May the Neutrophil/Lymphocyte Ratio Be a Predictor in the Differentiation of Different Thyroid Disorders?

Background: The neutrophil/lymphocyte ratio (NLR) is a simple index of systemic inflammatory response,and has been shown to be a prognostic indicator in some types of cancer. Inflammation has been implicatedin the initiation and progression of thyroid cancer. The aim of this study was to examine the relationship ofNLR with papillary thyroid cancer (PTC) and different benign thyroid pathologies like multinodular goiter(MNG) and lymphocytic thyroiditis (LT). Materials and
Methods: We retrospectively evaluated the neutrophil,lymphocyte counts and NLR calculated from these parameters of 232 patients with histologically confirmed asmultinodular goiter (group MNG) (n=70), lymphocytic thyroiditis (group LT) (n=97), LT with PTC (group LTPTC)(n=25) and PTC (group PTC) (n=40). The optimal cut-off value for NLR was determined.
Results: NLRlevel was significantly higher in groups LT-PTC and PTC as compared to groups MNG and LT (p<0.05). NLRof LT subgroups according to TSH levels were not different (p>0.05). When we grouped the patients as benignand malignant according to PTC presence, the optimum NLR cut-off point obtained from ROC analysis was 1.91(sensitivity 89.0% and specificity 54.5%).
Conclusions: Since NLR was significantly elevated in group LT-PTCand group PTC, NLR value may give an opinion as a potential marker in differentiation of benign and malignthyroid disorders. For this purpose a cut-off value of 1.91 for NLR may be accepted.