Thyroid and Parathyroid Surgery Center, West China Hospital of Sichuan University, Chengdu, China.
West China School of Medicine, Sichuan University, Chengdu, China.
J Surg Oncol. 2020 Oct;122(5):897-905. doi: 10.1002/jso.26089. Epub 2020 Jun 28.
Easily accessible, generalized, and inexpensive methods are expected to differentiate anaplastic thyroid carcinoma (ATC) from advanced differentiated thyroid cancer (aDTC). We aimed to explore potential diagnostic and prognostic value of systematic inflammatory markers (SIMs) in ATC and aDTC.
About 22 ATC, 101 aDTC, and 100 matched early DTC patients were analyzed retrospectively. SIMs included the comprehensive index, neutrophil-monocyte-platelet-to-lymphocyte ratio (NMPLR) and the previously reported ones. Receiver operating characteristic, Kaplan-Meier, and COX regression analyses were mainly conducted.
NMPLR exhibited the highest area under the curve value 0.806 (P < .0001) to diagnose ATC from aDTC. NMPLR was identified as an independent risk factor for overall survival (OS) (hazard ratio [HR]: 47.821, 95% confidence interval [CI], 2.863-798.765, P = .007) in ATC, as well as for OS (HR: 7.360, 95% CI, 1.620-33.430, P = .010) and recurrence-free survival (HR: 4.172, 95% CI, 1.139-15.286, P = .031) in aDTC. Taken both refractory types (ATC and aDTC) together, NMPLR could independently predict OS (HR: 6.470; 95% CI, 2.134-19.616; P = .001).
NMPLR is a generalized index. It showed excellent potential in differential diagnosis and survival prediction in refractory thyroid cancer. However, it needs to be validated in larger cohort and clinical practice.
人们期望能够找到简便、通用且廉价的方法来区分间变性甲状腺癌（ATC）和晚期分化型甲状腺癌（aDTC）。本研究旨在探讨系统性炎症标志物（SIMs）在 ATC 和 aDTC 中的潜在诊断和预后价值。
回顾性分析了 22 例 ATC、101 例 aDTC 和 100 例匹配的早期 DTC 患者。SIMs 包括综合指数、中性粒细胞-单核细胞-血小板与淋巴细胞比值（NMPLR）以及之前报道的指标。主要进行了受试者工作特征曲线、Kaplan-Meier 分析和 COX 回归分析。
NMPLR 诊断 ATC 与 aDTC 的曲线下面积最高（AUC）值为 0.806（P<0.0001）。NMPLR 被确定为 ATC 患者总生存（OS）的独立危险因素（HR：47.821，95%置信区间[CI]，2.863-798.765，P=0.007），也是 aDTC 患者 OS（HR：7.360，95% CI，1.620-33.430，P=0.010）和无复发生存（HR：4.172，95% CI，1.139-15.286，P=0.031）的独立危险因素。将两种难治性类型（ATC 和 aDTC）合并，NMPLR 可独立预测 OS（HR：6.470；95% CI，2.134-19.616；P=0.001）。
NMPLR 是一种通用指标。它在难治性甲状腺癌的鉴别诊断和生存预测方面具有很好的潜力。然而，它需要在更大的队列和临床实践中得到验证。
