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Lymphocyte-to-monocyte ratio prior to radioiodine ablation in low- and intermediate-risk, papillary thyroid cancer

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Abstract

Purpose

We aimed to investigate inflammation indices based on preablation hematological parameter of the lymphocyte-to-monocyte ratio (LMR) to predict the clinical outcome in papillary thyroid cancer (PTC) patients with low- and intermediate-risk stratification.

Methods

This retrospective study analyzed 772 patients with low- and intermediate-risk PTC who underwent total thyroidectomy followed by radioiodine therapy between July 2005 and July 2009 with a median of 10 years. Kaplan–Meier statistics were used to test differences in recurrence-free survival (RFS) between groups based on the optimal cutoff point of biomarkers identified using receiver operating characteristic curves.

Results

With an optimal cutoff point of 7.05, 215 patients (29.8%) were classified as having low LMR and 557 patients (71.2%) were classified as having high LMR. High LMR was significantly associated with a prolonged RFS (hazard ratio [HR]: 2.048, 95% confidence interval [CI]: 1.062–4.359, p = 0.001). Multivariate analysis showed that low LMR (HR = 2.035, 95% CI: 1.011–4.095, p = 0.012), tumor size over 2 cm (HR = 2.762, 95% CI: 1.303–5.852, p = 0.008), and high preablative simulated thyroglobulin level over 10 ng/ml (HR = 7.826, 95% CI: 2.353–26.033, p < 0.001) were independent prognostic markers for worse RFS in the enrolled PTC patients.

Conclusions

LMR at the time of radioiodine therapy has comparable predictor for the clinical outcome with both tumor size and preablative simulated thyroglobulin level in low- to intermediate-risk PTC patients.

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Author contributions

S.-J.K. designed and directed the research. K.K. analyzed the data and wrote the manuscript. K.P., I.-J.K., and M.K. collected the data. B.H.K. and B.-J.L. reviewed the manuscript and references.

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Authors and Affiliations

  1. Department of Nuclear Medicine and Biomedical Research Institute, Pusan National University Hospital, Busan, 49241, Republic of Korea

    Keunyoung Kim, Kyoungjune Pak & In-Joo Kim

  2. Department of Internal Medicine and Biomedical Research Institute, Pusan National University Hospital, Busan, 49241, Republic of Korea

    Mijin Kim & Bo Hyun Kim

  3. Department of Otorhinolaryngology—Head and Neck Surgery, Pusan National University School of Medicine and Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea

    Byung-Joo Lee

  4. Department of Nuclear Medicine, Pusan National University Yangsan Hospital, Yangsan, 50612, Republic of Korea

    Seong-Jang Kim

  5. BioMedical Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, 50612, Republic of Korea

    Seong-Jang Kim

  6. Department of Nuclear Medicine, College of Medicine, Pusan National University, Yangsan, 50612, Republic of Korea

    Seong-Jang Kim

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  1. Keunyoung Kim
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Correspondence to Seong-Jang Kim.

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Institutional review board approval was approved (IRB No. H-1906–028–080).

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Kim, K., Pak, K., Kim, IJ. et al. Lymphocyte-to-monocyte ratio prior to radioiodine ablation in low- and intermediate-risk, papillary thyroid cancer. Endocrine 70, 364–371 (2020). https://doi.org/10.1007/s12020-020-02328-y

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  • DOI: https://doi.org/10.1007/s12020-020-02328-y

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