Sorrenti Salvatore, Scerrino Gregorio, Lori Eleonora, Vassallo Fabrizio, Saverino Stefania, Amato Calogera, Melfa Giuseppina, Richiusa Pierina, Mazzola Sergio, Lopes Antonella, Orlando Giuseppina, Graceffa Giuseppa
Department of Surgery, Sapienza University of Rome, Viale del Policlinico 155, 00161 Rome, Italy.
Unit of Endocrine Surgery, Department of Surgical Oncological and Oral Sciences, Policlinico "P. Giaccone", University of Palermo, Via Liborio Giuffré 5, 90127 Palermo, Italy.
Cancers (Basel). 2025 Apr 19;17(8):1363. doi: 10.3390/cancers17081363.
Inflammation within tumor microenvironments has been correlated to numerous malignancies. This study aims to explore its significance in thyroid cancer (TC).
Retrospective analysis of 157 thyroid carcinomas and 40 benign cases involved initial univariate analysis. The value of neutrophils/value of lymphocytes (NLR), value of platelets/value of lymphocytes (PLR), value of lymphocytes/value of monocytes (LMR), and value of platelets × value of neutrophils/value of lymphocytes (SII) indexes were related to TC characteristics and number and location of involved lymph nodes using χ or Fischer's exact tests for categorical variables and Student's -tests for continuous ones. A 1:1 propensity score matching balanced malignant and benign TC groups based on age, sex, and tumor size was used. Post-matching, a multivariate logistic model integrated sex, age, Central lymph node metastases (CLNM), and SII index. Statistically significant immune index values underwent ROC curve analysis for determining cut-offs. Among the 157 malignant TC, median test and density plots were performed.
The SII index emerged as a predictor of malignancy in both univariate and multivariate analyses (-value = 0.0202). The ROC curve indicated a cut-off SII value of 465.71, (specificity = 58% [95% CI: 0.43-0.73]; sensitivity = 80% [95% CI: 0.68-0.93]). Median SII index values for tumor sizes of 1 and >1 were 522.8 and 654.8, respectively (-value = 0.016). When central lymph nodes metastases(CLNMs) was considered (CLNM = 0 vs. CLNM > 0), median SII values were 530.7 and 1121.7, respectively (-value = 0.011).
The SII index appears to be a valuable tool in the presence of TC, showing correlations with malignancy, tumor size, and CLNMs.
肿瘤微环境中的炎症与多种恶性肿瘤相关。本研究旨在探讨其在甲状腺癌（TC）中的意义。
对157例甲状腺癌和40例良性病例进行回顾性分析，首先进行单因素分析。中性粒细胞/淋巴细胞值（NLR）、血小板/淋巴细胞值（PLR）、淋巴细胞/单核细胞值（LMR）以及血小板×中性粒细胞/淋巴细胞值（SII）指数与TC特征、受累淋巴结的数量和位置相关，分类变量采用χ检验或费舍尔精确检验，连续变量采用学生t检验。基于年龄、性别和肿瘤大小，采用1:1倾向评分匹配平衡恶性和良性TC组。匹配后，多因素逻辑模型纳入性别、年龄、中央淋巴结转移（CLNM）和SII指数。对具有统计学意义的免疫指数值进行ROC曲线分析以确定临界值。在157例恶性TC中，进行了中位数检验和密度图分析。
在单因素和多因素分析中，SII指数均显示为恶性肿瘤的预测指标（P值 = 0.0202）。ROC曲线显示SII临界值为465.71，（特异性 = 58% [95% CI：0.43 - 0.73]；敏感性 = 80% [95% CI：0.68 - 0.93]）。肿瘤大小为1和>1时的SII指数中位数分别为522.8和654.8（P值 = 0.016）。当考虑中央淋巴结转移（CLNMs）时（CLNM = 0与CLNM > 0），SII中位数分别为530.7和1121.7（P值 = 0.011）。
SII指数似乎是TC诊断中的一个有价值的工具，显示出与恶性程度、肿瘤大小和CLNMs的相关性。
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