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Lv X, Lu JJ, Song SM, Hou YR, Hu YJ, Yan Y, Yu T, Ye DM. Prediction of lymph node metastasis in patients with papillary thyroid cancer based on radiomics analysis and intraoperative frozen section analysis: A retrospective study. Clin Otolaryngol 2024; 49:462-474. [PMID: 38622816 DOI: 10.1111/coa.14162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 01/28/2024] [Accepted: 03/24/2024] [Indexed: 04/17/2024]
Abstract
INTRODUCTION To evaluate the diagnostic efficiency among the clinical model, the radiomics model and the nomogram that combined radiomics features, frozen section (FS) analysis and clinical characteristics for the prediction of lymph node (LN) metastasis in patients with papillary thyroid cancer (PTC). METHODS A total of 208 patients were randomly divided into two groups randomly with a proportion of 7:3 for the training groups (n = 146) and the validation groups (n = 62). The Least Absolute Shrinkage and Selection Operator (LASSO) regression was used for the selection of radiomics features extracted from ultrasound (US) images. Univariate and multivariate logistic analyses were used to select predictors associated with the status of LN. The clinical model, radiomics model and nomogram were subsequently established by logistic regression machine learning. The area under the curve (AUC), sensitivity and specificity were used to evaluate the diagnostic performance of the different models. The Delong test was used to compare the AUC of the three models. RESULTS Multivariate analysis indicated that age, size group, Adler grade, ACR score and the psammoma body group were independent predictors of lymph node metastasis (LNM). The results showed that in both the training and validation groups, the nomogram showed better performance than the clinical model, albeit not statistically significant (p > .05), and significantly outperformed the radiomics model (p < .05). However, the nomogram exhibits a slight improvement in sensitivity that could reduce the incidence of false negatives. CONCLUSION We propose that the nomogram holds substantial promise as an effective tool for predicting LNM in patients with PTC.
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Affiliation(s)
- Xin Lv
- Department of Oncology, Yingkou Central Hospital, Yingkou, People's Republic of China
| | - Jing-Jing Lu
- Department of Medical Imaging, Cancer Hospital of China Medical University, Liaoning Cancer Hospital & Institute, Shenyang, People's Republic of China
| | - Si-Meng Song
- Department of Medical Imaging, Cancer Hospital of China Medical University, Liaoning Cancer Hospital & Institute, Shenyang, People's Republic of China
| | - Yi-Ru Hou
- Department of Medical Imaging, Cancer Hospital of China Medical University, Liaoning Cancer Hospital & Institute, Shenyang, People's Republic of China
| | - Yan-Jun Hu
- Department of Medical Imaging, Cancer Hospital of China Medical University, Liaoning Cancer Hospital & Institute, Shenyang, People's Republic of China
| | - Yan Yan
- Department of Medical Imaging, Cancer Hospital of China Medical University, Liaoning Cancer Hospital & Institute, Shenyang, People's Republic of China
| | - Tao Yu
- Department of Medical Imaging, Cancer Hospital of China Medical University, Liaoning Cancer Hospital & Institute, Shenyang, People's Republic of China
| | - Dong-Man Ye
- Department of Medical Imaging, Cancer Hospital of China Medical University, Liaoning Cancer Hospital & Institute, Shenyang, People's Republic of China
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Gu Y, Yu M, Deng J, Lai Y. The Association of Pretreatment Systemic Immune Inflammatory Response Index (SII) and Neutrophil-to-Lymphocyte Ratio (NLR) with Lymph Node Metastasis in Patients with Papillary Thyroid Carcinoma. Int J Gen Med 2024; 17:2887-2897. [PMID: 38974140 PMCID: PMC11225953 DOI: 10.2147/ijgm.s461708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2024] [Accepted: 06/18/2024] [Indexed: 07/09/2024] Open
Abstract
Objective Immunoinflammatory response can participate in the development of cancer. To investigate the relationship between pretreatment systemic immune inflammatory response index (SII), systemic inflammatory response index (SIRI), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR) and lymph node metastasis in patients with papillary thyroid carcinoma (PTC). Methods A retrospective analysis was performed on 547 PTC patients treated in Meizhou People's Hospital from January 2018 to December 2021. Clinicopathological data were collected, including gender, age, Hashimoto's thyroiditis, maximum tumor diameter, extra-membrane infiltration, disease stage, BRAF V600E mutation, pretreatment inflammatory index levels, and lymph node metastasis. The optimal cutoff values of SII, SIRI, NLR, PLR and LMR were calculated by receiver operating characteristic (ROC) curve, and the relationship between inflammatory indexes and other clinicopathological features and lymph node metastasis was analyzed. Results There were 303 (55.4%) PTC patients with lymph node metastasis. The levels of SII, SIRI, NLR, and PLR in patients with lymph node metastasis were significantly higher than those in patients without lymph node metastasis, while the levels of LMR were significantly lower than those in patients without lymph node metastasis (all p<0.05). When lymph node metastasis was taken as the endpoint, the critical value of SII was 625.375, the SIRI cutoff value was 0.705, the NLR cutoff value was 1.915 (all area under the ROC curve >0.6). The results of regression logistic analysis showed that age <55 years old (OR: 1.626, 95% CI: 1.009-2.623, p=0.046), maximum tumor diameter >1cm (OR: 2.681, 95% CI: 1.819-3.952, p<0.001), BRAF V600E mutation (OR: 2.709, 95% CI: 1.542-4.759, p=0.001), SII positive (≥625.375/<625.375, OR: 2.663, 95% CI: 1.560-4.546, p<0.001), and NLR positive (≥1.915/<1.915, OR: 1.808, 95% CI: 1.118-2.923, p=0.016) were independent risk factors for lymph node metastasis of PTC. Conclusion Age <55 years old, maximum tumor diameter >1cm, BRAF V600E mutation, SII positive, and NLR positive were independent risk factors for lymph node metastasis in PTC.
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Affiliation(s)
- Yihua Gu
- Department of Thyroid Surgery, Meizhou People’s Hospital, Meizhou Academy of Medical Sciences, Meizhou, People’s Republic of China
| | - Ming Yu
- Department of Thyroid Surgery, Meizhou People’s Hospital, Meizhou Academy of Medical Sciences, Meizhou, People’s Republic of China
| | - Jiaqin Deng
- Department of Thyroid Surgery, Meizhou People’s Hospital, Meizhou Academy of Medical Sciences, Meizhou, People’s Republic of China
| | - Yeqian Lai
- Department of Thyroid Surgery, Meizhou People’s Hospital, Meizhou Academy of Medical Sciences, Meizhou, People’s Republic of China
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Liu T, Jin Y, Yang X, Tong Z, Dong M. The incidence rate of allergic reactions induced by oxaliplatin is higher in patients with rectal cancer compared with colon cancer. Drug Chem Toxicol 2024; 47:365-371. [PMID: 37246950 DOI: 10.1080/01480545.2023.2217700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 04/13/2023] [Indexed: 05/30/2023]
Abstract
AIM To explore the diverse profiles of adverse reactions caused by oxaliplatin between colon and rectal cancer, we investigated the toxicity of oxaliplatin in patients with colon and rectal cancer. METHODS From January 2017 to December 2021, 200 cases of sporadic CRC patients with adverse reactions after oxaliplatin were collected from Harbin Medical University Cancer Hospital, Harbin, China. All patients received a chemotherapy regimen containing oxaliplatin (100 colon cancer and 100 rectal cancer). We reviewed the adverse reactions induced by oxaliplatin in patients with colon and rectal cancer. RESULTS We found there was no significant difference in gastrointestinal toxicity, hematotoxicity, neurotoxicity, hepatotoxicity, respiratory toxicity, and cardiotoxicity caused by oxaliplatin between patients with colon cancer and patients with rectal cancer, but patients with rectal cancer were more prone to allergic reactions than patients with colon cancer after oxaliplatin. In addition, we found neutrophil-to-lymphocyte ratios (NLR) and platelet-to-lymphocyte ratios (PLR) were higher in patients with colon cancer than in patients with rectal cancer. This may reflect differences in immune status and inflammatory responses between colon cancer and rectal cancer, which might be the reason for more allergic reactions caused by oxaliplatin in colon cancer patients compared to rectal cancer patients. CONCLUSION Except for a higher incidence of allergic reactions in patients with rectal cancer, no significant difference in the incidence of adverse drug reactions associated with oxaliplatin was noted between patients with colon cancer and rectal cancer. Our results suggested more attention should be paid to the allergic reaction caused by oxaliplatin in patients with colon cancer.
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Affiliation(s)
- Tong Liu
- Department of Pharmacy, Harbin Medical University Cancer Hospital, No.150 Haping Rd, Nangang District, Harbin, 150081, P.R. China
| | - Yao Jin
- Department of Pharmacy, Harbin Medical University Cancer Hospital, No.150 Haping Rd, Nangang District, Harbin, 150081, P.R. China
| | - Xu Yang
- Department of Pharmacy, Harbin Medical University Cancer Hospital, No.150 Haping Rd, Nangang District, Harbin, 150081, P.R. China
| | - Zhiqiang Tong
- Department of Pharmacy, Harbin Medical University Cancer Hospital, No.150 Haping Rd, Nangang District, Harbin, 150081, P.R. China
| | - Mei Dong
- Department of Pharmacy, Harbin Medical University Cancer Hospital, No.150 Haping Rd, Nangang District, Harbin, 150081, P.R. China
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Wei L, Wu Y, Bo J, Fu B, Sun M, Zhang Y, Xiong B, Dong J. Dual-Energy Computed Tomography Parameters Combined With Inflammatory Indicators Predict Cervical Lymph Node Metastasis in Papillary Thyroid Cancer. Cancer Control 2024; 31:10732748241262177. [PMID: 38881040 PMCID: PMC11181884 DOI: 10.1177/10732748241262177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2024] [Revised: 05/26/2024] [Accepted: 05/30/2024] [Indexed: 06/18/2024] Open
Abstract
BACKGROUND AND OBJECTIVE Cervical lymph node metastasis (CLNM) is considered a marker of papillar Fethicy thyroid cancer (PTC) progression and has a potential impact on the prognosis of PTC. The purpose of this study was to screen for predictors of CLNM in PTC and to construct a predictive model to guide the surgical approach in patients with PTC. METHODS This is a retrospective study. Preoperative dual-energy computed tomography images of 114 patients with pathologically confirmed PTC between July 2019 and April 2023 were retrospectively analyzed. The dual-energy computed tomography parameters [iodine concentration (IC), normalized iodine concentration (NIC), the slope of energy spectrum curve (λHU)] of the venous stage cancer foci were measured and calculated. The independent influencing factors for predicting CLNM were determined by univariate and multivariate logistic regression analysis, and the prediction models were constructed. The clinical benefits of the model were evaluated using decision curves, calibration curves, and receiver operating characteristic curves. RESULTS The statistical results show that NIC, derived neutrophil-to-lymphocyte ratio (dNLR), prognostic nutritional index (PNI), gender, and tumor diameter were independent predictors of CLNM in PTC. The AUC of the nomogram was .898 (95% CI: .829-.966), and the calibration curve and decision curve showed that the prediction model had good predictive effect and clinical benefit, respectively. CONCLUSION The nomogram constructed based on dual-energy CT parameters and inflammatory prognostic indicators has high clinical value in predicting CLNM in PTC patients.
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Affiliation(s)
- Longyu Wei
- Department of Graduate, Bengbu Medical University, Bengbu, China
| | - Yaoyuan Wu
- Department of Radiology, Anhui Provincial Cancer Hospital, The First Affiliated Hospital of University of Science and Technology of China, Hefei, China
| | - Juan Bo
- Department of Radiology, Anhui Provincial Hospital Affiliated to Anhui Medical University, Hefei, China
| | - Baoyue Fu
- Department of Graduate, Bengbu Medical University, Bengbu, China
| | - Mingjie Sun
- Department of Radiology, Wannan Medical College, Wuhu, China
| | - Yu Zhang
- Department of Radiology, Anhui Provincial Hospital Affiliated to Anhui Medical University, Hefei, China
| | - Baizhu Xiong
- Department of Graduate, Bengbu Medical University, Bengbu, China
| | - Jiangning Dong
- Department of Graduate, Bengbu Medical University, Bengbu, China
- Department of Radiology, Anhui Provincial Cancer Hospital, The First Affiliated Hospital of University of Science and Technology of China, Hefei, China
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Chen E, Zhou D, Deng R. Serum resolvin D1 potentially predicts neurofunctional recovery, the risk of recurrence and death in patients with acute ischemic stroke. Biomed Rep 2024; 20:10. [PMID: 38124765 PMCID: PMC10731167 DOI: 10.3892/br.2023.1698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 10/24/2023] [Indexed: 12/23/2023] Open
Abstract
Resolvin D1 (RvD1) represses inflammation, oxidative damage and neural injury related to acute ischemic stroke (AIS) progression. The present study aimed to explore the association of serum RvD1 with disease features, neurological recovery and prognosis in patients with AIS. A total of 212 patients with newly diagnosed AIS, whose serum RvD1 was quantified at admission and at discharge using an ELISA were enrolled in the current study. The modified Rankin scale (mRS) score was noted at 3 months after patient enrolment (M3), and patients were followed up for a median duration of 11.4 (range, 1.1-21.0) months. The median RvD1 in patients with AIS at admission was 1.07 (range, 0.11-9.29) ng/ml and it was negatively correlated with the neutrophil/lymphocyte ratio (r=-0.160; P=0.009) and C-reactive protein level (r=-0.272; P<0.001), but it was not correlated with comorbidities or other biochemical indexes. RvD1 at admission was lower in patients with mRS >2 at M3 (P=0.001), recurrence (P=0.001) or death (P=0.032) compared with that in patients without the aforementioned characteristics, which had a general ability to estimate mRS >2 at M3 [area under curve (AUC), 0.633], as well as lower risk of recurrence (AUC, 0.745) and death (AUC, 0.757) according to receiver operator characteristic (ROC) curve analyses. The median RvD1 was raised to 1.70 (range, 0.30-16.62) ng/ml at discharge. RvD1 at discharge was able to forecast mRS >2 at M3 (AUC, 0.678) and was able to predict the risk of recurrence (AUC, 0.796) and death (AUC, 0.826) in the ROC curve analyses. Increased serum RvD1 was associated with an attenuated inflammation status, and predicted improved neurological recovery, and lower risk of recurrence and death in patients with AIS. More specifically, its level at discharge exhibits a better prognostic utility than that at admission.
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Affiliation(s)
- Enzhuo Chen
- Department of Neurology, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200336, P.R. China
| | - Dong Zhou
- Department of Organic Chemistry, Shanghai Institute of Organic Chemistry, Chinese Academy of Sciences, Shanghai 200032, P.R. China
| | - Ruoyu Deng
- Health Management, University of Montpellier, Montpellier 34090, France
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Ecin SM, Gezer D. Evaluation of the clinical and prognostic importance of infection parameters in thyroid cancers: A cross-sectional study. Medicine (Baltimore) 2023; 102:e36532. [PMID: 38065882 PMCID: PMC10713110 DOI: 10.1097/md.0000000000036532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 11/17/2023] [Indexed: 12/18/2023] Open
Abstract
Thyroid cancers are among the most common endocrine cancers. An inflammation is associated with many stages of cancer. Therefore, in this study, we aimed to evaluate whether it has a prognostic significance inflammation marker. Neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, monocyte/lymphocyte ratio, systemic inflammation response, systemic immune-inflammation index, and neutrophils to lymphocytes and platelets ratio (N/LP) in patients diagnosed with thyroid cancer in the internal medicine outpatient clinic and operated between March 1, 2017 and May 1, 2022 were evaluated retrospectively. Three hundred forty patients were diagnosed with thyroid cancer; 275 (80.9%) of them were women and the mean age was 44.6 ± 13.5 years. Multifocality (P = .02) was significant in patients with invasion. High N/LP ratio (odds ratio: 1.4, 95% confidence interval: 1.0-2.0, p: 0.003) and high invasion (odds ratio: 0.2, 95% confidence interval: 0.1-0.4, P < .01) was found to be significant in patients with tumor size ≥2 cm. There is a relationship between multifocality and invasion, and the risk of invasion increases as the tumor size increases in thyroid cancer. The N/LP ratio was significant as it could be a new marker in showing the relationship between thyroid cancer and its prognosis. Further studies are needed in which the prognosis is followed up, longer-term, more comprehensive, and confounding factors are excluded.
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Affiliation(s)
- Seval Müzeyyen Ecin
- Unit of Occupational Diseases and Internal Medicine Clinic, Mersin City Training and Research Hospital, Mersin, Turkey
| | - Deniz Gezer
- Unit of Internal Medicine Clinic, Mersin City Training and Research Hospital, Mersin, Turkey
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Malapure SS, Oommen S, Bhushan S, Suresh S, Devaraja K. Association of Neutrophil-to-Lymphocyte Ratio and Lymphocyte-to-Monocyte Ratio with Clinicopathological Features and Short-Term Outcome in Well-Differentiated Thyroid Cancer. Indian J Nucl Med 2023; 38:313-319. [PMID: 38390543 PMCID: PMC10880857 DOI: 10.4103/ijnm.ijnm_35_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Accepted: 03/30/2023] [Indexed: 02/24/2024] Open
Abstract
Purpose of the Study To assess the association of inflammatory markers with known risk factors and short-term outcome of well-differentiated thyroid cancer. Materials and Methods Well-differentiated nonmetastatic thyroid cancer patients diagnosed and treated between September 2015 and December 2019 at Kasturba Hospital, Manipal, India, were retrieved for the study. Patients' presurgical blood parameters were noted, and neurtrophil-to-lymphocyte ratio (NLR) and lymphocyte-to-monocyte ratio (LMR) were calculated. Clinicopathological details along with tumor markers at baseline and at 6 months' follow-up were tabulated. Patients were categorized as complete disease clearance if their clinical examination was normal, stimulated thyroglobulin (Tg) was <1 ng/ml, Anti-thyroglobulin antibodies <65 IU/L or showing a decreasing trend, and follow-up I-131 whole-body scan was negative. The association of the inflammatory markers with known risk factors and short-term outcomes were compared. Results A total of 272 patients were analyzed in the study. The median NLR in our study cohort was 2.55 (mean = 3.96 with standard deviation [SD] =4.20) and the median LMR was 3.72 (mean = 3.79 with SD = 1.94). The disease clearance rate of our study cohort was 73.9%. The median NLR (2.4 vs. 3.1) and LMR (3.13 vs. 3.93) were significantly different among the patients with complete disease clearance and those with persistent disease (P = 0.008 and P = 0.003, respectively). The known risk factors such as multifocality (P = 0.04), tumor size (P = 0.013), lymph node metastases (P = 0.001), and baseline Tg (P ≤ 0.001) were significantly associated with persistent disease at 6 months. The NLR showed a positive correlation and LMR had a negative correlation with the known risk factors, however, the associations were not statistically significant. Conclusions The NLR and LMR are simple yet potential prognostic tools in well-differentiated thyroid cancer.
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Affiliation(s)
- Sumeet Suresh Malapure
- Department of Nuclear Medicine, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Sibi Oommen
- Department of Nuclear Medicine, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Shivanand Bhushan
- Department of Nuclear Medicine, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Sucharitha Suresh
- Department of Community Medicine, Father Muller Medical College, Mangalore, Karnataka, India
| | - K. Devaraja
- Division of Head and Neck Surgery, Department of ORL-HNS Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
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Wang G, Ma Y, Liu Y, Fan Y, Miao X, Zhang Y, Zhu H. Predictive value of systemic inflammatory markers for recurrence of papillary thyroid cancer. J Surg Oncol 2023; 128:743-748. [PMID: 37243870 DOI: 10.1002/jso.27363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 05/06/2023] [Accepted: 05/17/2023] [Indexed: 05/29/2023]
Abstract
BACKGROUND Papillary thyroid cancer (PTC) is the most common type of differentiated thyroid cancer. Early identification of patients at higher risk of recurrence may allow to improve relevant follow-up strategies and plan tailored treatment. Inflammation play an important role in the prognosis of cancer. We aimed to explore the predictive value of systemic inflammatory markers in PTC recurrence. METHODS We retrospectively enrolled 200 consecutive patients who were diagnosed with PTC and underwent curative resection at Lianyungang Oriental Hospital between January 2006 and December 2018. Clinicopathological characteristics, preoperative hematologic results were analyzed. The optimal cutoff values were calculated using x-tile software. The multivariate logistic regression and univariable survival analysis were performed by SPSS. RESULTS Multivariable analysis showed that lymph node metastases (odds ratio [OR] = 2.506, 95% confidence interval [CI]: 1.226-5.119, p = 0.012) and higher monocyte-to-lymphocyte ratio (MLR) (OR = 2.100, 95% CI: 1.042-4.233, p = 0.038) were independent prognostic factors for tumor recurrence. The cutoff value 0.22 of MLR significantly predicted recurrence at 53.3% sensitivity and 67.9% specificity. Patients with MLR ≥ 0.22 exhibited significantly poor long-term prognosis (46.8%) compared to the counterpart (76.8%, p = 0.0004). CONCLUSIONS Preoperative MLR significantly predicted PTC recurrence after curative resection, which may provide clues for early identification of patients at higher risk of PTC recurrence.
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Affiliation(s)
- Guoqiang Wang
- Department of General Surgery, Lianyungang Oriental Hospital, Lianyungang, Jiangsu, China
| | - Yahui Ma
- Department of General Surgery, Lianyungang Oriental Hospital, Lianyungang, Jiangsu, China
| | - Yixiang Liu
- Department of General Surgery, Lianyungang Oriental Hospital, Lianyungang, Jiangsu, China
| | - Yuzhu Fan
- Department of General Surgery, Lianyungang Oriental Hospital, Lianyungang, Jiangsu, China
| | - Xiang Miao
- Department of General Surgery, Lianyungang Oriental Hospital, Lianyungang, Jiangsu, China
| | - Yiqi Zhang
- Department of General Surgery, Lianyungang Oriental Hospital, Lianyungang, Jiangsu, China
| | - Hongbo Zhu
- Department of General Surgery, Lianyungang Oriental Hospital, Lianyungang, Jiangsu, China
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Matei M, Vlad MM, Golu I, Dumitru CȘ, De Scisciolo G, Matei SC. Can Routine Laboratory Tests Be Suggestive in Determining Suspicions of Malignancy in the Case of Thyroid Nodules? MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1488. [PMID: 37629778 PMCID: PMC10456539 DOI: 10.3390/medicina59081488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 08/16/2023] [Accepted: 08/17/2023] [Indexed: 08/27/2023]
Abstract
Background and objectives: Thyroid nodules are a common finding in clinical practice and can be either benign or malignant. The aim of this study was to compare laboratory parameters between patients with malignant thyroid nodules and those with benign thyroid nodules. Materials and methods: A total of 845 patients were included, with 251 in the study group (malignant thyroid nodules) and 594 in the control group (benign thyroid nodules). Results: Our results show that there were statistically significant differences in several laboratory parameters, including FT3, FT4, ESR, fibrinogen, WBC, and lymphocyte percentage, between the two patient groups (p < 0.05). Conclusions: These findings suggest that certain laboratory parameters may be useful in differentiating between benign and malignant thyroid nodules and could aid in the diagnosis and treatment of thyroid cancer. However, further diagnostic tests such as fine-needle aspiration biopsy and imaging studies are typically required for an accurate diagnosis. Routine laboratory tests prove most effective when combined with other diagnostic methods to identify thyroid cancer. Although not conclusive on their own, these tests significantly suggest and guide physicians to suspect malignancy in thyroid nodules. This affirmative answer to our question, "Can routine laboratory tests be suggestive in determining suspicions of malignancy in the case of thyroid nodules?" aligns with the results of our study.
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Affiliation(s)
- Mervat Matei
- Department of Doctoral Studies, “Victor Babeș” University of Medicine and Pharmacy Timișoara, Eftimie Murgu Sq. no. 2, 300041 Timișoara, Romania;
- Endocrinology Clinic, “Pius Brînzeu” Emergency Clinical Hospital Timișoara, Liviu Rebreanu Boulevard no. 156, 300723 Timișoara, Romania; (M.M.V.); (I.G.)
| | - Mihaela Maria Vlad
- Endocrinology Clinic, “Pius Brînzeu” Emergency Clinical Hospital Timișoara, Liviu Rebreanu Boulevard no. 156, 300723 Timișoara, Romania; (M.M.V.); (I.G.)
- Endocrinology Department, “Victor Babeș” University of Medicine and Pharmacy Timișoara, Eftimie Murgu Sq. no. 2, 300041 Timișoara, Romania
| | - Ioana Golu
- Endocrinology Clinic, “Pius Brînzeu” Emergency Clinical Hospital Timișoara, Liviu Rebreanu Boulevard no. 156, 300723 Timișoara, Romania; (M.M.V.); (I.G.)
- Endocrinology Department, “Victor Babeș” University of Medicine and Pharmacy Timișoara, Eftimie Murgu Sq. no. 2, 300041 Timișoara, Romania
| | - Cristina Ștefania Dumitru
- Department of Microscopic Morphology/Histology, Angiogenesis Research Center, “Victor Babeș” University of Medicine and Pharmacy, Sq. Eftimie Murgu no. 2, 300041 Timișoara, Romania
| | - Graziano De Scisciolo
- Faculty of Medicine, “Victor Babeș” University of Medicine and Pharmacy Timișoara, Eftimie Murgu Sq. no. 2, 300041 Timișoara, Romania;
| | - Sergiu-Ciprian Matei
- Abdominal Surgery and Phlebology Research Center, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Sq. no. 2, 300041 Timișoara, Romania;
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Gambardella C, Mongardini FM, Paolicelli M, Bentivoglio D, Cozzolino G, Ruggiero R, Pizza A, Tolone S, del Genio G, Parisi S, Brusciano L, Cerbara L, Docimo L, Lucido FS. Role of Inflammatory Biomarkers (NLR, LMR, PLR) in the Prognostication of Malignancy in Indeterminate Thyroid Nodules. Int J Mol Sci 2023; 24:6466. [PMID: 37047439 PMCID: PMC10094849 DOI: 10.3390/ijms24076466] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Revised: 03/22/2023] [Accepted: 03/28/2023] [Indexed: 03/31/2023] Open
Abstract
Indeterminate follicular thyroid lesions (Thyr 3A and 3B) account for 10% to 30% of all cytopathologic diagnoses, and their unpredictable behavior represents a hard clinical challenge. The possibility to preoperatively predict malignancy is largely advocated to establish a tailored surgery, preventing diagnostic thyroidectomy. We analyzed the role of the neutrophil-to-lymphocyte ratio (NLR), the platelet-to-lymphocyte ratio (PLR) and the lymphocyte-to-monocyte ratio (LMR) as prognostic factors of malignancy for indeterminate thyroid nodules. In patients affected by cytological Thyr 3A/3B nodules, NLR, PLR and LMR were retrospectively compared and correlated with definitive pathology malignancy, utilizing student's t-test, ROC analysis and logistic regression. One-hundred and thirty-eight patients presented a Thyr 3A and 215 patients presented a Thyr 3B. After the logistic regression, in Thyr 3A, none of the variables were able to predict malignancy. In Thyr 3B, NLR prognosticated thyroid cancer with an AUC value of 0.685 (p < 0.0001) and a cut-off of 2.202. The NLR results were also similar when considering the overall cohort. The use of cytological risk stratification in addressing the management of indeterminate thyroid nodules in patients is not always reliable. NLR is an easy and reproducible inflammatory biomarker capable of improving the accuracy of preoperative prognostication of malignancy.
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Affiliation(s)
- Claudio Gambardella
- Division of General, Oncological, Mini-Invasive and Obesity Surgery, University of Study of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
| | - Federico Maria Mongardini
- Division of General, Oncological, Mini-Invasive and Obesity Surgery, University of Study of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
| | - Maddalena Paolicelli
- Division of General, Oncological, Mini-Invasive and Obesity Surgery, University of Study of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
| | - Davide Bentivoglio
- Division of General, Oncological, Mini-Invasive and Obesity Surgery, University of Study of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
| | - Giovanni Cozzolino
- Division of General, Oncological, Mini-Invasive and Obesity Surgery, University of Study of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
| | - Roberto Ruggiero
- Division of General, Oncological, Mini-Invasive and Obesity Surgery, University of Study of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
| | - Alessandra Pizza
- Division of General, Oncological, Mini-Invasive and Obesity Surgery, University of Study of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
| | - Salvatore Tolone
- Division of General, Oncological, Mini-Invasive and Obesity Surgery, University of Study of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
| | - Gianmattia del Genio
- Division of General, Oncological, Mini-Invasive and Obesity Surgery, University of Study of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
| | - Simona Parisi
- Division of General, Oncological, Mini-Invasive and Obesity Surgery, University of Study of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
| | - Luigi Brusciano
- Division of General, Oncological, Mini-Invasive and Obesity Surgery, University of Study of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
| | - Loredana Cerbara
- Institute for Research on Population and Social Policies, National Research Council of Italy, 00185 Rome, Italy
| | - Ludovico Docimo
- Division of General, Oncological, Mini-Invasive and Obesity Surgery, University of Study of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
| | - Francesco Saverio Lucido
- Division of General, Oncological, Mini-Invasive and Obesity Surgery, University of Study of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
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Treistman N, Cavalcante LBCP, Gonzalez F, Fernandes PIW, de Andrade FA, Garcis Alves-Junior PA, Corbo R, Bulzico DA, Vaisman F. Neutrophil-to-lymphocyte ratio as an independent factor for worse prognosis in radioiodine refractory thyroid cancer patients. Endocrine 2023:10.1007/s12020-023-03340-8. [PMID: 36905576 DOI: 10.1007/s12020-023-03340-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 02/24/2023] [Indexed: 03/12/2023]
Abstract
PURPOSE This study aimed to evaluate neutrophil to lymphocyte ratio (NLR) as a laboratory biomarker in radioactive iodine-refractory (RAIR) locally advanced and/or metastatic differentiated thyroid cancer (DTC) and determine its correlation with overall survival (OS). METHODS We retrospectively included 172 patients with locally advanced and/or metastatic RAIR DTC admitted between 1993 and 2021 at INCA. Age at diagnosis, histology, presence of distant metastasis (DM), DM site, neutrophil-to- lymphocyte ratio (NLR), imaging studies such as PET/CT results, progression free survival (PFS) and overall survival (OS) data were analyzed. NLR was calculated at the time of locally advanced and/or metastatic disease diagnosis and the cutoff value was 3. Survival curves were established using the Kaplan-Meier method. The confidence interval is 95%, and a p-value of less than 0.05 was considered statistically significant RESULTS: Out of 172 patients, 106 were locally advanced, and 150 presented DM at some point during follow-up. Regarding NLR data, 35 had NLR over 3 and 137 had NLR under 3. Higher NLR at was associated with shorter OS (6 vs. 10; p = 0.05) and with highest SUV on FDG PET-CT (15.9 vs. 7.7, p = 0.013). We found no association between higher NLR and age at diagnosis, DM or final status. CONCLUSION NLR higher than 3 at the time of locally advanced and/or metastatic disease diagnosis is an independent fator for shorter OS in RAIR DTC patients. Noteworthy higher NLR was also associated with highest SUV on FDG PET-CT in this population.
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Affiliation(s)
- Natália Treistman
- Department of Medicine, Endocrinology Service, Faculdade de medicina, Hospital Universitário Clementino Fraga Filho (HUCFF), Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil
| | - Lara Bessa Campelo Pinheiro Cavalcante
- Department of Medicine, Endocrinology Service, Faculdade de medicina, Hospital Universitário Clementino Fraga Filho (HUCFF), Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil
| | - Fabiola Gonzalez
- Department of Medicine, Endocrinology Service, Instituto Nacional do Cancer (INCA), Rio de Janeiro, RJ, Brazil
| | | | - Fernanda Accioly de Andrade
- Department of Medicine, Endocrinology Service, Instituto Nacional do Cancer (INCA), Rio de Janeiro, RJ, Brazil
| | | | - Rossana Corbo
- Department of Medicine, Endocrinology Service, Instituto Nacional do Cancer (INCA), Rio de Janeiro, RJ, Brazil
| | - Daniel Alves Bulzico
- Department of Medicine, Endocrinology Service, Instituto Nacional do Cancer (INCA), Rio de Janeiro, RJ, Brazil
| | - Fernanda Vaisman
- Department of Medicine, Endocrinology Service, Faculdade de medicina, Hospital Universitário Clementino Fraga Filho (HUCFF), Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil.
- Department of Medicine, Endocrinology Service, Instituto Nacional do Cancer (INCA), Rio de Janeiro, RJ, Brazil.
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12
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The Prognostic Value of Serum Apolipoprotein A-I Level and Neutrophil-to-Lymphocyte Ratio in Colorectal Cancer Liver Metastasis. JOURNAL OF ONCOLOGY 2022; 2022:9149788. [PMID: 36204177 PMCID: PMC9532097 DOI: 10.1155/2022/9149788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 09/08/2022] [Indexed: 12/24/2022]
Abstract
Background Colorectal cancer liver metastasis (CRLM) is a high degree of malignancy with rapid disease progression and has a poor prognosis. Both serum apolipoprotein A-I (ApoA-I) and neutrophil-to-lymphocyte ratio (NLR) play key roles in anti-inflammation and antitumor. This study is aimed at evaluating the implication of serum ApoA-I level in combination with NLR in the prognosis of CRLM. Methods We retrospectively analyzed the serum ApoA-I level and NLR in 237 patients with CRLM. Cox regression analyses were used to identify the independent prognostic significance of these indicators. Kaplan-Meier method and Log-rank test were applied to compute overall survival (OS). Both the ApoA-I and NLR were divided into three levels, according to their medians. A risk-stratified prediction model was established to evaluate the prognosis of patients with CRLM. The ROC curve AUC values were applied to evaluate the capability of the model. Results Higher levels of ApoA-I and lower NLR were strongly associated with prolonged OS (Log-rank test, P < 0.05). The patients were then grouped into three queues according to the ApoA-I level and NLR. There was a crucial diversity in the OS (P < 0.001) between the high-risk (ApoA − I ≤ 1.03 g/L and NLR > 3.24), medium-risk (ApoA − I > 1.03 g/L or NLR ≤ 3.24) and low-risk groups (ApoA − I > 1.03 g/L and NLR ≤ 3.24). The AUC value of the prediction model (AUC = 0.623, 95% CI: 0.557-0.639, P = 0.001) was higher than other individual indicators (including ApoA-I, NLR, cT classification, and cN classification). Additionally, the association of the prediction model and cTN classification (AUC = 0.715, 95% CI: 0.606-0.708, P < 0.001) was better than the model and cTN classification alone. Conclusion The combination of ApoA-I level and NLR could be a prognostic indicator for CRLM.
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Jin J, Wu G, Ruan C, Ling H, Zheng X, Ying C, Zhang Y. Preoperative platelet distribution width-to-platelet ratio combined with serum thyroglobulin may be objective and popularizable indicators in predicting papillary thyroid carcinoma. J Clin Lab Anal 2022; 36:e24443. [PMID: 35441746 PMCID: PMC9169195 DOI: 10.1002/jcla.24443] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 04/02/2022] [Accepted: 04/06/2022] [Indexed: 11/30/2022] Open
Abstract
Objectives The incidence of papillary thyroid carcinoma (PTC) has increased more rapidly than that of any other cancer type in China. Early indicators with high sensitivity and specificity during diagnosis are required. To date, there has been a paucity of studies investigating the relationship between preoperative platelet distribution width‐to‐platelet count ratio (PPR) and PTC. This study thus aimed to assess the diagnostic value of PPR combined with serum thyroglobulin (Tg) in patients with PTC. Methods A total of 1001 participants were included in our study. 876 patients who underwent surgery for nodular goiter were divided into the PTC group or benign thyroid nodule (BTN) group according to pathology reports, and 125 healthy controls (HCs) were included. Preoperative hemogram parameters and serum Tg levels were compared among three groups. Receiver operating characteristic (ROC) curve was used to evaluate the value of PPR combined with serum Tg for diagnosing PTC. Results Platelet distribution width (PDW) and PPR levels were higher in the PTC group than in the BTN and HC groups (both p < 0.05) but did not significantly differ between the BTN and HC groups. PDW and PPR levels significantly differed in the presence/absence of lymph node metastasis, the presence/absence of capsule invasion (p = 0.005), and TNM stages (p < 0.001). Multivariable analyses indicated that high serum Tg levels [adjusted odds ratio (OR), 1.007; 95% confidence interval (CI), 1.004–1.009; p < 0.001], high neutrophil‐to‐lymphocyte ratio (NLR,adjusted OR, 1.928; 95% CI, 1.619–2.295; p < 0.001), and high PPR (adjusted OR, 1.378; 95% CI, 1.268–1.497; p < 0.001) were independent risk factors for PTC. In ROC analysis, the areas under the curves (AUCs) of serum Tg, PDW, PPR, and NLR for predicting PTC were 0.603, 0.610, 0.706, and 0.685, respectively. PPR combined with serum Tg (PPR + Tg) had a higher diagnostic value (AUC, 0.738; sensitivity, 60%; specificity, 74.7%) compared with PDW + Tg (AUC, 0.656; sensitivity, 64.4%; specificity, 59.9%) and NLR + Tg (AUC, 0.714; sensitivity, 61.6%; specificity, 71.1%). Conclusions Preoperative PPR combined with serum Tg may be objective and popularizable indicators for effective predicting PTC.
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Affiliation(s)
- Jin Jin
- The Graduate School, Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Guihua Wu
- The Graduate School, Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Chengwei Ruan
- Department of Proctology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Hongwei Ling
- Department of Endocrinology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Xueman Zheng
- The Graduate School, Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Changjiang Ying
- Department of Endocrinology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Ying Zhang
- The Graduate School, Xuzhou Medical University, Xuzhou, Jiangsu, China
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Zhang J, Gong Z, Li S, Fan P, Yue G, Zou G, He S, Wang J, Xu J. The value of neutrophil‐to‐lymphocyte ratio combined with the thyroid imaging reporting and data system in the diagnosis of the nature of thyroid nodules. J Clin Lab Anal 2022; 36:e24429. [PMID: 35403307 PMCID: PMC9102493 DOI: 10.1002/jcla.24429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 03/27/2022] [Accepted: 04/04/2022] [Indexed: 11/12/2022] Open
Abstract
Objective The aim of this study was to investigate the diagnostic value of peripheral blood neutrophil‐to‐lymphocyte ratio (NLR) combined with the thyroid imaging reporting and data system (TIRADS) for benign and malignant thyroid nodules. Methods A total of 585 adults were enrolled in the study. The receiver operating characteristic curves were used to determine the optimal cut‐off values for NLR and Kwak TIRADS (K‐TIRADS) grades, which were 1.87 and 4a, respectively. Thyroid nodules were scored as follows: NLR–K‐TIRADS score is 2 (both elevated K‐TIRADS grade and NLR), NLR–K‐TIRADS score is 1 (one of these was elevated) and NLR–k‐TIRADS score is 0 (neither were elevated). Results The proportions of malignant nodules with NLR‐K‐TIRADS scores of 2, 1 and 0 were 98.59%, 69.62% and 10.19%, and the difference was statistically significant (p < 0.001). In terms of the sensitivity of diagnosis of malignant nodules, NLR‐K‐TIRADS 1 tends to increase relative to K‐TIRADS grades ≥ 4a; in terms of specificity and positive predictive value for the diagnosis of malignant nodules, NLR–K‐TIRADS 2 was significantly higher than K‐TIRADS grades ≥ 4a (all p < 0.05). Conclusions NLR combined with K‐TIRADS grades may be a novel method for screening benign and malignant thyroid nodules.
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Affiliation(s)
- Jie Zhang
- Department of Endocrinology and Metabolism First Affiliated Hospital of Nanchang University Nanchang China
| | - Zhaoxia Gong
- Department of Endocrinology and Metabolism First Affiliated Hospital of Nanchang University Nanchang China
| | - Shanshan Li
- Department of Endocrinology and Metabolism First Affiliated Hospital of Nanchang University Nanchang China
| | - Ping Fan
- Department of Endocrinology and Metabolism First Affiliated Hospital of Nanchang University Nanchang China
| | - Guanru Yue
- Department of Endocrinology and Metabolism First Affiliated Hospital of Nanchang University Nanchang China
| | - Guilin Zou
- Department of Endocrinology and Metabolism First Affiliated Hospital of Nanchang University Nanchang China
| | - Shasha He
- Department of Endocrinology and Metabolism First Affiliated Hospital of Nanchang University Nanchang China
| | - Jiao Wang
- Department of Endocrinology and Metabolism First Affiliated Hospital of Nanchang University Nanchang China
| | - Jixiong Xu
- Department of Endocrinology and Metabolism First Affiliated Hospital of Nanchang University Nanchang China
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15
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Deng Y, Zhang J, Zou G, Li S, Gong Z, Yue G, Fan P, Xu J. Peripheral Blood Inflammatory Markers Can Predict Benign and Malignant Thyroid Nodules. Int J Endocrinol 2022; 2022:2319660. [PMID: 35795844 PMCID: PMC9251144 DOI: 10.1155/2022/2319660] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Accepted: 05/27/2022] [Indexed: 12/04/2022] Open
Abstract
OBJECTIVE Inflammation is related to the occurrence and development of various cancers. This study was designed to explore the role of peripheral blood platelet count, neutrophil-lymphocyte ratio (NLR), platelet count-lymphocyte count ratio (PLR), systemic inflammation index (SII), and other inflammatory markers in predicting benign and malignant Thyroid Imaging Reporting and Data System (TI-RADS) grade 3 thyroid nodules. METHODS In this retrospective study, 514 patients with TI-RADS grade 3 thyroid nodules were enrolled. According to the pathological results, the patients were divided into the benign and malignant nodule groups. We compared the clinical characteristics between the two groups and analysed the influencing factors for malignant thyroid nodules by univariate and stepwise multivariate logistic regression analyses and then analysed the cutoff value of each influencing factor according to the receiver operating characteristic curve. RESULTS The leukocyte count, neutrophil count, platelet count, NLR, PLR, and SII of the malignant nodule group were significantly higher than those of the benign nodule group (P < 0.05), the age and the diameter of nodule of the malignant nodule group were significantly smaller than those of the benign nodule group (P < 0.05). After excluding the influence of confounding factors, SII (odds ratio (OR) = 1.006; 95% confidence interval (CI) = 1.003-1.008; P < 0.001), PLR (odds ratio (OR) = 0.981; 95% confidence interval (CI) = 0.981-0.992; P < 0.05), leukocyte count (odds ratio (OR) = 0.654; 95% confidence interval (CI) = 0.466-0.892; P < 0.05), and age (OR = 0.969; 95% CI = 0.954-0.985; P < 0.001) were independent risk factors for malignant thyroid nodules, and the cutoff value of SII and PLR in predicting benign and malignant thyroid nodules were 545.63 × 109/L and 138.63. CONCLUSION This study showed that peripheral blood SII, PLR, leukocyte count and age were independent risk factors for malignant thyroid nodules, and the combination of these can better predict benign and malignant thyroid nodules, which can further guide the diagnosis and treatment of TI-RADS grade 3 thyroid nodules.
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Affiliation(s)
- Yuanyuan Deng
- Department of Endocrinology and Metabolism, First Affiliated Hospital of Nanchang University, Jiangxi Clinical Research Center for Endocrine and Metabolic Disease, Nanchang 330006, China
| | - Jie Zhang
- Department of Endocrinology and Metabolism, First Affiliated Hospital of Nanchang University, Jiangxi Clinical Research Center for Endocrine and Metabolic Disease, Nanchang 330006, China
| | - Guilin Zou
- Department of Endocrinology and Metabolism, First Affiliated Hospital of Nanchang University, Jiangxi Clinical Research Center for Endocrine and Metabolic Disease, Nanchang 330006, China
| | - Shanshan Li
- Department of Endocrinology and Metabolism, First Affiliated Hospital of Nanchang University, Jiangxi Clinical Research Center for Endocrine and Metabolic Disease, Nanchang 330006, China
| | - Zhaoxia Gong
- Department of Endocrinology and Metabolism, First Affiliated Hospital of Nanchang University, Jiangxi Clinical Research Center for Endocrine and Metabolic Disease, Nanchang 330006, China
| | - Guanru Yue
- Department of Basic Medicine, Jiangxi Medical College, Nanchang University, Nanchang 330006, China
| | - Ping Fan
- Department of Endocrinology and Metabolism, First Affiliated Hospital of Nanchang University, Jiangxi Clinical Research Center for Endocrine and Metabolic Disease, Nanchang 330006, China
| | - Jixiong Xu
- Department of Endocrinology and Metabolism, First Affiliated Hospital of Nanchang University, Jiangxi Clinical Research Center for Endocrine and Metabolic Disease, Nanchang 330006, China
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Platelet Activation and Inflammation in Patients with Papillary Thyroid Cancer. Diagnostics (Basel) 2021; 11:diagnostics11111959. [PMID: 34829306 PMCID: PMC8624142 DOI: 10.3390/diagnostics11111959] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Revised: 10/14/2021] [Accepted: 10/19/2021] [Indexed: 01/04/2023] Open
Abstract
Background: The primary endpoint was to analyze the preoperatory inflammatory markers and platelet indices in papillary thyroid cancer (PTC) patients compared with patients with benign thyroid pathology. The secondary endpoints were to analyze the relationship between these markers and the pathological features of PTC and to compare their pre- and postoperative levels in PTC patients. Methods: In this retrospective case-control study, we analyzed the files of 1183 patients submitted to thyroidectomy between January 2012 and December 2018. A total of 234 patients with PTC (mean age 51.54 ± 13.10 years, 84.6% females) were compared with an age-, gender- and BMI-matched control group of 108 patients with histologic benign thyroid disorders. Results: PTC patients had higher platelet count (PLT) (p = 0.011), plateletcrit (PCT) (p = 0.006), neutrophil (p = 0.022) and fibrinogen (p = 0.005) levels. Subgroup analysis showed that PTC females had higher PLT (p = 0.006), PCT (p < 0.001) and erythrocyte sedimentation rate (ESR) (p = 0.005), while males had higher neutrophil (p = 0.040) levels. Papillary thyroid cancer patients under 55 years had higher PLT (p < 0.001) and PCT (p = 0.010), while patients over 55 years had higher mean platelet volume (p = 0.032), neutrophil-to-lymphocyte ratio (p = 0.013), ESR (p = 0.005) and fibrinogen (p = 0.019) levels. Preoperative values for platelet indices and inflammatory markers were similar to the postoperative determinations in PTC patients. Fibrinogen (AUROC = 0.602, p = 0.02; cut-off = 327.5 mg/dL, Se = 53.8%, Sp = 62.9%) and PLT (AUROC = 0.584, p = 0.012; cut-off = 223.5 × 103/mm3, Se = 73.1%, Sp = 42.6%) were independent predictors of the presence of PTC. Conclusions: Our data show that fibrinogen and platelet count could be promising, inexpensive, independent predictors for the presence of PTC when compared with benign thyroid disorders.
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Szydełko J, Szydełko-Gorzkowicz M, Matyjaszek-Matuszek B. Neutrophil-to-Lymphocyte, Platelet-to-Lymphocyte Ratios, and Systemic Immune-Inflammation Index as Potential Biomarkers of Chronic Inflammation in Patients with Newly Diagnosed Acromegaly: A Single-Centre Study. J Clin Med 2021; 10:jcm10173997. [PMID: 34501445 PMCID: PMC8432467 DOI: 10.3390/jcm10173997] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Revised: 08/26/2021] [Accepted: 08/31/2021] [Indexed: 11/22/2022] Open
Abstract
Acromegaly is a rare disease caused by overproduction of growth hormone (GH) by a pituitary adenoma, and consequently increased insulin-like growth factor 1 (IGF-1) concentration. The GH/IGF-1 axis and immune cells interactions are hypothesized to be involved in subclinical inflammation. This retrospective study aimed to investigate the differences in neutrophil-to-lymphocyte (NLR), platelet-to-lymphocyte (PLR) ratios, and systemic immune-inflammation index (SII) in GH-secreting adenomas compared with non-functioning pituitary adenomas (NFPAs) concerning clinical and radiological findings. After evaluation of 665 patients with pituitary tumors, 62 individuals with newly diagnosed acromegaly and 134 with NFPAs were enrolled in the analysis. The control group consisted of 120 healthy individuals. Fifty-eight patients with acromegaly were re-evaluated after medical or surgical therapies. NLR, PLR, SII values, and neutrophil count were significantly higher (p ≤ 0.001), whereas lymphocyte count was lower in acromegaly than in NFPAs (p = 0.001). No significant differences between NFPAs and controls were observed in analyzed ratios. Higher preoperative NLR, PLR, SII values were found in patients who failed to achieve a cure with surgery (p < 0.05). Although NLR, PLR, and SII values were significantly higher in acromegaly, these indices cannot be used to discriminate GH-secreting pituitary tumors from NFPAs. Treatment of acromegaly decreased the value of NLR and SII, but it requires further studies to consolidate the real clinical role of these inflammation-related ratios.
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Affiliation(s)
- Joanna Szydełko
- Department of Endocrinology, Diabetology and Metabolic Diseases, Medical University of Lublin, Jaczewskiego 8, 20-090 Lublin, Poland;
- Correspondence: (J.S.); (M.S.-G.); Tel.: +48-81-72-44-668 (J.S.); +48-607-379-321 (M.S.-G.); Fax: +48-81-72-44-669 (J.S.)
| | - Magdalena Szydełko-Gorzkowicz
- Department of Obstetrics and Perinatology, Independent Public Clinical Hospital No. 4 in Lublin, Jaczewskiego 8, 20-954 Lublin, Poland
- Correspondence: (J.S.); (M.S.-G.); Tel.: +48-81-72-44-668 (J.S.); +48-607-379-321 (M.S.-G.); Fax: +48-81-72-44-669 (J.S.)
| | - Beata Matyjaszek-Matuszek
- Department of Endocrinology, Diabetology and Metabolic Diseases, Medical University of Lublin, Jaczewskiego 8, 20-090 Lublin, Poland;
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