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The predictive value of hematologic parameters in the risk of thyroid malignancy in cases with atypia/follicular lesion of undetermined significance

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Abstract

Background

Atypia/follicular lesion of undetermined significance (AUS/FLUS) is still the most challenging category in the Bethesda System for Reporting Thyroid Cytopathology. Therefore, the aim of the current study was to investigate the value of the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and mean platelet volume (MPV) in predicting malignancy in cases with AUS/FLUS nodules.

Methods

A total of 200 patients with AUS/FLUS nodules who underwent thyroidectomy were included in this study. Preoperative hemogram parameters, ultrasonographic findings, fine-needle aspiration results, and postoperative final histopathological diagnoses of the patients were recorded retrospectively.

Results

Thyroid malignancies were detected in 122 of the patients (61.0%). Patients in the benign group (BG) were older than those in the malignancy group (MG) (52.0 ± 11.3 vs. 45.9 ± 12.3 years, p  < 0.001). The median TSH values of the two groups were comparable. Statistically significant differences were obtained between the two groups in respect of mean WBC of 7.53 ± 1.44 in MG and 6.87 ± 1.35 (103/mm3) in BG, mean neutrophil of 4.65 ± 1.12 in MG and 3.95 ± 0.99 (103/mm3) in BG, and median NLR of 2.18 (0.71–4.57) in MG and 1.75 (0.80–3.42) in BG (p  < 0.001). The median PLR and MPV values of the two groups were similar. When NLR cut-off point was designated as 2.24, the accuracy of NLR in distinguishing malignancy from the benign condition was 0.65 in ROC analysis (area under the curve, 0.665; specificity, 0.808; sensitivity, 0.492).

Conclusion

High NLR values may provide limited help in predicting thyroid malignancy in the AUS/FLUS nodule population, while PLR and MPV are not reliable parameters.

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Funding

The authors did not receive any funding for the current study.

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Authors and Affiliations

  1. Department of Endocrinology and Metabolism, Diskapi Yildirim Beyazit Training and Research Hospital, University of Health Sciences, Ziraat Mahallesi, Şht. Ömer Halisdemir Blv No:1, Altındağ, 06110, Ankara, Turkey

    Hayri Bostan, Muhammed Erkam Sencar, Murat Calapkulu, Sema Hepsen, Pinar Akhanli, Hakan Duger, Bekir Ucan, Muhammed Kizilgul, Ilknur Ozturk Unsal, Mustafa Ozbek & Erman Cakal

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  1. Hayri Bostan
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  2. Muhammed Erkam Sencar
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  3. Murat Calapkulu
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  4. Sema Hepsen
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  6. Hakan Duger
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  8. Muhammed Kizilgul
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Contributions

HB, MES, and MC designed the study; all the authors contributed to intellectual content, HB, MC, SH, PA, and HD collected data; HB and MC wrote the manuscript; and all the authors reviewed the manuscript.

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Correspondence to Hayri Bostan.

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Ethical approval

This study was conducted ethically in accordance with the World Medical Association Declaration of Helsinki. Approval for this study was granted by the local Ethics Committee.

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Written consent was obtained from all participants before the study procedures.

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Bostan, H., Sencar, M.E., Calapkulu, M. et al. The predictive value of hematologic parameters in the risk of thyroid malignancy in cases with atypia/follicular lesion of undetermined significance. Eur Arch Otorhinolaryngol 279, 4077–4084 (2022). https://doi.org/10.1007/s00405-021-07248-9

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