Diagnostic value of modified systemic inflammation score for prediction of malignancy in patients with indeterminate thyroid nodules.

BACKGROUND

Approximately 20% of the thyroid biopsies render an indeterminate (ID) cytology. We evaluated the diagnostic value of preoperative modified systemic inflammation score (mSIS) in predicting the malignancy of ID thyroid nodules (TNs).

METHODS

Data of 162 patients with indeterminate TNs were examined retrospectively. The mSIS was calculated as follows: mSIS 0 [patients with albumin (ALB) ≥ 4.0 g/dL and lymphocyte-to-monocyte ratio (LMR) ≥ 3.4], mSIS 1 [ALB < 4.0 g/dL or LMR < 3.4], and mSIS 2 [ALB < 4.0 g/dL and LMR < 3.4].

RESULTS

Patients were classified into mSIS 0 (n = 105), mSIS 1 (n = 34) and mSIS 2 (n = 23) groups. The malignancy rates for the mSIS 0, 1 and 2 groups were 34.3%, 64.7% and 100% respectively. Preoperative mSIS was significantly associated with the presence of thyroid malignancy (p < 0.001).

CONCLUSIONS

If the mSIS of patients with ID cytology is 1 or 2, appropriate surgical treatment should be performed without delay, due to the increased risk of malignancy.