Role of Systemic Inflammation in Patients with Thyroid Nodule

Abstract

Objective: We aimed to investigate systemic inflammation markers together with hemogram parameters in patients with thyroid nodules.

Material and Methods: A total of 25 patients and 25 healthy subjects were included in this retrospective study. Patients with thyroid nodules were classified as Group 1 and healthy individuals as Group 2. Group 1 consisted of patients without additional systemic diseases in whom thyroid nodules were detected by ultrasonography while Group 2 consisted of healthy volunteers. Hemoglobin, platelet, neutrophil and lymphocyte values, neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), and systemic inflammation index (SII) values, which were markers of systemic inflammation, were screened from the patients' files. Comparison between groups was made with these values.

Results: The mean age was 43.52±11.65 in Group 1, and 39.04±12.11 in Group 2. Group 1 consisted of 3 male and 22 female patients, while Group 2 consisted of 8 male and 17 female subjects. No statistically significant difference was detected between Group 1 and Group 2 for NLR, PLR and SII values.

Conclusion: Our study revealed no significant difference between patients with thyroid nodule and healthy subjects with respect to NLR, PLR ve SII values that are significant markers of inflammation in many diseases. Randomized studies with larger series and thyroid nodules with different characteristics are needed to evaluate the importance of these parameters in patients with thyroid nodules.

Keywords

• Lymphocyte
• neutrophil
• platelet
• thyroid nodule

TİROİD NODÜLÜ BULUNAN HASTALARDA SİSTEMİK İNFLAMASYON BELİRTEÇLERİNİN ROLÜ

Abstract

Amaç: Tiroid nodulü olan hastalarda hemogram parametreleri ile birlikte sistemik inflamasyon belirteçlerinin incelenmesi amaçlanmıştır.

Gereç ve Yöntemler: Retrospektif olarak planlanan bu çalışmaya toplam 25 hasta ve 25 sağlıklı gönüllü dahil edildi. Tiroid nodülü olan hastalar Grup 1, sağlıklı bireyler ise Grup 2 olarak incelendi. Grup 1’de ultrasonografi ile tespit edilmiş tiroid nodülü olan ve ek sistemik hastalığı olmayan hastalar çalışmaya dahil edildi. Grup 2’de ise sağlıklı gönüllüler çalışmaya dahil edildi. Hastaların dosyalarından hemoglobin, platelet, nötrofil ve lenfosit değerleri ile sistemik inflamasyon belirteçlerinden olan nötrofil/lenfosit oranı (NLO), platelet/ lenfosit oranı (PLO) ve sistemik inflamasyon indeksi (SII) değerleri tarandı. Gruplar arası karşılaştırma bu değerler ile yapıldı.

Bulgular: Grup 1’de yaş ortalaması 43.52±11.65 iken, Grup 2’de 39.04±12.11 bulundu. Grup 1’de 3 erkek ve 22 kadın hasta bulunurken, Grup 2’de ise 8 erkek ve 17 kadın hasta mevcuttu. NLO, PLO ve SII değerleri incelendiğinde Grup 1 ve Grup 2 arasında istatistiksel olarak anlamlı fark saptanmadı.

Sonuç: Bizim çalışmamızda tiroid nodülü bulunan hastalarda, birçok hastalıkta inflamatuar belirteç olarak kullanılan NLO, PLO ve SII değerlerinde kontrol grubuna göre anlamlı fark saptanmadı. Daha geniş serilerde ve farklı özelliklerdeki tiroid nodüllerinde bu belirteçlerin incelendiği randomize çalışmalara ihtiyaç vardır.

Keywords

• Lenfosit
• nötrofil
• platelet
• tiroid nodülü

References

1. 1. Adaş M, Adaş G, Özülker F, Yalçın O. Tiroid nodülleri ve klinik önemi. Okmeydanı Tıp Dergisi. 2012;28(Ek sayı 1):20-5.
2. 2. Tan GH, Gharib H. Thyroid incidentalomas: management approaches to nonpalpable nodules discovered incidentally on thyroid imaging. Ann Intern Med. 1997;1;126(3):226-31.
3. 3. Hegedüs L. Clinical practice. The thyroid nodule. N Engl J Med. 2004;21;351(17):1764-71.
4. 4. Yao C, Zhang Z, Yao Y, Xu X, Jiang Q, Shi D. Predictive value of neutrophil to lymphocyte ratio and platelet to lymphocyte ratio for acute deep vein thrombosis after total joint arthroplasty: a retrospective study. J Orthop Surg Res. 2018;27;13(1):40.
5. 5. Tamhane UU, Aneja S, Montgomery D, Rogers EK, Eagle KA, Gurm HS. Association between admission neutrophil to lymphocyte ratio and outcomes in patients with acute coronary syndrome. Am J Cardiol. 2008;15;102(6):653-7.
6. 6. Lolli C, Caffo O, Scarpi E, Aieta M, Conteduca V, Maines F et al. Systemic Immune-Inflammation Index predicts the clinical outcome in patients with mCRPC treated with abiraterone. Front Pharmacol. 2016;13;7:376
7. 7. Yu J, Li SM, Kong Y, Si L, Sheng X, Chi Z et al. Association of immune-inflammation index with outcome of high-risk acral melanoma patients treated with adjuvant high dose interferon. J Clin Oncol. 2016;34(15suppl):e21070.
8. 8. Tunbridge WM, Evered DC, Hall R, Appleton D, Brewis M, Clark F et al. The spectrum of thyroid disease in a community: the Whickham survey. Clin Endocrinol (Oxf). 1977;7(6):481-93.

9. 9. Cooper DS, Doherty GM, Haugen BR, Kloos RT, Lee LS, Mandel SJ et al. Revised American Thyroid Association management guidelines for patients with thyroid nodules and differentiated thyroid cancer. Thyroid. 2009;19(11):1167-214.
10. 10. Gharib H, Papini E, Paschke R, Duick DS, Valcavi R, Hegedüs L et al. American Association of Clinical Endocrinologists, Associazione Medici Endocrinologi, and European Thyroid Association medical guidelines for clinical practice for the diagnosis and management of thyroid nodules. Endocr Pract. 2010;16(Suppl 1):1-43.
11. 11. Hu B, Yang XR, Xu Y, Sun YF, Sun C, Guo W et al. Systemic immune-inflammation index predicts prognosis of patients after curative resection for hepatocellular carcinoma. Clin Cancer Res. 2014;20(23):6212-22.
12. 12. Fest J, Ruiter R, Ikram MA, Voortman T, van Eijck CHJ, Stricker BH. Reference values for white blood-cell-based inflammatory markers in the Rotterdam Study: a population-based prospective cohort study. Sci Rep. 2018;8(1):10566.
13. 13. Fest J, Ruiter R, Mulder M, Groot Koerkamp B, Ikram MA, Stricker BH, van Eijck CHJ. The systemic immune-inflammation index is associated with an increased risk of incident cancer-A population-based cohort study. Int J Cancer. 2020;146(3):692-8.
14. 14. Jomrich G, Gruber ES, Winkler D, Hollenstein M, Gnant M, Sahora K et al. Systemic Immune-Inflammation Index (SII) predicts poor survival in pancreatic cancer patients undergoing resection. J Gastrointest Surg. 2020;24(3):610-8.
15. 15. Furuncuoğlu Y, Tulgar S, Dogan AN, Cakar S, Tulgar YK, Cakiroglu B. How obesity affects the neutrophil/lymphocyte and platelet/lymphocyte ratio, systemic immune-inflammatory index and platelet indices: a retrospective study. Eur Rev Med Pharmacol Sci. 2016;20(7):1300-6. 16. Ulu Ş, Kınar A, Bucak A, Özdemir M. Systemic Immune Inflammatory Index of Patients with idiopathic sudden sensorineural hearing loss: comparison of NLR and PRL calues. Ear Nose Throat J. 2020:145561320924312.
16. 17. Deveci İ, Sürmeli M. Correlation of Systemic Immune-Inflammation Index and Neutrophil-to-Lymphocyte Ratio with histopathological findings in patients with tongue cancer. Haydarpaşa Numune Med J. 2018;58(3):122-7.
17. 18. Kilic E, Rezvani A, Toprak Erek A, Erman H, Ayhan Kesgin S, Poyraz E et al. Evaluation of neutrophil to lymphocyte and platelet to lymphocyte ratios in rheumatoid arthritis. Dicle Med J. 2016;43(2):241-7.
18. 19. Imtiaz F, Shafique K, Mirza SS, Ayoob Z, Vart P, Rao S. Neutrophil lymphocyte ratio as a measure of systemic inflammation in prevalent chronic diseases in Asian population. Int Arch Med. 2012;5(1):2.
19. 20. Sit M, Aktas G, Erkol H, Yaman S, Keyif F, Savli H. Neutrophil to Lymphocyte Ratio is useful in differentiation of malign and benign thyroid nodules. P R Health Sci J. 2019;38(1):60-3.
20. 21. Erdogan Yucel E, Demiral Sezer S. Relationship between the Neutrophil to Lymphocyte Ratio and the presence and size of thyroid nodules. Cureus. 2019;11(1):e3866.
21. 22. Pekgör S, Eryılmaz MA, Kaya İFK. Hipotiroidizmli hastalarda nötrofil-lenfosit oranı, trombosit lenfosit oranı ve ortalama trombosit hacminin değerlendirilmesi. Euras J Fam Med. 2020;9(3):139-46.
22. 23. Turkmen K, Erdur FM, Ozcicek F, Ozcicek A, Akbas EM, Ozbicer A et al. Platelet-to-lymphocyte ratio better predicts inflammation than neutrophil-to-lymphocyte ratio in end-stage renal disease patients. Hemodial Int. 2013;17(3):391-6.
23. 24. Liu XZ, Wang JM, Ji YX, Zhao DB. Monocyte-to-high-density lipoprotein cholesterol ratio is associated with the presence and size of thyroid nodule irrespective of the gender. Lipids Health Dis. 2020;19(1):36.