Prognostic importance of baseline neutrophil to lymphocyte ratio in patients with advanced papillary thyroid...

Inflammation is associated with several tumor development and progression. However, these associations are not clear in well-differentiated thyroid carcinomas. We assessed whether NLR is a useful prognostic marker in patients with papillary thyroid carcinomas (PTC). The medical records of all patients who underwent thyroid surgery at a single institution between March 2005 and September 2012 were retrospectively evaluated; as a control group, patients who underwent routine health examinations in 2012 were also evaluated. Differences in mean NLR among patient groups were assessed, and clinical characteristics according to NLR quartile were evaluated in patients with PTC. The association between NLR and disease-free survival (DFS) in PTC patients was determined. NLR was significantly higher in the groups with than without thyroid nodules, but did not differ significantly in patients with benign and malignant thyroid nodules. Mean NLR was significantly higher in patients with solid or mixed thyroid than in patients with cystic nodules (1.75 ± 0.92 vs. 1.65 ± 0.74, p = 0.004). Patient follow-up ranged from 6 to 99 months. At 5-year follow-up, 11 patients had disease-specific events. We found that 5-year DFS rate was significantly worse in stages III and IV patients with NLR ≥1.5 than NLR <1.5 (94.1 vs. 99.3 %, p = 0.013). The univariate Cox hazard proportional hazard model for DFS revealed that higher NLR was independently correlated with poorer prognosis (hazard ratio 8.76; 95 % confidence interval 1.09-70.27, p = 0.041). Higher NLR may be a negative prognostic marker for DFS in patients with PTC, especially those with stages III and IV.