Demet Sengul, Ilker Sengul


Objective: Neutrophil lymphocyte ratio (N/L) and mean platelet (Plt) volume (MPV), the markers of systemic inflammatory response, has been investigated in many cancers, but data for head and neck cancers and thyroid carcinoma are limited. It had been purposed to study N/L, MPV, and Plt levels in papillary thyroid carcinoma (PTC) as a diagnostic marker. Material and Methods: A total of 104 patients, had undergone ultrasonography (US) guided fine needle aspiration (FNA) and thyroidectomy, for indicated cases, between April 2010 and August 2013, were enrolled in the study and the laboratory tests, regarding N/L, MPV, and Plt, of the cases had been collected retrospectively. Results: No any difference was stated between PTC and benign nodular thyroid diseases (BNTD) in terms of age, gender, size of the nodule, N/L, MPV, and Plt (p>0.05). Conclusion: The preoperative inflammatory hematological parameters, in terms of N/L, MPV, and Plt, may not be useful as a predictive diagnostic marker of the thyroid malignancy, PTC.


Thyroid neoplasms; Papillary thyroid cancer (PTC); Ultrasonography (US); Ultrasonography guided fine needle aspiration (US-g-FNA); Bethesda; Neutrophils; Lymphocytes; Neutrophil lymphocyte ratio; Mean platelet volume; Blood platelets

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Hegedüs L. Thyroid size determined by ultrasound. Influence of physiological factors and non-thyroidal disease. Dan Med Bull. 1990;37(3):249–63.

National Cancer Institute. A snapshot of thyroid cancer; 2015 [Internet]. Bethesda (MD): National Cancer Institute; [posted 2014 Nov 5] Available from: snapshots/thyroid.

Pacini F, Schlumberger M, Dralle H, Elisei R, Smit JW, Wiersinga W et al. European consensus for the management of patients with differentiated thyroid carcinoma of the follicular epithelium. Eur J Endocrinol. 2006;154(6):787-803.

Pellegriti G, Frasca F, Regalbuto C, Squatrito S, Vigneri R. Worldwide increasing incidence of thyroid cancer: update on epidemiology and risk factors. J Cancer Epidemiol. 2013;2013:965212.

Cramer JD, Fu P, Harth KC, Margevicius S, Wilhelm SM. Analysis of the rising incidence of thyroid cancer using the Surveillance, Epidemiology and End Results national cancer data registry. Surgery. 2010;148(6):1147-52.

Hanahan D, Weinberg RA. The hallmarks of cancer. Cell. 2000;100(1):57–70.

Hanahan D, Weinberg RA. Hallmarks of cancer: the next generation. Cell. 2011;144(5):646–74.

Cibas ES, Ali SZ. The Bethesda system for reporting thyroid cytopathology. Thyroid. 2009;19(11):1159 65.

Haugen BR, Alexander EK, Bible KC, Doherty GM, Mandel SJ, Nikiforov YE, et al. 2015 American thyroid association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer: The American thyroid sssociation guidelines task force on thyroid nodules and differentiated thyroid cancer. Thyroid. 2016;26(1):1-33.

American Thyroid Association (ATA) Guidelines Taskforce on Thyroid Nodules and Differentiated Thyroid Cancer, Cooper DS, Doherty GM, Haugen BR, Kloos RT, Lee SL, et al. Revised American Thyroid Association management guidelines for patients with thyroid nodules and differentiated thyroid cancer. Thyroid. 2009;19(11):1167– 214.

Cooper DS, Doherty GM, Haugen BR, Kloos RT, Lee SL, Mandel SJ et al. Management guidelines for patients with thyroid nodules and differentiated thyroid cancer. Thyroid. 2006,16(2):109–42.

Ali SZ, Vielh P, Pusztaszeri M, Rossi D, Faquin WC, Bishop JA, et al. The Bethesda System for reporting thyroid cytopathology: past, present, future at The 19th International Congress of Cytology in Pacifico Yokohama, Japan, on 28 May–01 June, 2016, Symposiunm 12

Ali SZ, Cibas ES. The Bethesda system for reporting thyroid cytopathology II. Acta Cytol. 2016;60(5):397-8.

Pusztaszeri M, Rossi ED, Auger M, Baloch Z, Bishop J, Bongiovanni M, et al. The Bethesda system for reporting thyroid cytopathology: proposed modifications and updates for the decond edition from an international panel. Acta Cytol. 2016;60(5):399-405.

Hegedüs L Clinical practice. The thyroid nodule. N Engl J Med. 2004;351(17):1764-71.

Mandel SJ A 64-year-old woman with a thyroid nodule. JAMA. 2004;292(21):2632-42.

Sherman SI Thyroid carcinoma. Lancet 2003;361(9356):501–11.

Siegel R, Ma J, Zou Z, Jemal A Cancer statistics,2014 CA Cancer J Clin. 2014;64(1):9–29.

Davies L, Welch HG. Current thyroid cancer trends in the United States. JAMA Otolaryngol Head Neck Surg. 2014;140(4):317–22.

Aschebrook-Kilfoy B, Schechter RB, Shih YC, Kaplan EL, Chiu BC, Angelos P, et al. The clinical and economic burden of a sustained increase in thyroid cancer incidence. Cancer Epidemiol Biomarkers Prev. 2013;22(7):1252–9.

Chang H, Gao J, Xu BQ, Guo SP, Lu RB, et al Haemoglobin, neutrophil to lymphocyte ratio and platele.t count improve prognosis prediction of the TNM staging system in nasopharyngeal carcinoma: development and validation in 3,237 patients from a single institution. Clin Oncol (R Coll Radiol). 2013;25(11):639-46.

Perisanidis C, Kornek G, Pöschl PW, , Holzinger D, Pirklbauer K, Schopper C et al. High neutrophil-tolymphocyte ratio is an independent marker of poor disease-specific survival in patients with oral cancer. Med Oncol. 2013;30(1):334.

Chen J, Deng Q, Pan Y, He B, Ying H, Sun H et al. Prognostic value of neutrophil-tolymphocyte ratio in breast cancer. FEBS Open Bio. 2015;5:502–7.

Smith RA, Bosonnet L, Raraty M, Sutton R, Neoptolemos JP, Campbell F,et al. Preoperative platelet-lymphocyte ratio is an independent significant prognostic marker in resected pancreatic ductal adenocarcinoma. Am J Surg. 2009;197(4):466-72.

Feng JF, Huang Y, Liu JS. Combination of neutrophil lymphocyte ratio and platelet lymphocyte ratio is a useful predictor of postoperative survival in patients with esophageal squamous cell carcinoma. Onco Targets Ther. 2013;6:1605–12.

Mangalpally KK, Siqueiros-Garcia A, Vaduganathan M, Dong JF, Kleiman NS, Guthikonda S. Platelet activation patterns in platelet size subpopulations: differential responses to aspirin in vitro. J Thrombosis Thrombolysis. 2010;30(3):251-62.

Baldane S, Ipekci SH, Sozen M, Kebapcilar L. Mean platelet volume could be a possible biomarker for papillary thyroid carcinomas. Asian Pac J Cancer Prev. 2015;16(7):2671-4.



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