Peking Union Medical College Hospital, China
Title: Preoperative neutrophil to lymphocyte ratio predicts central compartment lymph nodes metastasis in papillary thyroid microcarcinoma
Biography: Xiequn Xu
Background:The incidence of papillary thyroid microcarcinoma (PTMC) is rising in most countries, which is a consequence of efficacy earlier diagnosis. Even though the central lymph nodes metastasis has be considered to be a risk factor of poor prognosis in PTMC, there is no reliable preoperative assessment for it. Our study was to confirm the value of preoperative neutrophil to lymphocyte ratio (NLR) to predict the central lymph nodes metastasis of PTMC by retrospective case control study.
Methods: A total of 142 patients who underwent total thyroidectomy with prophylactic central lymph nodes dissection at a single institution between Oct 2013 and Jan 2015 were analyzed. Patients were categorized into central lymph node metastasis positive and negative, those were confirmed by histological. Age, gender, blood cells counts with differential counts, medical history were measured or recorded in each patient before operation.
Results: In our study, 37.14% (n=52) were CLN metastasis positive while 62.86% (n=88) were negative. The factors that correlated (P<0.05) with the presence of central lymph node metastases were age and NLR. The NLR were significantly higher in the Central lymph node negative group (p=0.027). The optimum NLR cut-off value obtained from ROC analysis was 2.32 (Sensitivity 44% and Specificity 87.1%). The optimum Age cut-off value obtained from ROC analysis was 45(Sensitivity 53.1% and Specificity 76.3%).
Conclusions: Higher preoperative NLR could be a reliable negative marker for central compartment lymph node metastasis and cut-off value of 2.32 be supposed.