Preoperative High Neutrophil-Lymphocyte Ratio May Be Associated with Lateral Lymph Node Metastasis in Patients with Papillary Thyroid Cancers

ABSTRACT

BACKGROUND AND OBJECTIVES: The present study investigated the association between preoperative neutrophil-to-lymphocyte ratio (NLR) and poor prognostic outcomes in conventional papillary thyroid carcinomas (cPTCs). MATERIALS AND METHODS: Two hundred and five patients who underwent total thyroidectomy for cPTCs larger than 10 mm were evaluated retrospectively. Patients were classified into the low NLR (n=103) and high NLR (n=102) groups by the median NLR value (1.78) and logistic regression analysis was used to evaluate whether the NLR predicted aggressive PTC features. Patients were also classified into the disease-free (n=183) and persistence/recurrence (n=22) groups and Cox regression analysis was used to investigate factors affecting persistence/recurrence by Cox regression analysis. RESULTS: The high NLR group had a higher presence of lateral lymph node metastasis (p=0.004) and higher radioactive iodine doses (p=0.006) than the low NLR group. High NLR was an independent predictor of lateral lymph node metastasis (LNM) (OR, 2.786; p=0.005) but was not significantly associated with persistence/recurrence. CONCLUSION: Preoperative high NLR was an independent predictor of lateral LNM in cPTCs.