Clinical Value of Blood Neutrophil to Lymphocyte Ratio in Patients with Papillary Thyroid Carcinoma with Neck Lymph Node Metastasis

Hwa Bin Kim; Hyoung Shin Lee; Sung Won Kim; Seok Won Jeon; Ji Ah Song; Kang Dae Lee

doi:10.11106/ijt.2017.10.2.89

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Kim, Lee, Kim, Jeon, Song, and Lee: Clinical Value of Blood Neutrophil to Lymphocyte Ratio in Patients with Papillary Thyroid Carcinoma with Neck Lymph Node Metastasis

Original Article

International Journal of Thyroidology 2017; 10(2): 89-95.

Published online: 29 November 2017

DOI: https://doi.org/10.11106/ijt.2017.10.2.89

Clinical Value of Blood Neutrophil to Lymphocyte Ratio in Patients with Papillary Thyroid Carcinoma with Neck Lymph Node Metastasis

Hwa Bin Kim^1,^*, Hyoung Shin Lee^2,^*, Sung Won Kim², Seok Won Jeon², Ji Ah Song², Kang Dae Lee²

¹Department of Medicine, Kosin University College of Medicine, Busan, Korea.

²Department of Otolaryngology-Head and Neck Surgery, Kosin University College of Medicine, Busan, Korea.

Correspondence: Kang Dae Lee, MD, Department of Otolaryngology-Head and Neck Surgery, Kosin University College of Medicine, 262 Gamcheon-ro, Seo-gu, Busan 49267, Korea. Tel: 82-51-990-6470, Fax: 82-51-245-8539, kdlee59@gmail.com

Equal contributor:

*Hwa Bin Kim and Hyoung Shin Lee equally contributed to this work.

Received 16 June 2017 Revised 4 August 2017 Accepted 10 August 2017

The Korean Thyroid Association

(open-access):

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background and Objectives

Blood neutrophil-to-lymphocyte ratio (NLR) has been reported to have poor prognostic impact in variable malignancies. However, studies evaluating the clinical significance of blood NLR in patient with papillary thyroid carcinoma (PTC) has been relatively rare, and the outcomes were inconsistent. In this study, we sought to analyze the clinical value of NLR in patients with PTC who had cervical lymph node metastasis.

Materials and Methods

Retrospective chart review was conducted with 174 patients with confirmed neck metastasis of PTC after initial thyroidectomy. Blood NLR was estimated by dividing the absolute number of blood neutrophil with that of lymphocyte. Statistical analysis was conducted to evaluate correlation between NLR and clinicopathologic factors, patterns of metastatic lymph nodes, and recurrence.

Results

Higher NLR (>1.74) was correlated to younger age of patients (<45 years, p=0.045) and smaller size of tumor (<1 cm, p=0.017). Blood NLR had no impact on patterns of lymph node metastasis or recurrence.

Conclusion

Blood NLR may not be considered as a predictive factor for clinical aggressiveness or prognosis in patients with PTC with lymph node metastasis.

Keywords: Papillary thyroid carcinoma, Neck metastasis, Neutrophil, Lymphocyte

Figures and Tables

Table 1

Summary of clinicopathologic factors

ENE: extranodal extension, ETE: extrathyroidal extension, LN: lymph node, mets: metastasis, RAI: radioactive iodine

Table 2

Summary of complete blood counts and hormonal level in enrolled patients

Hb: hemoglobin, Hct: hematocrit, NLR: neutrophil-to-lymphocyte ratio, PLR: platelet-to-lymphocyte ration, SD: standard deviation, TSH: thyroid stimulating hormone, WBC: white blood cell

Table 3

Comparison of clinicopathologic factors according to blood neutrophil-to-lymphocyte ratio

ENE: extranodal extension, ETE: extrathyroidal extension, LN: lymph node, LVI: lymphovascular invasion, mets: metastasis, NLR: neutrophil-to-lymphocyte ratio, OP: operative

^*p<0.05

Table 4

Comparison of clinicopathologic factors according to blood platelet-to-lymphocyte ratio

ENE: extranodal extension, ETE: extrathyroidal extension, LN: lymph node, LVI: lymphovascular invasion, mets: metastasis, OP: operative, PLR: platelet-to-lymphocyte ratio

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