Ann Surg Treat Res.  2015 Apr;88(4):187-192. 10.4174/astr.2015.88.4.187.

The neutrophil to lymphocyte ratio can discriminate anaplastic thyroid cancer against poorly or well differentiated cancer

• Cho JS
• Park MH
• Ryu YJ
• Yoon JH

• KMID: 2167013
• DOI: http://doi.org/10.4174/astr.2015.88.4.187

Abstract

PURPOSE
We evaluated the capability of the neutrophil to lymphocyte ratio (NLR) as a diagnostic tool to discriminate between poorly differentiated thyroid cancer (PDTC) and anaplastic thyroid cancer (ATC) from well differentiated thyroid cancer (WDTC).
METHODS
The NLR of 3,870 patients with benign and malignant thyroid tumors were analyzed. There were 436 benign, 3,364 papillary, 15 medullary, 34 follicular or hurthle type, 14 PDTC, and 7 ATC type neoplasms. Patients were divided into two groups: a high NLR group and a low NLR group.
RESULTS
The NLR of all 3,870 patients was a normal distribution, and the median value was 1.57. Advanced stage cancer, such as T3 or T4 was high (30.4% vs. 26.5%, P = 0.027), and cancer-specific deaths were also high (1.2% vs. 0.4%, P = 0.018) in the high NLR group. The proportion of PDTC (0.6% vs. 0.1%) and ATC (0.3% vs. 0.1%) was higher in the high NLR group. The NLR can discriminate between PTC, PDTC, and ATC (P = 0.035, P = 0.002, and P = 0.025, respectively), and the cutoff value was 3.8 between PDTC versus ATC. None of the NLR of PDTC exceeded the cutoff value of 3.8.
CONCLUSION
NLR can play a relevant role as a discriminating tool and may be considered as a new diagnostic criterion in discriminating as well as in selecting therapeutic approaches to these aggressive forms of thyroid cancer.

Keyword

Neutrophils; Lymphocytes; Thyroid neoplasms; Inflammation

MeSH Terms

Humans
Inflammation
Lymphocytes*
Neutrophils*
Thyroid Gland
Thyroid Neoplasms*

Figure

• 

  Fig. 1 Neutrophil-lymphocyte ratio can discriminate anaplastic thyroid carcinoma from other types of thyroid cancer, especially poorly differentiated thyroid carcinoma (P = 0.025). The cutoff value was 3.8. PTC, papillary thyroid cancer; MTC, medullary thyroid cancer; TFA, thyroid follicular adenoma; TFC, thyroid follicular cancer; HCC, Hurthle cell carcinoma; PDTC, poorly differentiated cancer; ATC, anaplastic cancer.

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