Endocrine Abstracts

JOINT958

Background: Inflammation significantly contributes to the pathogenesis of thyroid cancers, as well as various cancer types. Studies indicate that many inflammatory biomarkers are reliable indicators of prognosis and progression in malignant tumors. These include the neutrophil/lymphocyte ratio (NLR), the platelet/lymphocyte ratio (PLR), the lymphocyte/monocyte ratio (LMR), the systemic immune-inflammation index (SII), the systemic inflammatory response index (SIRI), and the systemic inflammation aggregate index (SIAI). These markers have been shown to be linked to multifocality, tumor growth, and metastasis in differentiated thyroid cancers. They can also help predict central lymph node metastasis and the prognosis. The aim of this study was to evaluate the role of systemic immune-inflammatory markers in predicting malignancy in patients who underwent surgery for thyroid nodules.

Methods: A total of 400 patients who underwent surgery for thyroid nodules were included in this study, and the patients were divided according to the cytological results defined by Bethesda classification. We recorded demographic characteristics, Bethesda findings, NLR, PLR, LMR, SII, SIRI, SIAI values, and postoperative histopathological Results.

Results: Preoperative cytology results were benign in 62 (15.5%), nondiagnostic (ND) in 36 (9%), atypia of undetermined significance (AUS) in 115 (28.75%), follicular neoplasm (FN) in 30 (7.5%), suspicious for malignancy in 70 (17.5%), and malignant in 87 (21.75%) patients. The postoperative malignancy rate in patients with AUS was 49.56%. There was a significant difference between NLR, PLR, LMR, SII, SIRI, and SIAI between the patients with AUS who had benign and malignant histopathology (P < 0.001). In patients with FN, NLR was significantly different (P = 0.035). For those with ND cytology, there was no significant difference in any marker. Area Under the Curve (AUC), sensitivity, and specificity values for markers were found, respectively, as 0.753, 0.702, 0.31 for NLR, 0.692, 0.632, 0.36 for PLR, 0.697, 0.649, 0.362 for LMR, 0.751, 0.702, 0.293 for SII, 0.729, 0.632, 0.345 for SIRI, and 0.733, 0.684, 0.31 for SIAI. The cut-off values for markers were 1.935 for NLR, 123.675 for PLR, 5.965 for LMR, 493.56 for SII, 0.68 for SIRI, and 161.525 for SIAI.

Conclusion: The NLR, PLR, SII, SIRI, and SIAI values were all significantly higher while the LMR value was significantly lower in AUS patients who had malignant histopathology compared to those with benign histopathology. All these markers might be helpful to predict malignancy in patients with preoperative AUS cytology.