The relationship of thyroid papillary carcinoma with systemic immune inflammation value, pan immune inflammation value and neutrophil-lymphocyte ratio

Among the thyroid cancers that make up 1% of all malignancies, the most common type is papillary thyroid cancer with 80%. Its incidence has been increasing in recent years due to reasons such as radiation exposure and insufficient iodine intake. Benign thyroid diseases such as nodular goiter are also followed closely because of the risk of conversion to malignancy. For this reason, thyroid diseases constitute a very large population in outpatient clinic services in practice. Early diagnosis and treatment for suspected malignancy in benign thyroid diseases and determination of prognosis in patients with papillary thyroid cancer are extremely important. The importance of the relationship between inflammation and cancer has been increasing in recent years and has been the subject of many studies. Neutrophil-lymphocyte ratio (NLR), systemic immune inflammation index (SII) and pan immune inflammation index (PIV), calculated by a simple blood count, are markers of systemic inflammation. NLR, SII and PIV have an important place for diagnosis, prognosis and treatment follow-up in many cancer types. In our study, patients with papillary thyroid cancer and patients with benign thyroid diseases were compared in terms of neutrophil lymphocyte ratio (NLR), systemic immune inflammation index (SII) and pan immune inflammation index (PIV), which are markers of systemic immune inflammation. Between January 2016 and November 2022, 140 patients who were operated for total thyroidectomy in Fırat University Faculty of Medicine, General Surgery Clinic were examined. While 70 of these patients had papillary thyroid cancer with a definitive postoperative pathology report, 70 had benign thyroid diseases. The median age of the patients included in the study was 48.7. The median age was 51.1 in the group with papillary thyroid cancer and 46.3 in the benign thyroid disease group. It was observed that the mean age of the papillary thyroid cancer group was statistically significantly more advanced than the benign thyroid diseases. As a result of our study, NLR, SII and PIV values were found to be higher in the papillary thyroid cancer patient group compared to the benign thyroid diseases group. According to the American Joint Committee on Cancer (AJCC) and International Union Against Cancer Committee (UICC) in the group with papillary thyroid cancer, it is accepted as a poor prognostic indicator aged 55 and above in the TNM prognostic staging of differentiated thyroid cancers. NLR, SII and PIV values were found to be higher in the group over 55 years of age and those under 55 years of age. NLR, SII and PIV values were found to be higher in the patient group with lymph node invasion, when it was examined according to lymph node invasion, which can raise the suspicion of malignancy if it is seen in patients followed up for benign thyroid diseases and can change the type of surgery if it is seen in patients with papillary thyroid cancer. In conclusion, our study has shown that NLR, SII and PIV values calculated for the first time in thyroid cancer in the literature, may be compatible with malignancy if high in thyroid diseases, and these values can be used as prognostic indicators in patients with thyroid papillary cancer. Key words: thyroid papillary carcinoma, neutrophil to lymphocyte ratio, pan immune inflammation value, systemic immune inflammation index