Importance of neutrophi̇l / lymphcoyte ratio in well differentiated thyroid cancer

Background: Thyroid cancer is the most common endocrine malignancy. The majority of papillary or follicular cancers well-differentiated subtype derived from follicular epithelial cells. Thyroid cancer also exhibits a close association with inflammation. Aim: Inflammation plays a critical role in many aspects of cancer, including tumor development, progression, clinical presentation, and prognosis. Recently, neutrophil-lymphocyte ratio (NLR) has emerged as a simple and valid composite marker of systemic inflammatory response the increasing neutrophil/lymphocyte rate is a prognostic factor for malignancy. The aim of this study is to determine whether there is a prognostic value of the pre-operative neutrophil/ lymphocyte ratio. Materials and methods: In this study, archive files of 259 adult cases diagnosed as well differentiated papillary thyroid carcinoma have been evaluated retrospectively in department of endocrinology and metabolic diseases at School of Medicine at Gaziantep University between the years 2008-2014. The neutrophil and lymphocyte values of patients were obtained from their files. The neutrophil/lymphocyte ratio was estimated by the division preoperative neutrophil amounts into the lymphocyte amounts. SPSS 22.0, Kolmogorov Smirnov Test, Mann Whitney U Test, Kruskal Wallis and Dunn multiple comparisons tests are used in the statistical analyses to exhibit the relationship between the neutrophile/lymphocyte ratio and papillary thyroid carcinoma. Findings: A significant relationship was found between neutrophil/lymphocyte ratio and T staging (p<0.001). A significant relationship was found between neutrophil/lymphocyte ratio and the lymph node involvement of tumor (p=0.001). A significant relationship was found between neutrophil/lymphocyte ratio and the distant metastasis of tumor (p=0.021). According to TNM staging, a significant relationship was found between neutrophil/lymphocyte ratio and advanced stages (p=0.001). A significant relationship was found between neutrophil/lymphocyte ratio and papillary microcarcinomas and carcinomas grater than 1 cm (p=<0.001). The sensitivity of the neutrophil/lymphocyte ratio in predicting papillary carcinomas greater than 1 cm, lymph node involvement and distant metastasis was found 85.4% 73.8,% 96% respectively and the specificities were 46.9%, 56.6% 26.9% respectively as the cut-off values are >1.644 >2.0906 >1.644 respectively. Results: Neutrophil/lymphocyte ratio was increased with tumor size, lymph node involvement, distant metastasis and TNM stage. Neutrophil/lymphocyte ratio can be useful to predict tumor size, lymph node involvement and distant metastasis.