Evaluation of Serum Neutrophil to Lymphocyte Ratio in The Results of Thyroid Fine Needle Aspiration: Can It Discriminate A Clinical Benefit for the Atypia of Undetermined Significance?

Abstract

Introduction: Thyroid biopsy results are evaluated according to The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) worldwide. The most ambiguous result from these categories is the Bethesda-III which is defined as “atypia of undetermined significance” (AUS). Neutrophil to lymphocyte ratio (NLR) is still evaluated in thyroid disorders and malignancy. The purpose of this study was to evaluate the NLR results in Bethesda Categories and whether the NLR can discriminate a clinical benefit for the AUS category. Methods: In this retrospective study, 1771 patients who had fine needle aspiration biopsy(FNAB) were examined. Demographic characteristics, NLR, Bethesda scores, operation rates and postoperative histopathological results were recorded. Results: The categories were; Bethesda-I for 298(16,8%), Bethesda-II for 1320(74,5%), Bethesda-III for 60(3,4%), Bethesda-IV for 27(1,5%), Bethesda-V for 36(2%), Bethesda-VI for 30(1,7%) results respectively. The mean NLR was 2,68. There was no statistically significant difference between groups in terms of NLR(p=0.250). Overall, 226 (12,76%) patients were undergoing thyroidectomy. The AUS group was founded by 3.4%, operation rate was 21,66% and malignancy rate was 23,07%. There was a statistically significant difference between Bethesda scores and malignancy rates(p<0.001). There was no statistically significant difference between the postoperative results in terms of NLR(p=0,973). Conclusion: The NLR does not differ according to the Bethesda Categories neither the postoperative histopathological results. It is not a predictive parameter for the benign or malignant differentiation. We think that NLR cannot discriminate a clinical benefit for the surgery decision in the follow-up of the AUS category.

Keywords

• Neutrophil to lymphocyte ratio
• Bethesda Categories
• Fine needle aspiration biopsy
• Atypia of undetermined significance
• Thyroid malignancy

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