Is there a predictive value of systemic inflammatory parameters and prognostic nutritional index in the detection of lymphatic metastases in papillary thyroid cancers?
Öz
This study aimed to assess the predictive value of systemic inflammatory parameters and the prognostic nutritional index (PNI) in identifying lymphatic metastases in papillary thyroid cancers (PTC). PTCs, characterized by their in dolent nature and favorable prognosis, frequently disseminate to cervical lymphnodes, impacting recurrence and prognosis. However, the preoperative identification rate of cervical lymphnode metastases ranges from 20% to 75%, necessitating supplemental examinations for precise detection and surgical planning. A retrospective analysis of 441 thyroidectomy cases, encompassing 272 PTC patients, was conducted. Patients were categorized into two cohorts: 221 lacked lymphnode metastases, while 51 exhibited lymphatic metastases. Parameters including age, gender, systemic inflammatory markers derived from hemogram tests, serum albumin levels, and postoperative histopathology findings were scrutinized to evaluate the predictive potential of systemic inflammatory parameters and PNI in discerning between the two cohorts. The findings revealed that neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and systemic immune-inflammation index (SII) values bore statistically significant predictive capacity (p<0.05) in preoperatively detecting cervical lymphnode metastases in PTC. Receiver operating characteristic (ROC) curves delineated the efficacy of NLR, PLR, and SII in prognostication. NLR exhibited an area under the curve (AUC) value of 0.932 (95% CI, 0.902-0.962; p<0.001), while PLR yielded an AUC value of 0.638 (95% CI, 0.555-0.721; p=0.002). SII analysis yielded an AUC value of 0.798 (95% CI, 0.736-0.861; p<0.001). Conversely, the prognostic nutritional index (PNI) demonstrated meager predictive utility, registering an AUC value of 0.192 (95% CI, 0.124-0.260; p<0.001), positioning below the reference line on the ROC curve. In conclusion, this study under scores NLR's utility in identifying cervical lymphnode metastases in PTC. While PLR and SII evince some association with lymphnode metastasis detection, their predictive efficacy remains constrained. Additionally, despite statistical significance, PNI exhibited in efficacy in forecasting lymphnode metastases.
Anahtar Kelimeler
Papillary thyroid carcinomas Lymph node metastasis Prognostic nutritional index Inflammatory markers.
Destekleyen Kurum
NONE
Proje Numarası
NONE
Kaynakça
- Topaloğlu O, Başer H, ALTINBOĞA AA, Ulusoy S, Ersoy R, ÇAKIR B. Diferansiye Tiroid Kanserlerinin Klinikopatolojik Özelliklerinin Değerlendirilmesi. Ankara Medical Journal. 2018;18(3):419-29.
- Cabanillas ME, McFadden DG, Durante C. Thyroid cancer. The Lancet. 2016;388(10061):2783-95.
- Deng Y, Zhang J, Wang J, Wang J, Zhang J, Guan L, et al. Risk factors and prediction models of lymph node metastasis in papillary thyroid carcinoma based on clinical and imaging characteristics. Postgraduate Medicine. 2023;135(2):121-7.
- Adam MA, Pura J, Goffredo P, Dinan MA, Reed SD, Scheri RP, et al. Presence and number of lymph node metastases are associated with compromised survival for patients younger than age 45 years with papillary thyroid cancer. Journal of Clinical Oncology. 2015;33(21):2370-5.
- Haugen BR, Alexander EK, Bible KC, Doherty GM, Mandel SJ, Nikiforov YE, et al. 2015 American Thyroid Association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer: the American Thyroid Association guidelines task force on thyroid nodules and differentiated thyroid cancer. Thyroid. 2016;26(1):1-133.
- Zhao S, Yue W, Wang H, Yao J, Peng C, Liu X, et al. Combined Conventional Ultrasound and Contrast‐Enhanced Computed Tomography for Cervical Lymph Node Metastasis Prediction in Papillary Thyroid Carcinoma. Journal of Ultrasound in Medicine. 2023;42(2):385-98.
- Suh C, Baek J, Choi Y, Lee J. Performance of CT in the preoperative diagnosis of cervical lymph node metastasis in patients with papillary thyroid cancer: a systematic review and meta-analysis. American Journal of Neuroradiology. 2017;38(1):154-61.
- Zhao H, Li H. Meta-analysis of ultrasound for cervical lymph nodes in papillary thyroid cancer: Diagnosis of central and lateral compartment nodal metastases. European journal of radiology. 2019;112:14-21.
- Kim SY, Kim B-W, Pyo JY, Hong SW, Chang H-S, Park CS. Macrometastasis in papillary thyroid cancer patients is associated with higher recurrence in lateral neck nodes. World Journal of Surgery. 2018;42:123-9.
- Wada N, Duh Q-Y, Sugino K, Iwasaki H, Kameyama K, Mimura T, et al. Lymph node metastasis from 259 papillary thyroid microcarcinomas: frequency, pattern of occurrence and recurrence, and optimal strategy for neck dissection. Annals of surgery. 2003;237(3):399-407.
- Mantovani A, Allavena P, Sica A, Balkwill F. Cancer-related inflammation. nature. 2008;454(7203):436-44.
- Chen W, Wei T, Li Z, Gong R, Lei J, Zhu J, et al. Association of the preoperative inflammation-based scores with TNM stage and recurrence in patients with papillary thyroid carcinoma: a retrospective, multicenter analysis. Cancer Management and Research. 2020:1809-18.
- Onodera T, Goseki N, Kosaki G. Prognostic nutritional index in gastrointestinal surgery of malnourished cancer patients. Nihon geka gakkai zasshi. 1984;85(9):1001-5.
- Kars A, Sahin A, Kılıc K, Sakat MS, Bilen A. Systemic immune inflammation index in differentiated thyroid cancers. Acta Otorhinolaryngologica Italica. 2022;42(2):150.
- Offi C, Romano RM, Cangiano A, Candela G, Docimo G. Clinical significance of neutrophil-to-lymphocyte ratio, lymphocyte-to-monocyte ratio, platelet-to-lymphocyte ratio and prognostic nutritional index in low-risk differentiated thyroid carcinoma. Acta Otorhinolaryngologica Italica. 2021;41(1):31.
- Atasever Akkas E, Erdis E, Yucel B. Prognostic value of the systemic immune-inflammation index, systemic inflammation response index, and prognostic nutritional index in head and neck cancer. European Archives of Oto-Rhino-Laryngology. 2023;280(8):3821-30.
- Dupré A, Malik HZ. Inflammation and cancer: what a surgical oncologist should know. European Journal of Surgical Oncology. 2018;44(5):566-70.
- Ceylan Y, Kumanlıoğlu K, Oral A, Ertan Y, Özcan Z. The correlation of clinicopathological findings and neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios in papillary thyroid carcinoma. Molecular Imaging and Radionuclide Therapy. 2019;28(1):15.
- Wen W, Wu P, Li J, Wang H, Sun J, Chen H. Predictive values of the selected inflammatory index in elderly patients with papillary thyroid cancer. Journal of Translational Medicine. 2018;16:1-7.
- Deng J, Zhang P, Sun Y, Peng P, Huang Y. Prognostic and clinicopathological significance of platelet to lymphocyte ratio in esophageal cancer: a meta-analysis. Journal of Thoracic Disease. 2018;10(3):1522.
- Zhong J-H, Huang D-H, Chen Z-Y. Prognostic role of systemic immune-inflammation index in solid tumors: a systematic review and meta-analysis. Oncotarget. 2017;8(43):75381.
- Zhang Z, Xia F, Wang W, Huang Y, Li X. The systemic immune-inflammation index-based model is an effective biomarker on predicting central lymph node metastasis in clinically nodal-negative papillary thyroid carcinoma. Gland surgery. 2021;10(4):1368.
- Wang Y, Battseren B, Yin W, Lin Y, Zhou L, Yang F, et al. Predictive and prognostic value of prognostic nutritional index for locally advanced breast cancer. Gland Surgery. 2019;8(6):618.
- Tam AA, Özdemir D, Çuhacı N, Başer H, Aydın C, Yazgan AK, et al. Association of multifocality, tumor number, and total tumor diameter with clinicopathological features in papillary thyroid cancer. Endocrine. 2016;53:774-83.
Öz
Anahtar Kelimeler
Proje Numarası
NONE
Kaynakça
- Topaloğlu O, Başer H, ALTINBOĞA AA, Ulusoy S, Ersoy R, ÇAKIR B. Diferansiye Tiroid Kanserlerinin Klinikopatolojik Özelliklerinin Değerlendirilmesi. Ankara Medical Journal. 2018;18(3):419-29.
- Cabanillas ME, McFadden DG, Durante C. Thyroid cancer. The Lancet. 2016;388(10061):2783-95.
- Deng Y, Zhang J, Wang J, Wang J, Zhang J, Guan L, et al. Risk factors and prediction models of lymph node metastasis in papillary thyroid carcinoma based on clinical and imaging characteristics. Postgraduate Medicine. 2023;135(2):121-7.
- Adam MA, Pura J, Goffredo P, Dinan MA, Reed SD, Scheri RP, et al. Presence and number of lymph node metastases are associated with compromised survival for patients younger than age 45 years with papillary thyroid cancer. Journal of Clinical Oncology. 2015;33(21):2370-5.
- Haugen BR, Alexander EK, Bible KC, Doherty GM, Mandel SJ, Nikiforov YE, et al. 2015 American Thyroid Association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer: the American Thyroid Association guidelines task force on thyroid nodules and differentiated thyroid cancer. Thyroid. 2016;26(1):1-133.
- Zhao S, Yue W, Wang H, Yao J, Peng C, Liu X, et al. Combined Conventional Ultrasound and Contrast‐Enhanced Computed Tomography for Cervical Lymph Node Metastasis Prediction in Papillary Thyroid Carcinoma. Journal of Ultrasound in Medicine. 2023;42(2):385-98.
- Suh C, Baek J, Choi Y, Lee J. Performance of CT in the preoperative diagnosis of cervical lymph node metastasis in patients with papillary thyroid cancer: a systematic review and meta-analysis. American Journal of Neuroradiology. 2017;38(1):154-61.
- Zhao H, Li H. Meta-analysis of ultrasound for cervical lymph nodes in papillary thyroid cancer: Diagnosis of central and lateral compartment nodal metastases. European journal of radiology. 2019;112:14-21.
- Kim SY, Kim B-W, Pyo JY, Hong SW, Chang H-S, Park CS. Macrometastasis in papillary thyroid cancer patients is associated with higher recurrence in lateral neck nodes. World Journal of Surgery. 2018;42:123-9.
- Wada N, Duh Q-Y, Sugino K, Iwasaki H, Kameyama K, Mimura T, et al. Lymph node metastasis from 259 papillary thyroid microcarcinomas: frequency, pattern of occurrence and recurrence, and optimal strategy for neck dissection. Annals of surgery. 2003;237(3):399-407.
- Mantovani A, Allavena P, Sica A, Balkwill F. Cancer-related inflammation. nature. 2008;454(7203):436-44.
- Chen W, Wei T, Li Z, Gong R, Lei J, Zhu J, et al. Association of the preoperative inflammation-based scores with TNM stage and recurrence in patients with papillary thyroid carcinoma: a retrospective, multicenter analysis. Cancer Management and Research. 2020:1809-18.
- Onodera T, Goseki N, Kosaki G. Prognostic nutritional index in gastrointestinal surgery of malnourished cancer patients. Nihon geka gakkai zasshi. 1984;85(9):1001-5.
- Kars A, Sahin A, Kılıc K, Sakat MS, Bilen A. Systemic immune inflammation index in differentiated thyroid cancers. Acta Otorhinolaryngologica Italica. 2022;42(2):150.
- Offi C, Romano RM, Cangiano A, Candela G, Docimo G. Clinical significance of neutrophil-to-lymphocyte ratio, lymphocyte-to-monocyte ratio, platelet-to-lymphocyte ratio and prognostic nutritional index in low-risk differentiated thyroid carcinoma. Acta Otorhinolaryngologica Italica. 2021;41(1):31.
- Atasever Akkas E, Erdis E, Yucel B. Prognostic value of the systemic immune-inflammation index, systemic inflammation response index, and prognostic nutritional index in head and neck cancer. European Archives of Oto-Rhino-Laryngology. 2023;280(8):3821-30.
- Dupré A, Malik HZ. Inflammation and cancer: what a surgical oncologist should know. European Journal of Surgical Oncology. 2018;44(5):566-70.
- Ceylan Y, Kumanlıoğlu K, Oral A, Ertan Y, Özcan Z. The correlation of clinicopathological findings and neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios in papillary thyroid carcinoma. Molecular Imaging and Radionuclide Therapy. 2019;28(1):15.
- Wen W, Wu P, Li J, Wang H, Sun J, Chen H. Predictive values of the selected inflammatory index in elderly patients with papillary thyroid cancer. Journal of Translational Medicine. 2018;16:1-7.
- Deng J, Zhang P, Sun Y, Peng P, Huang Y. Prognostic and clinicopathological significance of platelet to lymphocyte ratio in esophageal cancer: a meta-analysis. Journal of Thoracic Disease. 2018;10(3):1522.
- Zhong J-H, Huang D-H, Chen Z-Y. Prognostic role of systemic immune-inflammation index in solid tumors: a systematic review and meta-analysis. Oncotarget. 2017;8(43):75381.
- Zhang Z, Xia F, Wang W, Huang Y, Li X. The systemic immune-inflammation index-based model is an effective biomarker on predicting central lymph node metastasis in clinically nodal-negative papillary thyroid carcinoma. Gland surgery. 2021;10(4):1368.
- Wang Y, Battseren B, Yin W, Lin Y, Zhou L, Yang F, et al. Predictive and prognostic value of prognostic nutritional index for locally advanced breast cancer. Gland Surgery. 2019;8(6):618.
- Tam AA, Özdemir D, Çuhacı N, Başer H, Aydın C, Yazgan AK, et al. Association of multifocality, tumor number, and total tumor diameter with clinicopathological features in papillary thyroid cancer. Endocrine. 2016;53:774-83.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Genel Cerrahi |
| Bölüm | Research Article |
| Yazarlar | |
| Proje Numarası | NONE |
| Yayımlanma Tarihi | 29 Mart 2024 |
| Gönderilme Tarihi | 8 Haziran 2023 |
| Kabul Tarihi | 14 Mart 2024 |
| Yayımlandığı Sayı | Yıl 2024 Cilt: 41 Sayı: 1 |
Kaynak Göster
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.