Department of Endocrinology and Metabolism, First Affiliated Hospital of Nanchang University, Nanchang, China.
J Clin Lab Anal. 2022 May;36(5):e24429. doi: 10.1002/jcla.24429. Epub 2022 Apr 11.
The aim of this study was to investigate the diagnostic value of peripheral blood neutrophil-to-lymphocyte ratio (NLR) combined with the thyroid imaging reporting and data system (TIRADS) for benign and malignant thyroid nodules.
A total of 585 adults were enrolled in the study. The receiver operating characteristic curves were used to determine the optimal cut-off values for NLR and Kwak TIRADS (K-TIRADS) grades, which were 1.87 and 4a, respectively. Thyroid nodules were scored as follows: NLR-K-TIRADS score is 2 (both elevated K-TIRADS grade and NLR), NLR-K-TIRADS score is 1 (one of these was elevated) and NLR-k-TIRADS score is 0 (neither were elevated).
The proportions of malignant nodules with NLR-K-TIRADS scores of 2, 1 and 0 were 98.59%, 69.62% and 10.19%, and the difference was statistically significant (p < 0.001). In terms of the sensitivity of diagnosis of malignant nodules, NLR-K-TIRADS 1 tends to increase relative to K-TIRADS grades ≥ 4a; in terms of specificity and positive predictive value for the diagnosis of malignant nodules, NLR-K-TIRADS 2 was significantly higher than K-TIRADS grades ≥ 4a (all p < 0.05).
NLR combined with K-TIRADS grades may be a novel method for screening benign and malignant thyroid nodules.
本研究旨在探讨外周血中性粒细胞与淋巴细胞比值（NLR）联合甲状腺影像报告和数据系统（TIRADS）对甲状腺良恶性结节的诊断价值。
共纳入 585 例成年人。采用受试者工作特征曲线确定 NLR 和 Kwak TIRADS（K-TIRADS）分级的最佳截断值，分别为 1.87 和 4a。甲状腺结节评分如下：NLR-K-TIRADS 评分 2（K-TIRADS 分级和 NLR 均升高）、NLR-K-TIRADS 评分 1（其中一项升高）和 NLR-K-TIRADS 评分 0（均未升高）。
NLR-K-TIRADS 评分 2、1 和 0 的恶性结节比例分别为 98.59%、69.62%和 10.19%，差异有统计学意义（p<0.001）。在诊断恶性结节的敏感性方面，NLR-K-TIRADS 1 较 K-TIRADS 分级≥4a 有所增加；在诊断恶性结节的特异性和阳性预测值方面，NLR-K-TIRADS 2 明显高于 K-TIRADS 分级≥4a（均 p<0.05）。
NLR 联合 K-TIRADS 分级可能是一种筛查甲状腺良恶性结节的新方法。
