title: May the neutrophil/lymphocyte ratio be a predictor in the differentiation of different thyroid disorders?
abstract: BACKGROUND
  The neutrophil/lymphocyte ratio (NLR) is a simple index of systemic inflammatory response, and has been shown to be a prognostic indicator in some types of cancer. Inflammation has been implicated in the initiation and progression of thyroid cancer. The aim of this study was to examine the relationship of NLR with papillary thyroid cancer (PTC) and different benign thyroid pathologies like multinodular goiter (MNG) and lymphocytic thyroiditis (LT).
  
  
  METHODS
  We retrospectively evaluated the neutrophil, lymphocyte counts and NLR calculated from these parameters of 232 patients with histologically confirmed as multinodular goiter (group MNG) (n=70), lymphocytic thyroiditis (group LT) (n=97), LT with PTC (group LT- PTC) (n=25) and PTC (group PTC) (n=40). The optimal cut-off value for NLR was determined.
  
  
  RESULTS
  NLR level was significantly higher in groups LT-PTC and PTC as compared to groups MNG and LT (p<0.05). NLR of LT subgroups according to TSH levels were not different (p>0.05). When we grouped the patients as benign and malignant according to PTC presence, the optimum NLR cut-off point obtained from ROC analysis was 1.91 (sensitivity 89.0% and specificity 54.5%).
  
  
  CONCLUSIONS
  Since NLR was significantly elevated in group LT-PTC and group PTC, NLR value may give an opinion as a potential marker in differentiation of benign and malign thyroid disorders. For this purpose a cut-off value of 1.91 for NLR may be accepted.
authors.affiliation: Clinical Biochemistry, Training and Research Hospital, Kayseri, Turkey E-mail : ayder78@yahoo.com.
authors.forename: Derya
authors.initials: D
authors.lastname: Kocer
authors.forename: Cigdem
authors.initials: C
authors.lastname: Karakukcu
authors.forename: Hatice
authors.initials: H
authors.lastname: Karaman
authors.forename: Ferhat
authors.initials: F
authors.lastname: Gokay
authors.forename: Fahri
authors.initials: F
authors.lastname: Bayram
mesh_terms: D002291:Carcinoma, Papillary / Q000473:pathology*; D002454:Cell Differentiation; D005260:Female; D005500:Follow-Up Studies; D006044:Goiter, Nodular / Q000473:pathology*; D006801:Humans; D008214:Lymphocytes / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009504:Neutrophils / Q000473:pathology*; D011379:Prognosis; D012372:ROC Curve; D012189:Retrospective Studies; D013964:Thyroid Neoplasms / Q000473:pathology*; D013967:Thyroiditis, Autoimmune / Q000473:pathology*