Immunoinflammatory Markers in Lymph Node Metastasis & PTC | IJGM

Yihua Gu, Ming Yu, Jiaqin Deng, and Yeqian Lai from the Department of Thyroid Surgery at Meizhou People's Hospital in China have conducted a comprehensive study to investigate the relationship between pretreatment systemic immune inflammatory response index (SII), systemic inflammatory response index (SIRI), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), and lymph node metastasis in patients with papillary thyroid carcinoma (PTC). 
 
Thyroid cancer is one of the most common malignant tumors affecting the endocrine system. Particularly in China, both incidence and mortality rates are on the rise due to an aging population. Papillary thyroid carcinoma accounts for about 80% of all thyroid malignancies. 
 
A retrospective analysis was carried out on 547 PTC patients treated at Meizhou People's Hospital from January 2018 to December 2021. The researchers collected clinicopathological data including gender, age, Hashimoto's thyroiditis status, maximum tumor diameter, extra-membrane infiltration, and disease stage, among others. 
 
The results revealed that there were 303 PTC patients with lymph node metastasis—approximately 55.4% of those studied. In these cases, levels of SII, SIRI, NLR, and PLR were significantly higher than those without metastasis; conversely, LMR levels were notably lower. 
 
Through logistic regression analysis, it was determined that being younger than 55 years old, having a maximum tumor diameter greater than one centimeter, possessing the BRAF V600E mutation, showing positive SII indicators (>625.375), or demonstrating NLR positivity (>1.915) increased risk factors for lymph node metastasis in PTC cases. 
 
The research team concluded that these five elements could be considered independent risk factors for lymph node metastases within this particular patient group. This is significant as the presence of lymph node metastasis can affect prognosis, increase postoperative recurrence rates, and increase mortality. 
 
This study also highlighted the potential role of systemic immune inflammation in cancer development. The researchers found that SII, SIRI, and NLR were linked to several diseases, including hepatocellular carcinoma, pancreatic cancer, gastric cancer, and breast cancer, among others. However, their relationship with lymph node metastasis in PTC remains unclear. 
 
In order to address these gaps in knowledge, Gu et al. conducted a retrospective analysis of 547 patients treated at Meizhou People's Hospital between January 2018 and December 2021. They collected data such as gender, age, Hashimoto's thyroiditis status, maximum tumor diameter, extra-membrane infiltration, and disease stage, among others. 
 
The findings showed that there were increased levels of SII, SIRI, NLR,and PLR in patients who had developed lymph node metastases compared with those who had not. Conversely, LMR levels were lower within this group, suggesting a correlation between these immunoinflammatory markers and PTC cases where lymph node metastasis has occurred. 
 
These results present an opportunity for further research into how pretreatment systemic immune inflammatory response index (SII), systemic inflammatory response index (SIRI), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) could be used to predict the likelihood of developing papillary thyroid carcinoma or associated complications like lymph node metastases. 
  
Additionally, this study may have implications for future preventative strategies or treatment options through early identification of risk factors such as being under 55 years old, having a maximum tumor diameter greater than one centimeter, or possessing the BRAF V600E mutation, which currently appear to increase susceptibility to PTC-related health issues.