Predicting Value Of Preoperative NLR And PLR For Tumor Recurrence Of Medullary Thyroid Carcinoma

Objective To analyze the relationship between neutrophil-to-lymphocyte ratio(NLR),plateletto-lymphocyte ratio(PLR)and clinicopathological features of medullary thyroid carcinoma(MTC)and postoperative recurrence of patients.To evaluate its value in predicting postoperative recurrence of MTC and to provide clinical indicators for predicting recurrence.Methods We collected the clinical and pathological data of patients who underwent radical thyroidectomy for the first time in our Hospital from November 2007 to February 2019.Relapse was followed up by telephone inquiry or verification of outpatient review results.Establish the inclusion criteria and enroll the cases.ROC curve was used to calculate the cutoff values of NLR and PLR,and this value is bounded divided the patients into low NLR group and high NLR,low PLR group and high PLR.Then the clinical data of two groups of NLR and PLR patients were compared and analyzed.The data were analyzed by Cox proportional hazards model to explore independent risk factors influencing the prognosis of patients with MTC.Results A total of 82 patients were enrolled,the median follow-up time was 47 months(95%CI=34.3-59.7).17 patients with recurrence were observed,and the 1-,3-,5-year recurrence free survival(RFS)were 96.1,81.1and 75.1%,respectively.The rates of central lymph node metastasis in the NLR-H group and NLR-L group were 68.9% and 40.5%(P=0.01),the rates of lateral lymph node metastasis were 53.3% and 29.7%(P=0.03),and the proportion of clinicopathologic stage(IIII+IV)was 77.8% and 43.2%(P=0.001),respectively.The proportion of clinicopathologic stage(IIII+IV)in the PLRH group and PLR-L group were 76.5% and 52.1%(P=0.03),the rates of lateral lymph node metastasis were 55.9% and 33.3%(P=0.04),respectively.Univariate analysis showed that multifocal,T stage,central lymph node metastasis and preoperative NLR were important factors affecting postoperative recurrence of MTC(P <0.05).Additionally,multivariate analyses showed that the T stage(P=0.031)and preoperative level of NLR(P=0.019)were independent predictors of recurrence in patients with MTC.Conclusion 1.Preoperative NLR and PLR were associated with lymph node metastasis and clinicopathologic stage of MTC.2.Preoperative NLR is an independent risk factor for postoperative recurrence of MTC and can be used as a prognostic indicator for patients with MTC.However,PLR is not an independent risk factor for postoperative recurrence of MTC.