients was determined. NLR was significantly higher in the groups with than without thyroid nodules, but did not differ significantly in patients with benign and malignant thyroid nodules. Mean NLR was significantly higher in patients with solid or mixed thyroid than in patients with cystic nodules (1.75 ± 0.92 vs. 1.65 ± 0.74, p = 0.004). Patient follow-up ranged from 6 to 99 months. At 5-year follow-up, 11 patients had disease-specific events. We found that 5-year DFS rate was significantly worse in stages III and IV patients with NLR ≥1.5 than NLR <1.5 (94.1 vs. 99.3 %, p = 0.013). The univariate Cox hazard proportional hazard model for DFS revealed that higher NLR was independently correlated with poorer prognosis (hazard ratio 8.76; 95 % confidence interval 1.09-70.27, p = 0.041). Higher NLR may be a negative prognostic marker for DFS in patients with PTC, especially those with stages III and IV.

Elevated NLR in gallbladder cancer and cholangiocarcinoma – making bad cancers even worse: results from the US Extrahepatic Biliary Malignancy Consortium

“…This finding is consistent with other smaller studies demonstrating that elevated NLR portends poor prognosis in solid tumor malignancies. [1][2][3][4][5][6][7][8][9][10][11][12][13] Other studies in patients with hepato-pancreato-biliary (HPB) cancers agree with the findings presented in this paper. In a study of 452 patients who underwent a HPB procedure for malignant disease, NLR >5 was found to be associated with worse OS.…”

“…Elevated NLR is independently associated with worse outcomes in cancers of the breast, 1,2 thyroid, 3 colon, 4 stomach, 5 prostate, 6 lung, 7 adrenal, 8 pancreas 9,10 urogenital tract, 11 esophagus 12 and in glioblastoma, 13 as well as hematologic cancers, including multiple myeloma 14 and diffuse large B-cell lymphoma. 15 According to a recent systematic review and meta-analysis including 100 studies and greater than 40,000 patients, high NLR is associated with adverse overall survival (OS) in many solid tumors.…”

Neutrophil to Lymphocyte Ratio - Not an Independent Prognostic Factor in Patients with the Myelodysplastic Syndrome

“…A high preoperative or pretreatment NLR was identified as an independent prognostic factor associated with poor survival in various cancers, including breast cancer, colon cancer, lung cancer, and mesothelioma (He et al, 2014;Kemal et al, 2014). The pathogenesis and progression of the disease may be correlated to ovarian cancer; prognosis was found to be correlated with tumour volume in metastatic renal cell carcinoma, and there are reports that NLR may be a negative prognostic marker in thyroid carcinoma (Kim et al, 2013). In diffuse large B cell lymphoma cases, high NLR is considered as a poor prognostic factor.…”

Neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) may be superior to C-reactive protein (CRP) for predicting the occurrence of differentiated thyroid cancer

“…Platelet to lymphocyte ratio (PLR) is a novel marker. Platelet counts as an infl ammation marker and is involved in the progress of tumor invasion (Kim et al 2014). Th ese markers can be easily, inexpensively, and reproducibly assayed, enhancing the ability to evaluate the prognosis in the cancer patients.…”

“…Th ey have found that NLR is signifi cantly higher with large sized tumors. Kim et al (2014) have reported the associations of NLR with disease-free and overall survival. Th ey have found out that higher NLR was a negative prognostic marker for disease-free survival.…”