Abstract
Is to assess the diagnostic and prognostic role of different inflammatory indices in patients with benign and malignant thyroid nodules. The neutrophil to lymphocyte ratio (NLR), lymphocyte to monocyte ratio (LMR), platelet to lymphocyte ratio (PLR), derived NLR (dNLR), systemic inflammation index (SII), neutrophil to lymphocyte, platelet ratio (NLPR), systemic inflammation response index (SIRI), and aggregate index of systemic inflammation (AISI) were assessed in150 thyroid cancer (TC) patients, 75 benign nodule patients, compared to 70 healthy controls. There was a significant difference among TC patients and control group regarding the PLR, LMR, SII, NLPR, SIRI, and AISI (p = 0.006, p < 0.001, p = 0.043,p < 0.001 p < 0.001, and p < 0.001; respectively). LMR and SIRI could efficiently differentiate malignant versus benign thyroid nodules at a cutoff of 5.2 and 0.597; respectively. LMR, PLR, SIRI, and AISI were notably associated with high-risk stratification of TC patients (p = 0.011, p = 0.035, p = 0.036, and p = 0.034; respectively). Moreover, PLR was significantly elevated in TC patients with lymph node (LN) metastasis (p = 0.010). The LMR (OR = 0.318, p < 0.001), SIRI (OR = 2.293, p = 0.001), AISI (OR = 2.714, p < 0.001), and FT4 (OR = 0.250, p < 0.001) could differentiate TC against non-TC groups. LMR, SIRI, AISI, and FT4 are independent risk factors for TC (p < 0.001, p = 0.030, p = 0.026, and p < 0.001; respectively). There was no significant impact of the assessed inflammatory indices on the disease-free survival of the patients. LMR, PLR, SII, NLPR, SIRI, and AISI could be potential supportive markers for TC diagnosis. LMR and SIRI could help in differentiating malignant versus benign thyroid nodules.