Department of General Surgery, Faculty of Medicine, Giresun University, Giresun, Turkey.
Medicine (Baltimore). 2023 Aug 4;102(31):e34596. doi: 10.1097/MD.0000000000034596.
Inflammation plays an important role in the pathogenesis of many cancer types and is associated with thyroid malignancy. The systemic immune-inflammation index (SII) is a new inflammation marker that can be calculated from routine complete blood count (CBC). This study investigated the association between SII, a marker derived from routine CBC, and different thyroid diseases. The objective was to determine if this simple inflammation marker can distinguish between benign and malignant thyroid diseases. The medical records of all patients who underwent surgical treatment for thyroid disease between January 2018 and January 2022 were systematically evaluated. The routine preoperative CBC parameters' demographic, clinical, and laboratory data were recorded. A total of 241 patients were included in the study, and the patients were grouped as having multinodular goiter (n = 125), lymphocytic thyroiditis (n = 44), and papillary thyroid carcinoma (PTC) (n = 73) according to pathological results. The SII was defined as the ratio of the total count of neutrophils × platelets divided by the lymphocyte count. Subgroup analysis of patients was performed according to the presence of follicular variant or thyroiditis, micro or macro carcinoma, or bilaterality of the tumor. The SII level was significantly higher in the PTC group than in the lymphocytic thyroiditis and multinodular goiter groups (P < .001). When we grouped the patients according to the presence of PTC as benign or malignant, the optimum cutoff point for SII level was found 654.13, with 73.8% sensitivity and 72.3% specificity from ROC analysis. In the subgroup analysis of patients with PTC, the SII level was similar according to the clinicopathological characteristics of the tumor. The differential diagnosis of thyroid diseases is important for patient management. We found that preoperative SII levels were significantly elevated in patients with PTC compared to those with benign thyroid disorders, and this simple marker can be used for the differentiation of benign and malignant thyroid disease.
炎症在许多癌症类型的发病机制中起着重要作用，并且与甲状腺恶性肿瘤有关。全身免疫炎症指数（SII）是一种新的炎症标志物，可以从常规全血细胞计数（CBC）中计算得出。本研究调查了 SII（一种源自常规 CBC 的标志物）与不同甲状腺疾病之间的关系。目的是确定这种简单的炎症标志物是否可以区分良性和恶性甲状腺疾病。系统性地评估了 2018 年 1 月至 2022 年 1 月期间因甲状腺疾病接受手术治疗的所有患者的病历。记录了常规术前 CBC 参数的人口统计学、临床和实验室数据。共有 241 名患者纳入本研究，根据病理结果将患者分为多结节性甲状腺肿（n = 125）、淋巴细胞性甲状腺炎（n = 44）和甲状腺乳头状癌（PTC）（n = 73）。SII 定义为中性粒细胞×血小板总数与淋巴细胞计数的比值。根据滤泡变体或甲状腺炎、微癌或巨癌或肿瘤的双侧性对患者进行亚组分析。PTC 组的 SII 水平明显高于淋巴细胞性甲状腺炎和多结节性甲状腺肿组（P <.001）。当我们根据 PTC 患者的良性或恶性分组时，发现 SII 水平的最佳截断值为 654.13，ROC 分析的敏感性为 73.8%，特异性为 72.3%。在 PTC 患者的亚组分析中，根据肿瘤的临床病理特征，SII 水平相似。甲状腺疾病的鉴别诊断对患者管理很重要。我们发现与良性甲状腺疾病患者相比，PTC 患者的术前 SII 水平明显升高，这种简单的标志物可用于良性和恶性甲状腺疾病的鉴别。
