Does Preoperative Neutrophil Lymphocyte Ratio Predict Risk of Recurrence and Occult Central Nodal Metastasis in Papillary Thyroid Carcinoma?

Utilizing BRAFV600E mutation as a marker may reduce unnecessary prophylactic central neck dissection (pCND) in clinically nodal negative (cN0) neck for small (≤2 cm) classical papillary thyroid carcinoma (PTC). We aimed to assess whether BRAF is a significant independent predictor of occult central nodal metastasis (CNM) and its contribution to the overall prediction after adjusting for other significant preoperative clinical factors in small PTC. Primary tumor tissue (paraffin-embedded) from 845 patients with small classical cN0 PTC who underwent pCND was tested for BRAF mutation. Clinicopathologic factors were compared between those with and without BRAF. BRAF was evaluated to see if it was an independent factor for CNM. Prediction scores were generated using logistic regression models and their predictability was measured by the area under the ROC curve (AUC). The prevalence of BRAF was 628/845 (74.3%) while the rate of CNM was 285/845 (33.7%). Male sex (odds ratio (OR): 2.68, 95% CI: 1.71–4.20), large tumor size (OR: 2.68, 95% CI: 1.80–4.00), multifocality (OR: 1.49, 95% CI: 1.07–2.09), lymphovascular permeation (OR: 10.40, 95% CI: 5.18–20.88), and BRAF (OR: 1.65, 95% CI: 1.10–2.46) were significant independent predictors of CNM, while coexisting Hashimoto's thyroiditis (OR: 0.56, 95% CI: 0.40–0.80) was an independent protective factor. The AUC for prediction score based on tumor size and male sex was similar to that of prediction score based on tumor size, male sex, and BRAF status (0.68 vs 0.69, P=0.60). Although BRAF was an independent predictor of CNM, knowing its status did not substantially improve the overall prediction. A simpler prediction score based on male sex and tumor size might be sufficient.

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Risk factor analysis for central nodal metastasis in papillary thyroid carcinoma

Oncology Letters ◽

10.3892/ol.2014.2667 ◽

2014 ◽

Vol 9 (1) ◽

pp. 103-107 ◽

Cited By ~ 13

Author(s):

LING-NA MAO ◽

PING WANG ◽

ZHI-YU LI ◽

YONG WANG ◽

ZHENG-YA SONG

Keyword(s):

Factor Analysis ◽

Risk Factor ◽

Papillary Thyroid Carcinoma ◽

Thyroid Carcinoma ◽

Nodal Metastasis ◽

Risk Factor Analysis ◽

Papillary Thyroid ◽

Central Nodal Metastasis

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Comparison of Mean Platelet Volume, Platelet Count, Neutrophil/ Lymphocyte Ratio and Platelet/Lymphocyte Ratio in the Euthyroid, Overt Hypothyroid and Subclinical Hyperthyroid Phases of Papillary Thyroid Carcinoma

Endocrine Metabolic & Immune Disorders - Drug Targets ◽

10.2174/1871530319666190206125545 ◽

2019 ◽

Vol 19 (6) ◽

pp. 859-865 ◽

Cited By ~ 1

Author(s):

Faruk Kutluturk ◽

Serdar S. Gul ◽

Safak Sahin ◽

Turker Tasliyurt

Keyword(s):

Platelet Count ◽

Papillary Thyroid Carcinoma ◽

Thyroid Carcinoma ◽

Mean Platelet Volume ◽

Papillary Thyroid ◽

Platelet Volume ◽

Neutrophil Lymphocyte Ratio ◽

Lymphocyte Ratio ◽

Platelet Size ◽

The Mean

Introduction:Thyroid hormones are essential for the normal development, differentiation, metabolic balance and physiological function of all tissues. Mean platelet volume (MPV) indicates mean platelet size and reflects platelet production rate and stimulation. Increased platelet size has been observed in association with known cardiovascular risk factors. The neutrophil/lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR) are known markers of the systemic inflammatory response. This study aimed to investigate the effect of thyroid hormone changes by comparing platelet count, MPV values, NLR and PLR in thyroid papillary carcinoma.Methods:Forty-nine females and nine males comprising a total of 58 patients were included in the study. Clinical and laboratory parameters of patients were recorded in the following three phases of the disease: euthyroid phase (before thyroid surgery), overt hypothyroid (OH) phase (before radioactive iodine [RAI] treatment) and subclinical hyperthyroid (SCH) phase (six months after RAI treatment).Results:The mean thyroid-stimulating hormone (TSH) values of the patients in the euthyroid, OH and SCH phases were 1.62±1.17, 76.4±37.5 and 0.09±0.07 μIU/mL, respectively. The mean MPV values of the patients in the euthyroid, OH and SCH phases were 9.45±1.33, 9.81±1.35 and 9.96±1.21 fL, respectively. MPV was significantly higher in the SCH phase than in the euthyroid phase (p=0.013). Platelet count, NLR and PLR were not statistically different between the euthyroid, OH and SCH phases.Conclusion:The results of this study demonstrated that the levels of MPV increased significantly in the SCH phase in patients with papillary thyroid carcinoma (PTC), and increased MPV values contributed to increased risk of cardiovascular complications. These findings suggest that MPV can be a valuable, practical parameter for monitoring the haemostatic condition in thyroid disorders. No significant difference was observed in platelet count, NLR and PLR in all stages of PTC.

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