Ann Surg Treat Res.  2019 Feb;96(2):70-77. 10.4174/astr.2019.96.2.70.

Different prognostic values of individual hematologic parameters in papillary thyroid cancer due to age-related changes in immunity

• Lee KH
• Seok EY
• Kim EY
• Yun JS
• Park YL
• Park CH

• KMID: 2433943
• DOI: http://doi.org/10.4174/astr.2019.96.2.70

Abstract

PURPOSE
Several studies have reported the plausible association of neutrophil-to-lymphocyte ratio (NLR) with the prognosis of papillary thyroid cancer (PTC), but the results are inconsistent. In PTC, chronic inflammation is closely related to tumor progression, and the age of the patient has a great influence on prognosis. Therefore, considering the changes in the immune system with aging, we classified the patients according to age and assessed the prognostic value of individual hematologic parameters.
METHODS
This retrospective analysis included 1,921 patients who underwent thyroidectomy for PTC. Patients were divided into 2 groups based on their age: Y-group (age < 45) and O-group (age ≥ 45). Blood counts were measured within 14 days before surgery.
RESULTS
The Y-group consisted of 914 patients aged < 45 years and the O-group consisted of 932 patients aged ≥ 45. In both groups, the common prognostic factors related to disease recurrence were only 6 or more metastatic lymph node and grossly extrathyroidal extension, and hematologic parameters were different between the 2 groups. High Platelet-lymphocyte ratio (PLR) in the Y-group and high NLR in the O-group were identified as independent predictors of disease recurrence (NLR: hazard ratio [HR], 3.28; 95% confidence interval [CI], 1.23-8.73; P = 0.018; PLR: HR, 3.08; 95% CI, 1.26-7.52; P = 0.014).
CONCLUSION
The results suggest that changes in immunity with aging may affect prognosis in patients with PTC, and thus hematologic parameters might be employed as prognostic markers depending on the age of the patients.

Keyword

Thyroid neoplasms; Neutrophils; Lymphocytes; Hematologic tests

MeSH Terms

Aging
Hematologic Tests
Humans
Immune System
Inflammation
Lymph Nodes
Lymphocytes
Neutrophils
Prognosis
Recurrence
Retrospective Studies
Thyroid Gland*
Thyroid Neoplasms*
Thyroidectomy

Figure

• 

  Fig. 1 Hematologic parameters (including LMR, NLR, and PLR) and prognosis. Kaplan-Meier estimates of disease-free survival in the 914 cases of the Y-group (patients aged < 45 years) (A), the 932 cases of the O-group (patients aged ≥ 45 years) (B) classified based on the cutoff values of each parameter (high group vs. low group). LMR, lymphocyte-to-monocyte ratio; NLR, neutrophil-to-lymphocyte ratio; PLR, platelet-to-lymphocyte ratio.

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