Temporary changes in neutrophil-to-lymphocyte, platelet-to-lymphocyte ratios, and mean platelet volume reflecting the inflammatory process after radioiodine therapy

Demir, Yusuf; Üçler, Rıfkı; Sürücü, Erdem; Turan, Mahfuz; Balli, Zekeriya; Şengöz, Tarık

doi:10.1097/mnm.0000000000000452

Cited by 12 publications

(9 citation statements)

References 31 publications

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“…Although increased IL-10 downmodulates immune responses against malignant cells, it may also prevent metastases by reducing inflammation. Our results, however, are inconsistent with findings reported by Demir et al, who observed some cellular evidence of increased systemic inflammation 2 months after RAI ablation with 100 or 150 mCi in patients with DTC [34]. We also observed significant reductions in IL-17F and IL-21 levels 1 week after intermediate-dose RAI ablation in our patients (G1: Fig.…”

Section: Discussioncontrasting

confidence: 93%

Prophylactic and therapeutic immunomodulatory effects of omega-3 fatty acids in patients with differentiated thyroid cancer scheduled for radioiodine ablation

Amirkhani

Alavi

Kalani

et al. 2020

Preprint

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Radioactive iodine (RAI)-induced thyrocyte destruction may lead to uncontrolled inflammation. This study was designed to evaluate the prophylactic and therapeutic immunomodulatory effects of omega-3 fatty acids in patients with differentiated thyroid cancer scheduled for RAI ablation. A total of 85 patients were divided into two groups based on radioiodine dosage after thyroidectomy: high-dose with 150 mCi and intermediate-dose with 100 mCi. Then patients in each group were randomly divided into three subgroups: G1 with RAI ablation only, G2 treated with omega-3 for 30 days before RAI ablation, and G3 treated with omega-3 for 30 days after RAI ablation. Serum cytokine levels were determined with the cytometric bead assay at different time points. Within-group comparisons showed transient elevation of IL-13 after pretreatment with omega-3, significant reductions in Th1+Th17/Th2+Th22 ratio after high-dose RAI ablation, and decreased Th1+Th17/Th2+Th22 and Th1+Th17/Th2+Th9+Th22 ratios after intermediate-dose RAI ablation in G2. Between-group comparisons showed that IL-10 level in G3 was significantly higher than in G1 1 week after high-dose RAI ablation, whereas Th1+Th17/Th2+Th22 and Th1+Th17/Th2+Th9+Th22 ratios were significantly lower in G3 than G2 1 month after intermediate-dose RAI ablation. However, cytokine changes 1 week and 1 month after RAI ablation when adjusted for baseline values showed no differences among groups. Despite observing within-group changes in some cytokines, we found no real changes attributable to a prophylactic or therapeutic anti-inflammatory effect of omega-3. Because of the specific effect of radioactive iodine on thyroid cells, extensive systemic inflammation may not be induced after RAI ablation.

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Section: Discussioncontrasting

confidence: 93%

Prophylactic and therapeutic immunomodulatory effects of omega-3 fatty acids in patients with differentiated thyroid cancer scheduled for radioiodine ablation

Amirkhani

Alavi

Kalani

et al. 2020

Preprint

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“…As such, one would expect a rise in NLR following RAI therapy. In this respect, Demir and collaborators demonstrated that the NLR level significantly increased two months after RAI and returned nearly to baseline by six months after RAI 34. The timing of obtaining the follow-up NLR data in this study was 6 to 18 months post treatment and prior to TSH stimulation to verify the absence of disease.…”

Section: Discussionmentioning

confidence: 80%

An Increased Neutrophil-to-Lymphocyte Ratio Predicts Incomplete Response to Therapy in Differentiated Thyroid Cancer

Lee¹,

Yang²,

Chien³

et al. 2018

Int. J. Med. Sci.

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Background: Previously we have shown that an elevated baseline neutrophil-to-lymphocyte ratio (NLR) was associated with a high risk of recurrence in patients with differentiated thyroid cancer. The clinical significance of the longitudinal changes in NLR following treatment remained unestablished.Methods: Adults patients with differentiated thyroid cancer were included in the study if the follow-up NLR data at 6 to 18 months after initial treatment were available. The response to treatment was categorized as excellent, indeterminate, biochemical incomplete, and structural incomplete as per guidelines of the American Thyroid Association.Results: Among 151 patients with thyroid cancer, a significant decrease in NLR following treatment was observed in those with stage I disease, those with low risk of recurrence, and those with an excellent response to therapy. Patients with a structural incomplete response had a significant increase in NLR at follow-up (p = 0.012). On multivariate analysis, incomplete response to therapy was associated with male sex (odds ratio [OR] = 3.35), tumor size (OR = 1.63), lymph node metastasis (OR = 4.80), distant metastasis (OR = 12.95), and increased NLR (OR = 13.68).Conclusions: An increase in systemic inflammation following treatment as measured by NLR is independently associated with an incomplete response to therapy in differentiated thyroid cancer.

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“…Demir et al examined the changes in inflammatory markers after RAI treatment in patients with DTC over time using RAI treatment, non-RAI treatment, and healthy subject groups; NLR was found to increase significantly 2 months after RAI. Although NLR subsequently and comparatively decreased, it remained high, and this change was reportedly due to systemic inflammation caused by RAI ablation to residual thyroid tissue ( 16 ). Furthermore, Kutluturk et al observed blood-cell count variability due to thyroid hormone fluctuations in patients during RAI treatment and reported no statistical difference due to thyroid hormone fluctuations ( 33 ).…”

Section: Discussionmentioning

confidence: 99%

“…Neutrophil-to-lymphocyte ratio (NLR), one of the indicators of inflammation and immunology, is easily measured via peripheral blood sampling and is reportedly useful as a prognosis index of various types of cancer ( 12 , 13 , 14 , 15 ). Several studies have investigated the role of NLR in thyroid cancer, and reports evaluating changes in inflammatory markers and blood-cell count due to RAI treatment exist, but no reports of studies on the correlation between NLR and prognosis in patients with RAI-avid lung metastasis were found ( 16 , 17 ). This study aimed to determine the clinical prognostic factors, including NLR, in RAI-avid lung metastasis cases and to attempt risk classification to identify future cases for TKI therapy.…”

Section: Introductionmentioning

confidence: 99%

Risk stratification in differentiated thyroid cancer with RAI-avid lung metastases

Ohkuwa

Sugino

Nagahama

et al. 2021

Endocrine Connections

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Objective: Radioactive iodine (RAI) therapy is effective for differentiated thyroid cancer (DTC) patients with lung metastasis. However, some patients have poor prognosis despite the RAI accumulation. The utility of inflammatory biomarkers, including neutrophil-to-lymphocyte ratio (NLR), has been reported as a prognostic factor for many carcinomas. This study aimed to investigate the risk factors related to DTC patient survival with RAI-avid lung metastasis and to attempt risk stratification. Design and methods: This retrospective study included 123 patients with RAI-accumulating lung metastatic DTC. The cause-specific survival (CSS) rate from the time of detection of lung metastasis was tested using the Kaplan–Meier log-rank test, and the multivariate analysis was calculated using the Cox proportional hazards model. NLR was retrospectively calculated using the blood sample collected before initial RAI treatment. The NLR cutoff value was 2.6 on the ROC curve. Results: Age ≥55 years at time of operative treatment, follicular carcinoma, lung metastasis tumor ≥10 mm in diameter, age ≥55 years at the time of detection of lung metastasis, age ≥55 years at the time of RAI treatment, and NLR ≥2.6 at the initial RAI treatment were predictive of decreased CSS. Multivariate analysis identified that the independent prognostic factors were lung metastatic tumor ≥10 mm in diameter and NLR ≥2.6. Patients in the high-risk group with both factors had significantly lower CSS rates than those in the low- and intermediate-risk groups with one or none of these factors. Conclusions: The high-risk group patients had significantly poorer survival, and these patients could be considered as future candidates for tyrosine kinase inhibitor therapy.

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Temporary changes in neutrophil-to-lymphocyte, platelet-to-lymphocyte ratios, and mean platelet volume reflecting the inflammatory process after radioiodine therapy

Abstract: This is the first study to evaluate changes in NLR, PLR, and MPV after RAI therapy. Our findings suggest that NLR, PLR, and MPV changes indicate systemic inflammation that occurs after RAI therapy because of thyroid remnant tissue ablation.

Cited by 12 publications

References 31 publications

Prophylactic and therapeutic immunomodulatory effects of omega-3 fatty acids in patients with differentiated thyroid cancer scheduled for radioiodine ablation

Prophylactic and therapeutic immunomodulatory effects of omega-3 fatty acids in patients with differentiated thyroid cancer scheduled for radioiodine ablation

An Increased Neutrophil-to-Lymphocyte Ratio Predicts Incomplete Response to Therapy in Differentiated Thyroid Cancer

Risk stratification in differentiated thyroid cancer with RAI-avid lung metastases

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