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Malign Tiroid Nodülleri için Biyolojik Belirteçlerin Prediktif Değeri. Tek Merkez Deneyimi

Yıl 2022, Cilt: 6 Sayı: 2, 188 - 195, 30.08.2022
https://doi.org/10.34084/bshr.1165757

Öz

GİRİŞ ve AMAÇ: Tiroid nodülleri çoğunlukla benign özelliktedir. Yerleşim bölgelerine göre değişmekle birlikte erkeklerde nodüllerin %5,4'ü, kadınlarda ise %6,5'i malign olabilir. Radyoloji, endokrin cerrahisi, patoloji ve endokrinoloji bulunmadığı kırsal bölgelerde tiroid nodüllerinin yönetiminde zorluklar yaşanabilir. Çalışmamızda, tiroid nodülü olan hastalarda bazı biyolojik belirteçlerin analizi ve nodülün benign malign ayırımı açısından öneminin belirlemesi amaçlanmaktadır.
YÖNTEM ve GEREÇLER: Ocak 2019-Eylül 2020 tarihleri ​​arasında total tiroidektomi yapılan hastaların tiroid ultrasonografi sonuçları, tiroid ince iğne aspirasyon biyopsi sonuçları, tiroidektomi örneklerinin histopatolojik inceleme sonuçları, nötrofil, trombosit, lenfosit, eritrosit sayıları ve ortalama eritrosit hacmi (MCV) değerleri retrospektif olarak gözden geçirildi. Daha sonra her hasta için Mentzer indeksi, Sistemik immün-inflamatuar indeks ve nötrofil-lenfosit oranları hesaplandı
BULGULAR: Çalışmaya 140 hasta dahil edildi. Mentzer indeksi, Sistemik inflamatuar indeks ve nötrofil-lenfosit oranlarında malign ve benign tiroid nodülleri olan hastalar arasında istatistiksel olarak anlamlı fark yoktu.
TARTIŞMA ve SONUÇ: Biyolojik belirteçlerin tiroid nodüllerinin tedavisinde sınırlı prediktif gücü vardır. Bu nedenle tiroid nodüllerinin tedavisinde biyolojik belirteçlerin kullanımı uygun olmayabilir.

Kaynakça

  • 1. Reiners C, Wegscheider K, Schicha H, Theissen P, Vaupel R, Wrbitzky R, et al. Prevalence of thyroid disorders in the working population of Germany: ultrasonography screening in 96,278 unselected employees. Thyroid. 2004;14(11):926-32.
  • 2. Figge, J. J. Epidemiology of Thyroid Cancer. Thyroid Cancer, 206. 9–13 p.
  • 3. Rossi ED, Pantanowitz L, Hornick JL. A worldwide journey of thyroid cancer incidence centred on tumour histology. Lancet Diabetes Endocrinol. 2021;9(4):193-194.
  • 4. Cramer JD, Fu P, Harth KC, Margevicius S, Wilhelm SM. Analysis of the rising incidence of thyroid cancer using the Surveillance, Epidemiology and End Results national cancer data registry. Surgery. 2010;148(6):1147-52.
  • 5. Patel KN, Yip L, Lubitz CC, Grubbs EG, Miller BS, Shen W, et al. The American Association of Endocrine Surgeons Guidelines for the Definitive Surgical Management of Thyroid Disease in Adults. Ann Surg. 2020;271(3):21-93.
  • 6. Roman SA, Sosa JA, Solórzano CC. Management of Thyroid Nodules and Differentiated Thyroid Cancer: A Practical Guide. (Springer), 2017. 382 p.
  • 7. Gharib H, AACE/AME/ETA Task Force on Thyroid Nodules. 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. J. Endocrinol. Invest. 2010;33:1–50.
  • 8. Hendrickson CD, Saini S, Pothuloori A, Mecchella JN. Assessing referrals and improving informatıon availability for consultations in an academic endocrınology clinic. Endocr. Pract. 2017;23:190–198.
  • 9. Song CY, Meng YL, Liu B, Yan L, Shang PZ, Jia ZF et al. [Correlation analysis of neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio and central cervical lymph node metastasis of papillary thyroid microcarcinoma]. Zhonghua Zhong Liu Za Zhi. 2021;43:944–948.
  • 10. Bilge M, Akilli IK, Karaayvaz EB, Yesilova A, Kart YK. Comparison of systemic immune-inflammation index (SII), early warning score (ANDC) and prognostic nutritional index (PNI) in hospitalized patients with malignancy, and their influence on mortality from COVID-19. Infect. Agent. Cancer. 2021;16:60.
  • 11. Kucuk S, Mızrak S. Diagnostic Value of Inflammatory Factors in Patients with Gallbladder Cancer, Dysplasia, and Cholecystitis. Cancer Control. 2021;28:10732748211033746.
  • 12. Ozdemir A, Kocak SY, Karabela SN, Yılmaz M. [Can systemic immune inflammation index at admission predict in-hospital mortality in chronic kidney disease patients with SARS-CoV-2 infection]. Nefrologia. 2021;09:001.
  • 13. Seretis C, Gourgiotis S, Gemenerzis G, Seretis F, Lagoudianakis E, Dimitrakopoulos G. The significance of neutrophil/lymphocyte ratio as a possible marker of underlying papillary microcarcinomas in thyroidal goiters: a pilot study. Am. J. Surg. 2013:205:691–696.
  • 14. Ertok Ilyas, Karakayali O, Kocasaban DU. Clinical importance of neutrophil/lymphocyte ratio in differential diagnosis of acute cholecystitis and cholelithiasis. Kocaeli Medical Journal. 2016;5:6–11.
  • 15. Ozkan A, Gokce AH, Gokce FS. The importance of laboratory tests and Body Mass Index in the diagnosis of acute appendicitis. Pol. Przegl. Chir. 2020;92:7–11.
  • 16. Xu TM, Cheng XY, Yan PG, He XX, Li JN. [Clinicopathological characteristics of rectal neuroendocrine neoplasms]. Zhonghua Nei Ke Za Zhi. 2021;60: 886–890.
  • 17. Xu G, Li C, Wang Y, Ma J, Zhang J. Correlation between preoperative inflammatory markers, Ki-67 and the pathological grade of glioma. Medicine. 2021;100:26750.
  • 18. Li S, Ma PF, Zhang JL, Cao YH, Liu CY, Zhang XJ et al. [The value of spleen density in predicting prognosis of patients with gastric cancer after curative gastrectomy]. Zhonghua Yi Xue Za Zhi. 2021;101:2703–2709.
  • 19. Kocer D, Karakukcu C, Karaman H, Gokay F, Bayram F. May the neutrophil/lymphocyte ratio be a predictor in the differentiation of different thyroid disorders? Asian Pac. J. Cancer Prev. 2015;16:3875–3879.
  • 20. Ito Y, Onoda N, Kihara M, Miya A, Miyauchi A. Prognostic Significance of Neutrophil-to-Lymphocyte Ratio in Differentiated Thyroid Carcinoma Having Distant Metastasis: A Comparison With Thyroglobulin-doubling Rate and Tumor Volume-doubling Rate. In Vivo. 2021;35:1125–1132.
  • 21. Zhong JH, Huang DH, Chen ZY. Prognostic role of systemic immune-inflammation index in solid tumors: a systematic review and meta-analysis. Oncotarget 2017;8:75381–75388.
  • 22. Lu Z, Li R, Cao X, Liu C, Sun Z, Shi X et al. Assessment of Systemic Inflammation and Nutritional Indicators in Predicting Recurrence-Free Survival After Surgical Resection of Gastrointestinal Stromal Tumors. Front. Oncol. 2021;11:710191.
  • 23. Seban RD, Assie JB, Leprieur EG, Massiani MA, Bonardel G, Chouaid C et al. Prognostic value of inflammatory response biomarkers using peripheral blood and [18F]-FDG PET/CT in advanced NSCLC patients treated with first-line chemo- or immunotherapy. Lung Cancer. 2021;159:45–55.
  • 24. Inoue H, Kosuga T, Kubota T, Konishi H, Shiozaki A et al. Significance of a preoperative systemic immune-inflammation index as a predictor of postoperative survival outcomes in gastric cancer. World J. Surg. Oncol. 2021;19:173.
  • 25. Daly ME. Determinants of platelet count in humans. Haematologica. 2011;96:10–13.
  • 26. Bose S, Maimoon S. Is Mentzer index a reliable diagnostic screening tool for beta thalassemia trait. IOSR Journal of Dental and Medical Sciences. 2018;17:7–11.
  • 27. Kneifati HJ, Fleischman W, Bernstein LH, Riccioli A and Bellevue RA. Model for automated screening of thalassemia in hematology (math study). Lab. Hematol. 2007;13:119–123.
  • 28. Naoum FA. Iron deficiency in cancer patients. Rev. Bras. Hematol. Hemoter. 2016;38:325–330.
  • 29. Tessler FN, Middleton WD, Grant EG. and Hoang JK. ACR Thyroid Imaging, Reporting and Data System (TI-RADS): White Paper of the ACR TI-RADS Committee. Journal of the American College of Radiology. 2018;15:381–382.
  • 30. Jensen CB, Saucke MC, Francis DO, Voils CI, Pitt SC. From Overdiagnosis to Overtreatment of Low-Risk Thyroid Cancer: A Thematic Analysis of Attitudes and Beliefs of Endocrinologists, Surgeons, and Patients. Thyroid. 2020;30:696–703.
  • 31. Schneider DF, Stafford LMC, Brys N, Greenberg CC, Balentine CJ et al. Gauging The Extent Of Thyroidectomy For Indeterminate Thyroid Nodules: An Oncologıc Perspective. Endocr. Pract.2017;23:442–450.

The Predictive Power of Biological Markers for Malignant Thyroid Nodules. Single-Center Experience

Yıl 2022, Cilt: 6 Sayı: 2, 188 - 195, 30.08.2022
https://doi.org/10.34084/bshr.1165757

Öz

Background: Thyroid nodules are mostly benign. Although it varies by region, 5.4% of nodules in men and 6.5% of nodules in women may be malignant. In rural regions where a radiologist, an endocrine surgeon, a cytologist, and an endocrinologist are not present, difficulties may be experienced in the management of thyroid nodules.
Objectives: This present study aims to determine if it is possible to comment on whether the nodule is malignant by evaluating the biological markers in patients with thyroid nodules.
Methods: We reviewed retrospectively the data of patients between January 2019 and September 2020 who underwent total thyroidectomy in terms of thyroid ultrasonography results, thyroid fine-needle aspiration biopsy results, neutrophil, platelet, lymphocyte, red blood cell, and mean erythrocyte volume (MCV) values, histopathological examination results of thyroid specimens. Subsequently, we calculated Mentzer index, Systemic immune-inflammatory index, and neutrophil-lymphocyte ratio for each patient.
Results: 140 patients were included in the study. 110 (78.6%) of the patients were female and 30 (21.4%) were male. The mean age of the patients was 48 ± 12.5 (20-76). There was no statistically significant difference in Mentzer index, Systemic inflammatory index, and neutrophil-lymphocyte ratios between patients with malignant and benign thyroid nodules.
Conclusion: Biological markers have limited predictive power in the management of thyroid nodules. Therefore, the use of biomarkers that we have studied in the treatment of thyroid nodules does not seem possible at present.

Kaynakça

  • 1. Reiners C, Wegscheider K, Schicha H, Theissen P, Vaupel R, Wrbitzky R, et al. Prevalence of thyroid disorders in the working population of Germany: ultrasonography screening in 96,278 unselected employees. Thyroid. 2004;14(11):926-32.
  • 2. Figge, J. J. Epidemiology of Thyroid Cancer. Thyroid Cancer, 206. 9–13 p.
  • 3. Rossi ED, Pantanowitz L, Hornick JL. A worldwide journey of thyroid cancer incidence centred on tumour histology. Lancet Diabetes Endocrinol. 2021;9(4):193-194.
  • 4. Cramer JD, Fu P, Harth KC, Margevicius S, Wilhelm SM. Analysis of the rising incidence of thyroid cancer using the Surveillance, Epidemiology and End Results national cancer data registry. Surgery. 2010;148(6):1147-52.
  • 5. Patel KN, Yip L, Lubitz CC, Grubbs EG, Miller BS, Shen W, et al. The American Association of Endocrine Surgeons Guidelines for the Definitive Surgical Management of Thyroid Disease in Adults. Ann Surg. 2020;271(3):21-93.
  • 6. Roman SA, Sosa JA, Solórzano CC. Management of Thyroid Nodules and Differentiated Thyroid Cancer: A Practical Guide. (Springer), 2017. 382 p.
  • 7. Gharib H, AACE/AME/ETA Task Force on Thyroid Nodules. 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. J. Endocrinol. Invest. 2010;33:1–50.
  • 8. Hendrickson CD, Saini S, Pothuloori A, Mecchella JN. Assessing referrals and improving informatıon availability for consultations in an academic endocrınology clinic. Endocr. Pract. 2017;23:190–198.
  • 9. Song CY, Meng YL, Liu B, Yan L, Shang PZ, Jia ZF et al. [Correlation analysis of neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio and central cervical lymph node metastasis of papillary thyroid microcarcinoma]. Zhonghua Zhong Liu Za Zhi. 2021;43:944–948.
  • 10. Bilge M, Akilli IK, Karaayvaz EB, Yesilova A, Kart YK. Comparison of systemic immune-inflammation index (SII), early warning score (ANDC) and prognostic nutritional index (PNI) in hospitalized patients with malignancy, and their influence on mortality from COVID-19. Infect. Agent. Cancer. 2021;16:60.
  • 11. Kucuk S, Mızrak S. Diagnostic Value of Inflammatory Factors in Patients with Gallbladder Cancer, Dysplasia, and Cholecystitis. Cancer Control. 2021;28:10732748211033746.
  • 12. Ozdemir A, Kocak SY, Karabela SN, Yılmaz M. [Can systemic immune inflammation index at admission predict in-hospital mortality in chronic kidney disease patients with SARS-CoV-2 infection]. Nefrologia. 2021;09:001.
  • 13. Seretis C, Gourgiotis S, Gemenerzis G, Seretis F, Lagoudianakis E, Dimitrakopoulos G. The significance of neutrophil/lymphocyte ratio as a possible marker of underlying papillary microcarcinomas in thyroidal goiters: a pilot study. Am. J. Surg. 2013:205:691–696.
  • 14. Ertok Ilyas, Karakayali O, Kocasaban DU. Clinical importance of neutrophil/lymphocyte ratio in differential diagnosis of acute cholecystitis and cholelithiasis. Kocaeli Medical Journal. 2016;5:6–11.
  • 15. Ozkan A, Gokce AH, Gokce FS. The importance of laboratory tests and Body Mass Index in the diagnosis of acute appendicitis. Pol. Przegl. Chir. 2020;92:7–11.
  • 16. Xu TM, Cheng XY, Yan PG, He XX, Li JN. [Clinicopathological characteristics of rectal neuroendocrine neoplasms]. Zhonghua Nei Ke Za Zhi. 2021;60: 886–890.
  • 17. Xu G, Li C, Wang Y, Ma J, Zhang J. Correlation between preoperative inflammatory markers, Ki-67 and the pathological grade of glioma. Medicine. 2021;100:26750.
  • 18. Li S, Ma PF, Zhang JL, Cao YH, Liu CY, Zhang XJ et al. [The value of spleen density in predicting prognosis of patients with gastric cancer after curative gastrectomy]. Zhonghua Yi Xue Za Zhi. 2021;101:2703–2709.
  • 19. Kocer D, Karakukcu C, Karaman H, Gokay F, Bayram F. May the neutrophil/lymphocyte ratio be a predictor in the differentiation of different thyroid disorders? Asian Pac. J. Cancer Prev. 2015;16:3875–3879.
  • 20. Ito Y, Onoda N, Kihara M, Miya A, Miyauchi A. Prognostic Significance of Neutrophil-to-Lymphocyte Ratio in Differentiated Thyroid Carcinoma Having Distant Metastasis: A Comparison With Thyroglobulin-doubling Rate and Tumor Volume-doubling Rate. In Vivo. 2021;35:1125–1132.
  • 21. Zhong JH, Huang DH, Chen ZY. Prognostic role of systemic immune-inflammation index in solid tumors: a systematic review and meta-analysis. Oncotarget 2017;8:75381–75388.
  • 22. Lu Z, Li R, Cao X, Liu C, Sun Z, Shi X et al. Assessment of Systemic Inflammation and Nutritional Indicators in Predicting Recurrence-Free Survival After Surgical Resection of Gastrointestinal Stromal Tumors. Front. Oncol. 2021;11:710191.
  • 23. Seban RD, Assie JB, Leprieur EG, Massiani MA, Bonardel G, Chouaid C et al. Prognostic value of inflammatory response biomarkers using peripheral blood and [18F]-FDG PET/CT in advanced NSCLC patients treated with first-line chemo- or immunotherapy. Lung Cancer. 2021;159:45–55.
  • 24. Inoue H, Kosuga T, Kubota T, Konishi H, Shiozaki A et al. Significance of a preoperative systemic immune-inflammation index as a predictor of postoperative survival outcomes in gastric cancer. World J. Surg. Oncol. 2021;19:173.
  • 25. Daly ME. Determinants of platelet count in humans. Haematologica. 2011;96:10–13.
  • 26. Bose S, Maimoon S. Is Mentzer index a reliable diagnostic screening tool for beta thalassemia trait. IOSR Journal of Dental and Medical Sciences. 2018;17:7–11.
  • 27. Kneifati HJ, Fleischman W, Bernstein LH, Riccioli A and Bellevue RA. Model for automated screening of thalassemia in hematology (math study). Lab. Hematol. 2007;13:119–123.
  • 28. Naoum FA. Iron deficiency in cancer patients. Rev. Bras. Hematol. Hemoter. 2016;38:325–330.
  • 29. Tessler FN, Middleton WD, Grant EG. and Hoang JK. ACR Thyroid Imaging, Reporting and Data System (TI-RADS): White Paper of the ACR TI-RADS Committee. Journal of the American College of Radiology. 2018;15:381–382.
  • 30. Jensen CB, Saucke MC, Francis DO, Voils CI, Pitt SC. From Overdiagnosis to Overtreatment of Low-Risk Thyroid Cancer: A Thematic Analysis of Attitudes and Beliefs of Endocrinologists, Surgeons, and Patients. Thyroid. 2020;30:696–703.
  • 31. Schneider DF, Stafford LMC, Brys N, Greenberg CC, Balentine CJ et al. Gauging The Extent Of Thyroidectomy For Indeterminate Thyroid Nodules: An Oncologıc Perspective. Endocr. Pract.2017;23:442–450.
Toplam 31 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Klinik Tıp Bilimleri
Bölüm Araştırma Makalesi
Yazarlar

Recayi Capoglu 0000-0003-4438-4301

Zulfu Bayhan 0000-0002-7587-7267

Emre Gönüllü 0000-0001-6391-4414

Murat Coskun 0000-0002-6361-913X

Ahmet Tarık Harmantepe 0000-0003-2888-7646

Furkan Kucuk 0000-0002-2558-9144

Hakan Demir 0000-0001-5973-4605

Yayımlanma Tarihi 30 Ağustos 2022
Kabul Tarihi 29 Ağustos 2022
Yayımlandığı Sayı Yıl 2022 Cilt: 6 Sayı: 2

Kaynak Göster

AMA Capoglu R, Bayhan Z, Gönüllü E, Coskun M, Harmantepe AT, Kucuk F, Demir H. The Predictive Power of Biological Markers for Malignant Thyroid Nodules. Single-Center Experience. J Biotechnol and Strategic Health Res. Ağustos 2022;6(2):188-195. doi:10.34084/bshr.1165757
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