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The predictive value of platelet parameters for the response to initial 131I therapy in patients with differentiated
Xian Wang1,2, Suyun Yang3,4
1Academy of Medical Sciences, Shanxi Medical University, Taiyuan, Shanxi, China.
Objective:
This study aims to systematically evaluate the predictive value of platelet parameters (PLT, PDW, MPV, PCT) before initial 131I therapy in patients with differentiated thyroid cancer.
Methods:
This retrospective study included 365 patients with differentiated thyroid cancer (DTC) who underwent initial 131I therapy at the Department of Nuclear Medicine in a tertiary hospital. Treatment response was assessed according to the 2025 American Thyroid Association Guidelines for the Management of Adult Differentiated Thyroid Cancer, and was categorized as Excellent Response (ER) or Non-Excellent Response (non-ER). Univariate and multivariate analyses were performed to examine the association between PLT, PDW, MPV, and PCT with non-ER, adjusting for confounding factors. Results are presented as odds ratios (OR) and 95% confidence intervals (CI). The stability of the results was verified through interaction tests and subgroup analyses. Receiver operating characteristic (ROC) curves were plotted, and the area under the curve (AUC) was calculated to assess the predictive value of platelet indices for treatment response.
Results:
After adjusting for confounding factors, MPV was independently and negatively associated with non-ER (OR = 0.40, 95% CI 0.28-0.58). Interaction analysis suggested that age and ps-Tg influence the association between MPV and non-ER (P = 0.042 and P = 0.031). The ROC curve showed that MPV had a moderate predictive value for non-ER (AUC = 0.664). Based on the maximum Youden index, the optimal cutoff value was determined to be 9.95 fL, with a sensitivity of 0.595 and a specificity of 0.657.
Conclusion:
MPV demonstrated moderate predictive value in forecasting the response of DTC patients to initial 131I therapy (AUC = 0.664). In clinical practice, MPV may be of adjunctive value in helping to identify patients with poor treatment response at an early stage. However, it is insufficient to be used as the sole basis for clinical decision-making.
