Correlation of the Neutrophil Lymphocyte Ratio with Malignancy Status in Thyroid Nodule

Abstract

Background: Thyroid nodules are very common, found in more than 50% of patients when using ultrasonography. While the prevalence of thyroid nodules in the population is increasing, only 5% to 10% harbor malignant disease. Still, there is a pressing need to correctly identify the nature of thyroid nodules, because thyroid cancer is the most common endocrine malignancy and often presents in thyroid nodules. Inflammation plays a critical role in many aspects of cancer, including tumor development, progression, clinical presentations, and prognosis. The neutrophil/ lymphocyte ratio (NLR) is a simple index of systemic inflammatory response1,2. The aim of this study is to determine whether there is a relationship between the neutrophil/lymphocyte ratio with malignancy status of thyroid nodules. Methods: One hundred two cases of benign and malignant thyroid nodule were analyzed retrospectively. We evaluated neutrophil lymphocyte ratio with result post-operative pathological anatomy. Complete blood counts with differential counts were taken before operation. NLR was calculated by dividing preoperative neutrophil count with lymphocyte count. Sample were categorized into low grade (NLR < 1,91) and high grade (NLR ≥ 1,92). Results: There was statistically significant difference of neutrophil-lymphocyte ratio between benign thyroid nodule and malignant thyroid nodule (p=0,001). Conclusion: NLR is easily accessible tests that can be automatically calculated from complete blood count without additional cost in differentiation of malignant thyroid nodule from benign nodule in the preoperative period. Keywords: Thyroid nodule; neutrophil lymphocyte ratio; malignancy.