Lymphocyte-to-monocyte ratio prior to radioiodine ablation in low- and intermediate-risk, papillary thyroid cancer
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ORIGINAL ARTICLE
Lymphocyte-to-monocyte ratio prior to radioiodine ablation in lowand intermediate-risk, papillary thyroid cancer Keunyoung Kim1 Kyoungjune Pak1 In-Joo Kim1 Mijin Kim2 Bo Hyun Kim2 Byung-Joo Lee3 Seong-Jang Kim4,5,6 ●
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Received: 30 January 2020 / Accepted: 22 April 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose We aimed to investigate inflammation indices based on preablation hematological parameter of the lymphocyte-tomonocyte ratio (LMR) to predict the clinical outcome in papillary thyroid cancer (PTC) patients with low- and intermediaterisk stratification. Methods This retrospective study analyzed 772 patients with low- and intermediate-risk PTC who underwent total thyroidectomy followed by radioiodine therapy between July 2005 and July 2009 with a median of 10 years. Kaplan–Meier statistics were used to test differences in recurrence-free survival (RFS) between groups based on the optimal cutoff point of biomarkers identified using receiver operating characteristic curves. Results With an optimal cutoff point of 7.05, 215 patients (29.8%) were classified as having low LMR and 557 patients (71.2%) were classified as having high LMR. High LMR was significantly associated with a prolonged RFS (hazard ratio [HR]: 2.048, 95% confidence interval [CI]: 1.062–4.359, p = 0.001). Multivariate analysis showed that low LMR (HR = 2.035, 95% CI: 1.011–4.095, p = 0.012), tumor size over 2 cm (HR = 2.762, 95% CI: 1.303–5.852, p = 0.008), and high preablative simulated thyroglobulin level over 10 ng/ml (HR = 7.826, 95% CI: 2.353–26.033, p < 0.001) were independent prognostic markers for worse RFS in the enrolled PTC patients. Conclusions LMR at the time of radioiodine therapy has comparable predictor for the clinical outcome with both tumor size and preablative simulated thyroglobulin level in low- to intermediate-risk PTC patients. Keywords Papillary thyroid cancer Lymphocyte-to-monocyte ratio Radioiodine ablation Prognosis Immune system ●
* Seong-Jang Kim [email protected] 1
Department of Nuclear Medicine and Biomedical Research Institute, Pusan National University Hospital, Busan 49241, Republic of Korea
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Department of Internal Medicine and Biomedical Research Institute, Pusan National University Hospital, Busan 49241, Republic of Korea
3
Department of Otorhinolaryngology—Head and Neck Surgery, Pusan National University School of Medicine and Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
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Department of Nuclear Medicine, Pusan National University Yangsan Hospital, Yangsan 50612, Republic of Korea
5
BioMedical Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan 50612, Republic of Korea
6
Department of Nuclear Medicine, College of Medicine, Pusan National University, Yangsan 50612, Republic of Korea
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Introduction Papillary thyroid cancer (PTC) is the most frequent endocrine malignancy
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