Prognostic Impact of Inflammatory Markers PLR, LMR, PDW, MPV in Medullary Thyroid Carcinoma

Canxiao Li; Han Zhang; Shijie Li; Daqi Zhang; Jingting Li; Gianlorenzo Dionigi; Nan Liang; Hui Sun

doi:10.3389/fendo.2022.861869

Prognostic Impact of Inflammatory Markers PLR, LMR, PDW, MPV in Medullary Thyroid Carcinoma

Front Endocrinol (Lausanne). 2022 Mar 8:13:861869. doi: 10.3389/fendo.2022.861869. eCollection 2022.

Authors

Canxiao Li¹, Han Zhang¹, Shijie Li¹, Daqi Zhang¹, Jingting Li¹, Gianlorenzo Dionigi², Nan Liang¹, Hui Sun¹

Affiliations

¹ Division of Thyroid Surgery, The China-Japan Union Hospital of Jilin University, Jilin Provincial Key Laboratory of Surgical Translational Medicine, Jilin Provincial Precision Medicine Laboratory of Molecular Biology and Translational Medicine on Differentiated Thyroid Carcinoma, Changchun, China.
² Division of General and Endocrine Surgery, Istituto Auxologico Italiano Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Department of Medical Biotechnology and Translational Medicine, University of Milan, Milan, Italy.

Abstract

Background: Neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), mean platelet volume (MPV), and platelet distribution width (PDW) have been used as prognostic biomarkers in various cancers. We aim to investigate the relationship between the above inflammatory indices, clinicopathological features, and postoperative calcitonin (Ctn) progression in medullary thyroid carcinoma (MTC).

Methods: Sixty-eight patients diagnosed with MTC who underwent surgery at our institution between 2009 and 2020 were retrospectively evaluated. Areas under the receiver operating characteristic curves (ROC) and logistic regression were applied to explore the potential risk factors.

Results: PDW was predictive of lymph node metastasis (LN) (AUC=0.645, P=0.044), PLR, PDW, and MPV were predictive of capsule invasion (AUC=0.771, P=0.045; AUC=0.857, P=0.008; and AUC =0.914, P=0.002, respectively), and MPV and LMR were predictive of postoperative Ctn progression (AUC=0.728, P=0.003; AUC=0.657, P=0.040). Multivariate analysis revealed that PDW ≤ 16.4 [(OR=7.8, 95% CI: 1.532-39.720, P=0.013)] and largest tumor size ≥1 cm (OR=4.833, 95% CI: 1.514-15.427, P=0.008) were potential independent risk factors for lateral LN metastasis. We also found that, MPV ≤ 8.2(OR=13.999, 95% CI: 2.842-68.965, P=0.001), LMR ≤ 4.7 (OR=4.790, 95% CI: 1.034-22.187, P=0.045), and N1 (OR=45.890, 95%CI:3.879-542.936, P=0.002) were potential independent risk factors for postoperative Ctn progression. In addition, compared with the single indicator, the appropriate combination of MPV and LMR could improve the specificity and sensitivity of predicting postoperative Ctn progression.

Conclusions: PLR, LMR, PDW, and MPV were associated with clinicopathological features and postoperative Ctn progression in MTC, suggesting that those inflammatory indices might be potential biomarkers of MTC.

Keywords: biomarkers; calcitonin; clinicopathological characteristics; inflammation-based score; medullary thyroid carcinoma.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Biomarkers
Humans
Lymphocytes
Mean Platelet Volume*
Monocytes
Prognosis
Retrospective Studies
Thyroid Neoplasms* / diagnosis
Thyroid Neoplasms* / pathology
Thyroid Neoplasms* / surgery

Substances

Biomarkers