Peripheral Blood Inflammatory Markers Can Predict Benign and Malignant Thyroid Nodules

Area of Science:

• Oncology
• Immunology
• Endocrinology

Background:

• Inflammation plays a crucial role in the development and progression of various cancers.
• Thyroid nodules are common, and differentiating benign from malignant ones is essential for appropriate management.
• Thyroid Imaging Reporting and Data System (TI-RADS) classification aids in risk stratification, with grade 3 nodules requiring further evaluation.

Purpose of the Study:

• To investigate the predictive value of peripheral blood inflammatory markers, including platelet count, neutrophil-lymphocyte ratio (NLR), platelet count-lymphocyte count ratio (PLR), and systemic inflammation index (SII), for distinguishing benign from malignant TI-RADS grade 3 thyroid nodules.
• To identify independent risk factors for malignant thyroid nodules among these inflammatory markers and clinical characteristics.

Main Methods:

• A retrospective analysis of 514 patients with TI-RADS grade 3 thyroid nodules.
• Patients were categorized into benign and malignant groups based on pathological results.
• Univariate and stepwise multivariate logistic regression analyses were employed to identify influencing factors, with receiver operating characteristic (ROC) curve analysis used to determine cutoff values.

Main Results:

• Malignant nodule group showed significantly higher leukocyte count, neutrophil count, platelet count, NLR, PLR, and SII compared to the benign group (P < 0.05).
• Malignant nodules were associated with significantly smaller age and nodule diameter (P < 0.05).
• Independent risk factors for malignant nodules included higher SII (OR=1.006), lower PLR (OR=0.981), lower leukocyte count (OR=0.654), and younger age (OR=0.969). Cutoff values for SII and PLR were determined.

Conclusions:

• Peripheral blood SII, PLR, leukocyte count, and age are significant independent risk factors for malignant thyroid nodules.
• The combination of these factors offers improved prediction of malignancy in TI-RADS grade 3 thyroid nodules.
• These findings can guide the diagnosis and treatment strategies for TI-RADS grade 3 thyroid nodules.