Cho Jin-Seong, Park Min-Ho, Ryu Young-Jae, Yoon Jung-Han
Department of Surgery, Chonnam National University College of Medicine, Gwangju, Korea.
Ann Surg Treat Res. 2015 Apr;88(4):187-92. doi: 10.4174/astr.2015.88.4.187. Epub 2015 Mar 26.
We evaluated the capability of the neutrophil to lymphocyte ratio (NLR) as a diagnostic tool to discriminate between poorly differentiated thyroid cancer (PDTC) and anaplastic thyroid cancer (ATC) from well differentiated thyroid cancer (WDTC).
The NLR of 3,870 patients with benign and malignant thyroid tumors were analyzed. There were 436 benign, 3,364 papillary, 15 medullary, 34 follicular or hurthle type, 14 PDTC, and 7 ATC type neoplasms. Patients were divided into two groups: a high NLR group and a low NLR group.
The NLR of all 3,870 patients was a normal distribution, and the median value was 1.57. Advanced stage cancer, such as T3 or T4 was high (30.4% vs. 26.5%, P = 0.027), and cancer-specific deaths were also high (1.2% vs. 0.4%, P = 0.018) in the high NLR group. The proportion of PDTC (0.6% vs. 0.1%) and ATC (0.3% vs. 0.1%) was higher in the high NLR group. The NLR can discriminate between PTC, PDTC, and ATC (P = 0.035, P = 0.002, and P = 0.025, respectively), and the cutoff value was 3.8 between PDTC versus ATC. None of the NLR of PDTC exceeded the cutoff value of 3.8.
NLR can play a relevant role as a discriminating tool and may be considered as a new diagnostic criterion in discriminating as well as in selecting therapeutic approaches to these aggressive forms of thyroid cancer.
我们评估了中性粒细胞与淋巴细胞比值（NLR）作为一种诊断工具，用于区分低分化甲状腺癌（PDTC）、未分化甲状腺癌（ATC）与高分化甲状腺癌（WDTC）的能力。
分析了3870例甲状腺良恶性肿瘤患者的NLR。其中有436例良性肿瘤、3364例乳头状癌、15例髓样癌、34例滤泡型或许特莱细胞型癌、14例PDTC和7例ATC型肿瘤。患者分为两组：高NLR组和低NLR组。
3870例患者的NLR呈正态分布，中位数为1.57。高NLR组中晚期癌症（如T3或T4期）比例较高（30.4%对26.5%，P = 0.027），癌症特异性死亡比例也较高（1.2%对0.4%，P = 0.018）。高NLR组中PDTC（0.6%对0.1%）和ATC（0.3%对0.1%）的比例更高。NLR能够区分PTC、PDTC和ATC（分别为P = 0.035、P = 0.002和P = 0.025），PDTC与ATC之间的临界值为3.8。PDTC的NLR均未超过3.8的临界值。
NLR可作为一种有价值的鉴别工具，在区分以及选择针对这些侵袭性甲状腺癌的治疗方法时，可被视为一种新的诊断标准。
