The Correlation of Preoperative Neutrophil-to-Lymphocyte Ratio with Neck Ultrasonography and Pathological Findings in Patients with Differentiated Thyroid Cancer

Abstract

Aim: Neutrophil-lymphocyte ratio (NLR) is a strong biomarker of oxidative stress and systemic inflammation. The aim of this study is to compare NLR with lymph node features detected in USG and pathology results of patients operated with diagnosis of differentiated thyroid cancer. Methods: Demographic characteristics, preoperative neck USG and pathology results of patients who were operated with the diagnosis of differentiated thyroid cancer between 2012-2020 in the General Surgery Clinic of Hatay State Hospital were recorded. NLR was calculated by dividing the neutrophil count by the lymphocyte count in preoperative routine blood tests. The cut-off value for the NLO was calculated with Receiver Operating Curve (ROC) analysis and compared with other parameters. Results: 105 patients were included in our study. 71.4% are women. The average age is 47.9 ± 14.1. No lymph node was found in 63.8% of the preoperatively performed neck USG. Postoperative 94.3% were diagnosed with papillary carcinoma. Tumor diameter was 2-4 cm (T2) in 30.5%. No metastatic lymph node was found in 74.3% (N0). There was no capsule invasion in 63.8%. Surgical margins were free in 90.5%. 38.6% were multifocal and 23.8% were bilaterally located. The cut-off for NLR was calculated as 2.16. NLR was significantly higher in thyroid carcinomas with male gender (p=0,027), suspected lymph node metastasis on USG (p=0,001) and lymph node metastasis detected in pathology (p<0,001). There was no significant difference in other parameters. Conclusions: We recommend that the use of NLR as a prognostic indicator should be kept in mind in patients with thyroid cancer, due to the increase in neck lymph node metastasis development at high NLR values

Keywords

• Neutrophil / lymphocyte ratio,
• prognosis
• biomarker

Diferansiye Tiroid Kanserli Hastalarda Preoperatif Nötrofil / Lenfosit Oranının Boyun Ultrasonografisi ve Patolojik Bulgularla İlişkisi

Abstract

Amaç: Nötrofil lenfosit oranı (NLO) da oksidatif stresin ve sistemik enflamasyonun güçlü bir belirtecidir. Bu çalışma ile; diferansiye tiroid kanseri tanısı ile opere olan hastaların patolojik bulgularının ve ultrasonda (USG) saptanan lenf nodu özelliklerinin preoperatif dönemde bakılan NLO ile karşılaştırılması amaçlanmıştır. Materyal–Metot: 2012-2020 yılları arasında Hatay Devlet Hastanesi Genel Cerrahi Kliniği’nde diferansiye tiroid kanseri tanısı ile opere olan hastaların demogrofik özellikleri, preoperatif boyun USG’si ve patoloji sonuçları kayıt edildi. NLO; preoperatif rutin kan testlerindeki nötrofil sayısının lenfosit sayısına bölünmesiyle hesaplandı. Receiver Operating Curve (ROC) analizi ile NLO için cut-off değeri hesaplanarak diğer parametreler ile karşılaştırıldı. Bulgular: Çalışmamıza 105 hasta dahil edilmiştir. %71,4’ü kadındır. Yaş ortalaması 47,9 ± 14,1’dur. %63,8’ inin preoperatif yapılan boyun USG’ de lenf nodu tespit edilmedi. Ameliyat sonrası %94,3’ ü papiller karsinom tanısı aldı. %30,5’inde tümör çapı 2-4 cm (T2)’ di. %74,3’ünde metastatik lenf nodu saptanmadı (N0). %63,8’ inde kapsül invazyonu yoktu. %90,5’ inde cerrahi sınırlar negatifdi. %38,6’ sı multifokal ve %23,8’ i ise bilateral yerleşimliydi. NLO için cut-off 2,16 olarak hesaplandı. Tiroid kanserlerinde NLO; erkek cinsiyette (p=0,027), USG’de lenf nodu metastazı şüphesi olanlarda (p=0,001) ve patolojide lenf nodu metastazı saptananlarda (p<0,001) anlamlı olarak daha yüksekti. Diğer parametrelerde anlamlı fark izlenmedi. Sonuç: Tiroid kanserli hastalarda yüksek NLO değerlerinde boyun lenf nodu metastazı gelişiminin artması nedeni ile NLO’ nun prognostik gösterge olarak kullanımının akılda tutulmasını öneriyoruz.

Keywords

• Nötrofil / lenfosit oranı
• prognoz
• belirteç

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