Sitolojik tanısı “önemi belirlenememiş” ve “malignite kuşkusu” olan tiroid nodüllerinde nötrofil-lenfosit ve trombosit-lenfosit oranlarının prediktif rolü

Abstract

Objective: To evaluate the predictive role of complete blood count (CBC) parameters in thyroid cytological diagnosis in patients with the diagnosis of undetermined significance (AUS) and suspicious for malignancy (SM) in hematological inflammatory parameters.
Methods: The preoperative CBC of 127 patients who underwent total thyroidectomy were retrospectively evaluated. While 52 patients were defined as AUS (Group 1), 75 patients were defined as SM (Group 2) in thyroid fine-needle aspiration cytology. Both groups were divided into benign and malignant sub-groups according to histopathological diagnosis of thyroidectomy specimens. In each group, the preoperative hematologic parameters (leukocyte, neutrophil, lymphocyte, platelet, neutrophil/lymphocyte ratio ‘NLR’, platelet/lymphocyte ratio, ‘PLR’) were compared with respect to malignancy, tumor size, stage and multicentericity of cancer.
Results: The statistical analysis showed that there was no significant difference in comparison of hematological parameters in benign and malignant groups.
Conclusion: Our study showed that there was no role of NLR and PLR in the cytological diagnosis of AUS and SM to predict malignancy. There was also no correlation of hematological parameters to tumor size, multicentricity, and central lymph node metastasis.

Keywords

• Nötrofil-lenfosit oranı,trombosit-lenfosit oranı,tiroit,ince iğne aspirasyon biyopsisi,malignite kuşkusu

Kaynakça

1. 1. Hegedüs L. Thyroid size determined by ultrasound. Influence of physiological factors and non-thyroidal disease. Dan Med Bull 1990;37:249–63.
2. 2. National Cancer Institute. A snapshot of thyroid cancer; 2015 [Internet]. Bethesda (MD): National Cancer Institute; [posted 2014 Nov 5] Available from: www.cancer.gov/researchandfunding/ snapshots/thyroid.
3. 3. Cibas ES, Ali SZ; NCI Thyroid FNA State of the Science Conference. The Bethesda System For Reporting Thyroid Cytopathology. Am J Clin Pathol 2009;132:658–65.
4. 4. American Thyroid Association (ATA) Guidelines Taskforce on Thyroid Nodules and Differentiated Thyroid Cancer, Cooper DS, Doherty GM, Haugen BR, et al. Revised American Thyroid Association management guidelines for patients with thyroid nodules and differentiated thyroid cancer. Thyroid 2009;19:1167–214.
5. 5. de Matos PS, Ferreira AP, de Oliveira Facuri F, Assumpcao LV, Metze K, Ward LS. Usefulness of HBME-1, cytokeratin 19 and galectin-3 immunostaining in the diagnosis of thyroid malignancy. Histopathology 2005;47:391–401.
6. 6. Kim MI, Alexander EK. Diagnostic use of molecular markers in the evaluation of thyroid nodules. Endocr Pract 2012;18:796–802.
7. 7. Hanahan D, Weinberg RA. The hallmarks of cancer. Cell 2000; 100:57–70.
8. 8. Hanahan D, Weinberg RA. Hallmarks of cancer: the next generation. Cell 2011;14:646–74.

9. 9. Mantovani A, Allavena P, Sica A, Balkwill F. Cancer-related inflammation. Nature 2008;454(7203):436–44.
10. 10. Balkwill F, Mantovani A. Inflammation and cancer: back to Virchow? Lancet 2001;357(9255):539–45.
11. 11. Rakoff-Nahoum S. Why cancer and inflammation? Yale J Biol Med 2006;79:123–30.
12. 12. Chua W, Charles KA, Baracos VE, Clarke SJ. Neutrophil/lymphocyte ratio predicts chemotherapy outcomes in patients with advanced colorectal cancer. Br J Cancer 2011;104:1288–95.
13. 13. Feng JF, Huang Y, Liu JS. Combination of neutrophil lymphocyte ratio and platelet lymphocyte ratio is a useful predictor of postoperative survival in patients with esophageal squamous cell carcinoma. Onco Targets Ther 2013;6:1605–12.
14. 14. Mantovani A, Cassatella MA, Costantini C, Jaillon S. Neutrophils in the activation and regulation of innate and adaptive immunity. Nat Rev Immunol 2011;11:519–31.
15. 15. Seretis C, Gourgiotis S, Gemenetzis 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;205:691–6.
16. 16. He J-R, Shen G-P, Ren Z-F, et al. Pretreatment levels of peripheral neutrophils and lymphocytes as independent prognostic factors in patients with nasopharyngeal carcinoma. Head Neck 2012; 34:1769–76.
17. 17. Chang H, Gao J, Xu BQ, et al. Haemoglobin, neutrophil to lymphocyte ratio and platelet count improve prognosis prediction of the TNM staging system in nasopharyngeal carcinoma: development and validation in 3,237 patients from a single institution. Clin Oncol (R Coll Radiol) 2013;25:639–46.
18. 18. Perisanidis C, Kornek G, Pöschl PW, et al. High neutrophil-tolymphocyte ratio is an independent marker of poor disease-specific survival in patients with oral cancer. Med Oncol 2013;30:334.
19. 19. Chen J, Deng Q, Pan Y, et al. Prognostic value of neutrophil-tolymphocyte ratio in breast cancer. FEBS Open Bio 2015;5:502–7.
20. 20. Ozdemir Y, Akin ML, Sucullu I, Balta AZ, Yucel E. Pretreatment neutrophil/lymphocyte ratio as a prognostic aid in colorectal cancer. Asian Pac J Cancer Prev 2014;15:2647–50.
21. 21. Azab B, Shah N, Radbel J, et al. Pretreatment neutrophil/lymphocyte ratio is superior to platelet/lymphocyte ratio as a predictor of long-term mortality in breast cancer patients. Med Oncol 2013;30: 432.
22. 22. Smith RA, Bosonnet L, Raraty M, et al. Preoperative platelet-lymphocyte ratio is an independent significant prognostic marker in resected pancreatic ductal adenocarcinoma. Am J Surg 2009;197: 466–72.
23. 23. Liu CL, Lee JJ, Liu TP, Chang YC, Hsu YC, Cheng SP. Blood neutrophil- to-lymphocyte ratio correlates with tumor size in patients with differentiated thyroid cancer. J Surg Oncol 2013;107:493–7.