Predictive values of the selected inflammatory index in elderly patients with papillary thyroid cancer

Weiheng Wen, Peili Wu, Jitong Li, He Wang, Jia Sun, Hong Chen, Weiheng Wen, Peili Wu, Jitong Li, He Wang, Jia Sun, Hong Chen

Abstract

Background: The American Joint Committee on Cancer has recently revised the tumor-node-metastasis (TNM) staging system on thyroid cancer, which illustrated that the cut-off age for predicting mortality has elevated from 45 to 55 years old. We aimed to investigate the inflammation index based on hematological parameters to predict the clinical characteristics of elderly papillary thyroid cancer (PTC) patients with an inferior prognosis.

Methods: We retrospectively analyzed 558 patients newly diagnosed with PTC from January 2013 to December 2017, and 82 out of the 558 patients were over 55 years old. Receiver operating characteristic (ROC) study and univariate and multivariate logistic analysis was conducted to evaluate the diagnostic value of these preoperative inflammation indexes in PTC patients ≥ 55 years of age.

Results: Elevated neutrophils were prognostic of bilaterality (area under the ROC curve (AUC) = 0.673, p = 0.023) and lymph node metastasis (AUC = 0.649, p = 0·020). Decreased mean platelet volume (MPV) and platelet distribution width (PDW) were prognostic of coexistence with Hashimoto's thyroiditis (AUC = 0.736, p = 0.016; AUC = 0.721, p = 0.024). Elevated lymphocyte and lymphocyte-to-monocyte ratio (LMR) were prognostic of advanced TNM stage (AUC = 0.691, p = 0.029; AUC = 0.680, p = 0.040). Meanwhile, the logistic regression model further revealed that LMR ≥ 5.45 was an independent risk factor for the advanced TNM stage (odds ratio (OR) = 7.306, p = 0.036).

Conclusions: The preoperative neutrophils, lymphocytes, MPV, PDW, LMR were all prognostic. More importantly, the increased in LMR independently contributed to the advanced TNM stage of PTC patients ≥ 55 years.

Keywords: Inflammatory index; Lymphocyte-to-monocyte ratio; Papillary thyroid cancer; Prognosis; Tumor-node-metastasis staging system.

Figures

Fig. 1
Fig. 1
ROC for determination of predictive ability of hematological parameters in elderly patients with PTC to: a bilaterality, b lymph node metastasis, c coexistence with Hashimoto’s thyroiditis, and d TNM stage, respectively. Abbreviations: ROC, receiver operating curve; NLR, neutrophil-to-lymphocyte ratio; LMR, lymphocyte-to-monocyte ratio; MPV, and mean platelet volume; PDW, platelet distribution width

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