Nötrofil lenfosit oranı: Papiller tiroit kanserini multinodüler guatrdan gerçekten ayırt eder mi?
Amaç: Bu çalışmanın amacı, preoperatif nötrofil lenfosit oranının papiller tiroit karsinomu, papiller tiroit mikrokarsinomu ve benign multinodüler guatr arasında ayırıcı tanıdaki değerini ortaya koymaktır. Metod: Çalışmaya, total tiroidektomi uygulanan ve histopatolojik tanıları postoperatif patoloji raporları ile doğrulanan papiller tiroit karsinomu, papiller tiroit mikrokarsinomu ve multinodüler guatr hastaları dahil edildi. Bulgular: Ortalama TSH düzeyi papiller tiroit karsinomu grubunda 1.85 ± 1.18 mIU / L, papiller tiroit mikrokarsinomu grubunda 1.78 ± 1.04 mIU / L ve multinodüler guatr grubunda 1.15 ± 0.91 mIU / L idi. TSH düzeyleri gruplar arasında istatistiksel olarak anlamlı farklıydı (p
Neutrophil to iymphocyte ratio: Does it really differentiate between papillary thyroid carcinomas and multinodular goiter
Aim: The aim of this study is to reveal the value of preoperative neutrophil lymphocyte ratio in differential diagnosis between papillary thyroid carcinoma, papillary thyroid microcarcinoma and benign multinodular goiter. Materials and methods: Patients with papillary thyroid carcinoma, papillary thyroid microcarcinoma, and multinodular goiter whose histopathological diagnosis was confirmed by postoperative pathology reports were included in the study. Results: The TSH levels were statistically significantly different among the groups (p < 0.001). The intergroup comparison revealed that the TSH levels were significantly lower in the multinodular goiter group compared to the papillary thyroid carcinoma and papillary thyroid microcarcinoma groups (p < 0.001, p0.001). The mean neutrophil count was 4.98 ± 1.19 in the papillary thyroid carcinoma group, 4.68 ± 1.33 in the papillary thyroid microcarcinoma group, and 4.59 ± 1.40 in the multinodular goiter group. The neutrophil counts of the groups were found to be significantly different (p = 0.013). The papillary thyroid carcinoma group had a significantly higher neutrophil count than the multinodular goiter group. The mean Neutrophil lymphocyte ratio value was 2.20 ± 0.71 in the papillary thyroid carcinoma group and 2.02 ± 0.92 in the multinodular goiter group. Neutrophil lymphocyte ratio values were significantly higher in the the papillary thyroid carcinoma group (p = 0.006). Conclucion: We believe that increased neutrophil lymphocyte ratio may be an indicator of underlying malignant disease in patients with thyroid nodules in the preoperative period.
___
- 1. Polyzos SA, Kita M, Avramidis A Thyroid nodulesstepwise diagnosis and management. Hormones 2007; 6: 101-19.
- 2. Luo J, McManus C, Chen H, et al. Are there predictors of malignancy in patients with multinodular goiter? J Surg Res 2012; 174, 207-10.
- 3. Dean, D. S. & Gharib H. Epidemiology of thyroid nodules. Best practice & research. Clinical endocrinology & metabolism 2008; 22: 901–11, doi: 10.1016/j.beem.09.019.
- 4. Erdem H, Gundogdu C, Sipal S Correlation of E-cadherin, VEGF, COX-2 expression to prognostic parameters in papillary thyroid carcinoma. Exp Mol Pathol 2011; 90: 312–17.
- 5. Cho JS, Yoon JH, Park MH, et al. Age and prognosis of papillary thyroid carcinoma: Retrospective stratification into three groups. J Korean Surg Soc 2012; 83: 259–66.
- 6. Davies L, Welch HG. Increasing incidence of thyroid cancer in the United States 1973-2002. JAMA 295:2164–67.
- 7. Yu XM, Wan Y, Sippel RS, et al. Should all papillary thyroid micro- carcinomas be aggressively treated? An analysis of 18,445 cases. Ann Surg 2011; 254: 653–60.
- 8. Mantovani A, Allavena P, Sica A, et al. Cancer-related inflammation. Nature 2008; 454: 436–44.
- 9. Guarino V, Castellone MD, Avilla E, et al. Thyroid cancer and inflammation. Mol Cell Endocrinol 2010; 321: 94–02.
- 10. Moore MM, Chua W, Charles KA, et al. Inflammation and cancer: Causes and consequences. Clin Pharmacol Ther 2010; 87: 504–08.
- 11. Rashid F, Waraich N, Bhatti I, et al. Pre-operative elevated neutrophil: lymphocyte ratio does not predict survival from oesophageal cancer resection. World J Surg Oncol 2010; 8: 1.
- 12. Proctor M. J, McMillan DC, Morrison DS et al., A derived neutrophil to lymphocyte ratio predicts survival in patients with cancer. British journal of cancer 2012;107, 695–99, doi: 10.1038/bjc.2012.292
- 13. Shimada H, Takiguchi N, Kainuma O, et al. High preoperative neutrophil-lymphocyte ratio predicts poor survival in patients with gastric cancer. Gastric Cancer 2010; 13: 170–76.
- 14. Kisucka J, Butterfield CE, Duda DG, et al. Platelets and platelet adhesion support angiogenesis while preventing excessive hemorrhage. Proc Natl Acad Sci USA 2006; 103, 855-60.
- 15. Okuturlar Y, Gunaldi M, Tiken, et al. Utility of peripheral blood parameters in predicting breast cancer risk. Asian Pac J Cancer Prev 2015; 16 (6): 2409–12.
- 16. Pujol P, Daures J P, Nsakala N, et al. Degree of thyrotropin suppression as a prognostic determinant in differentiated thyroid cancer. J Clin Endocrinol Metab 1996; 81:4318 –23.
- 17. Seretis C, Gourgiotis S, Gemenetzis G, et al. The significance of neutrophil/lymphocyte ratio as a possible marker of underlying papillary microcarcinomas in thyroidal goiters: a pilot study. American journal of surgery 2013; 205: 691–96, doi: 10.1016/j.amjsurg.2012.08.006.