期刊
JOURNAL OF TRANSLATIONAL MEDICINE
卷 16, 期 -, 页码 -出版社
BMC
DOI: 10.1186/s12967-018-1636-y
关键词
Papillary thyroid cancer; Tumor-node-metastasis staging system; Inflammatory index; Lymphocyte-to-monocyte ratio; Prognosis
资金
- National Natural Science Foundation of China [81670783, 81570716, 81770835]
- Natural Science Foundation of Guangdong Province [2017A030313473, 2016A030313633]
- National Undergraduate Training Programs for Innovation and Entrepreneurship [201712121049]
Background: The American Joint Committee on Cancer has recently revised the tumor-node-metastasis (TNM) staging system on thyroid cancer, which illustrated that the cut-off age for predicting mortality has elevated from 45 to 55 years old. We aimed to investigate the inflammation index based on hematological parameters to predict the clinical characteristics of elderly papillary thyroid cancer (PTC) patients with an inferior prognosis. Methods: We retrospectively analyzed 558 patients newly diagnosed with PTC from January 2013 to December 2017, and 82 out of the 558 patients were over 55 years old. Receiver operating characteristic (ROC) study and univariate and multivariate logistic analysis was conducted to evaluate the diagnostic value of these preoperative inflammation indexes in PTC patients >= 55 years of age. Results: Elevated neutrophils were prognostic of bilaterality (area under the ROC curve (AUC) = 0.673, p = 0.023) and lymph node metastasis (AUC = 0.649, p = 0.020). Decreased mean platelet volume (MPV) and platelet distribution width (PDW) were prognostic of coexistence with Hashimoto's thyroiditis (AUC = 0.736, p = 0.016; AUC = 0.721, p = 0.024). Elevated lymphocyte and lymphocyte-to-monocyte ratio (LMR) were prognostic of advanced TNM stage (AUC = 0.691, p = 0.029; AUC = 0.680, p = 0.040). Meanwhile, the logistic regression model further revealed that LMR >= 5.45 was an independent risk factor for the advanced TNM stage (odds ratio (OR) = 7.306, p = 0.036). Conclusions: The preoperative neutrophils, lymphocytes, MPV, PDW, LMR were all prognostic. More importantly, the increased in LMR independently contributed to the advanced TNM stage of PTC patients >= 55 years.
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