Association of the preoperative neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios with lymph node metastasis and recurrence in patients with medullary thyroid carcinoma

Abstract

The preoperative neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) are known to be prognostic factors in several cancers. However, no previous investigation has been performed to evaluate the significance of the NLR and PLR in medullary thyroid carcinoma (MTC).The aim of this study was to identify the ability of the preoperative NLR or PLR to predict lymph node metastasis and recurrence in patients with MTC. Data from all patients with MTC who had undergone surgery at our institution from May 2009 to May 2016 were retrospectively evaluated. Receiver operating characteristic (ROC) analysis was performed to identify optimal NLR and PLR cutoff points, and we assessed independent predictors of lymph node metastasis and recurrence using univariate and multivariate analyses.Based on the inclusion and exclusion criteria, a total of 70 patients were enrolled in this study. The ideal cutoff points for predicting lymph node involvement were 2.7 for the NLR and 105.3 for the PLR. The optimal cutoff points of the NLR and PLR for predicting recurrence were 2.8 and 129.8, respectively. Using the cutoff values, we found that PLR>105.3 (odds ratio [OR] 4.782, 95% confidence interval [CI] 1.4–16.7) was an independent predictor of lymph node metastasis and that PLR>129.8 (OR 3.838, 95% CI 1.1–13.5) was an independent predictor of recurrence.Our study suggests that the preoperative PLR, but not NLR, was significantly associated with lymph node metastasis and recurrence in patients with MTC.

Platelet count and platelet‐lymphocyte ratio as prognostic markers for head and neck squamous cell carcinoma: Meta‐analysis

“…30 In many types of cancers, the platelet count increases as a result of tumor-induced inflammation. Jiang et al 68 reported an association among preoperative PLR, NLR, lymph node metastasis, and recurrence in medullary thyroid carcinoma. Thus, a decreased platelet count represents severe liver cirrhosis and is a predictor of liver-related death in patients with HCC.…”

“…Inclusion criteria regarding tumor site, treatment modalities, and clinical stage were different. 66,68 Sixth, the cutoff values for platelet count or PLR were inconsistent among individual studies, which could have resulted in heterogeneity. Some studies excluded patients with conditions that could affect hematologic markers (eg, acute inflammation and autoimmune disease), 34,35,[43][44][45]51 although other studies did not use such criteria.…”

Comparison of the prognostic values of selected inflammation based scores in patients with medullary thyroid carcinoma: A pilot study

“…Between May 2009 and September 2016, a total of 78 patients who underwent initial surgery treatment for MTC in West China Hospital were included in the study. Some of the participants were partially overlapped with one of our previous study . Patients with initial surgery treatment at another hospital ( n = 49), unresectable at the time of referral ( n = 3), minor patients ( n = 2), other malignancy or cancer treatment within the past 12 months ( n = 1) were already excluded.…”

“…After initial surgery, a follow‐up visit was carried out for all patients as described in our previous study . Physical examination, serum calcitonin, and neck ultrasonography were measured every 3 months during the first year and every 6 months thereafter.…”

“…Cancer‐associated inflammation is now widely recognized as a key determinant of cancer initiation, progression, metastasis, and survival . Specifically, increasing evidences have shown that the host response in the form of systemic inflammation plays an important role in determining outcomes in a variety of malignancies, and as such the measurement of various systemic inflammation based scores are useful in predicting clinical outcomes of cancer, including MTC . Moreover, all the inflammation based scores included in our investigation are calculated based on routine evaluation before operation, including complete blood count, biochemical test, and blood coagulation.…”