Prognostic significance of inflammatory markers LMR, PLR, MPV, FIB in intermediate-and high-risk papillary thyroid carcinoma

BACKGROUND: Lymphocyte to monocyte ratio (LMR), platelet to lymphocyte ratio (PLR), mean platelet volume (MPV) and fibrinogen (FIB) have been identified as predictive biomarkers in several malignancies. The aim of this study was to explore the association between inflammatory index with clinicopathologic features as well as recurrence risk in intermediate-to high-risk papillary thyroid carcinoma (PTC). METHODS: Retrospective evaluation of 212 patients diagnosed with intermediate-to high-risk PTC who underwent surgery at China-Japan Union Hospital between 2015 and 2016. Logistic regression and receiver operating curves (ROC) were used to explore possible risk factors. RESULTS: LMR was predictive of capsular invasion (AUC=0.595, P=0.017), FIB was predictive of lymph node metastasis (LN) (AUC=0.714, P=0.002), MPV was predictive of largest LN size ≥1cm (AUC=0.639, P=0.002), PLR and MPV were predictive of recurrence (AUC=0.616, P=0.032; AUC=0.626, P=0.020). In addition, FIB ≤ 2.6 (OR=6.440, 95%CI:1.777-23.336, P=0.005) and capsular invasion (OR=3.773, 95%CI:1.171-12.159, P=0.026) were identified as independent risk factors for lymph node metastasis by multivariate analysis. In addition, LN metastasis (P=0.048), largest LN size ≥ 1 cm (P=0.032), MPV > 9.4 (P=0.046), and PLR ≤ 128.1 (P=0.032) were significantly related with recurrence. Further multivariate regression analysis revealed that PLR ≤ 128.1 was a potentially independent risk factor for recurrence. Specifically, the risk of recurrence was 2.951 times higher in patients with a PLR ≤ 128.1 compared with patients with a PLR > 128.1 (OR=2.951, 95% CI:1.238-7.037, P=0.015). CONCLUSION: In intermediate-to high-risk PTC, LMR, PLR, MPV, and FIB could predict clinicopathologic features and recurrence, with lower PLR being the potential risk factors for recurrence.