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      Comparison of Mean Platelet Volume, Platelet Count, Neutrophil/Lymphocyte Ratio and Platelet/Lymphocyte Ratio in the Euthyroid, Overt Hypothyroid and Subclinical Hyperthyroid Phases of Papillary Thyroid Carcinoma

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          Abstract

          Introduction

          Thyroid hormones are essential for the normal development, differentiation, metabolic balance and physiological function of all tissues. Mean platelet volume (MPV) indicates mean platelet size and reflects platelet production rate and stimulation. Increased platelet size has been observed in association with known cardiovascular risk factors. The neutrophil/lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR) are known markers of the systemic inflammatory response. This study aimed to investigate the effect of thyroid hormone changes by comparing platelet count, MPV values, NLR and PLR in thyroid papillary carcinoma.

          Methods

          Forty-nine females and nine males comprising a total of 58 patients were included in the study. Clinical and laboratory parameters of patients were recorded in the following three phases of the disease: euthyroid phase (before thyroid surgery), overt hypothyroid (OH) phase (before radioactive iodine [RAI] treatment) and subclinical hyperthyroid (SCH) phase (six months after RAI treatment).

          Results

          The mean thyroid-stimulating hormone (TSH) values of the patients in the euthyroid, OH and SCH phases were 1.62±1.17, 76.4±37.5 and 0.09±0.07 µIU/mL, respectively. The mean MPV values of the patients in the euthyroid, OH and SCH phases were 9.45±1.33, 9.81±1.35 and 9.96±1.21 fL, respectively. MPV was significantly higher in the SCH phase than in the euthyroid phase (p=0.013). Platelet count, NLR and PLR were not statistically different between the euthyroid, OH and SCH phases.

          Conclusion

          The results of this study demonstrated that the levels of MPV increased significantly in the SCH phase in patients with papillary thyroid carcinoma (PTC), and increased MPV values contributed to increased risk of cardiovascular complications. These findings suggest that MPV can be a valuable, practical parameter for monitoring the haemostatic condition in thyroid disorders. No significant difference was observed in platelet count, NLR and PLR in all stages of PTC.

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          Role of systemic inflammatory response in predicting survival in patients with primary operable cancer.

          Campbell Roxburgh, Donald C. McMillan (2010)
          Disease progression in cancer is dependent on the complex interaction between the tumor and the host inflammatory response. There is substantial evidence in advanced cancer that host factors, such as weight loss, poor performance status and the host systemic inflammatory response, are linked, and the latter is an important tumor-stage-independent predictor of outcome. Indeed, the systemic inflammatory response, as evidenced by an elevated level of C-reactive protein, is now included in the definition of cancer cachexia. This review examines the role of the systemic inflammatory response in predicting survival in patients with primary operable cancer. Approximately 80 studies have evaluated the role of the systemic inflammatory response using biochemical or hematological markers, such as elevated C-reactive protein levels, hypoalbuminemia or increased white cell, neutrophil and platelet counts. Combinations of such factors have been used to derive simple inflammation-based prognostic scores, such as the Glasgow Prognostic Score, the neutrophil:lymphocyte ratio and the platelet:lymphocyte ratio. This review demonstrates that there is now good evidence that preoperative measures of the systemic inflammatory response predict cancer survival, independent of tumor stage, in primary operable cancer. The evidence is particularly robust in colorectal (including liver metastases), gastro-esophageal and renal cancers. As described in this article, measurement of the systemic inflammatory response is simple, reliable and can be clinically incorporated into current staging algorithms. This will provide the clinician with a better prediction of outcome, and therefore better treatment allocation in patients with primary operable cancer. Furthermore, systemic inflammation-based markers and prognostic scores not only identify patients at risk, but also provide well-defined therapeutic targets for future clinical trials.
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            Neutrophil to lymphocyte ratio and cardiovascular diseases: a review.

            Tariq Bhat, Sumaya Teli, Jharendra Rijal … (2013)
            The role of inflammatory markers in cardiovascular diseases has been studied extensively and a consistent relationship between various inflammatory markers and cardiovascular diseases has been established in the past. Neutrophil to lymphocyte ratio (NLR) is a new addition to the long list of these inflammatory markers. NLR, which is calculated from complete blood count with differential, is an inexpensive, easy to obtain, widely available marker of inflammation, which can aid in the risk stratification of patients with various cardiovascular diseases in addition to the traditionally used markers. It has been associated with arterial stiffness and high coronary calcium score, which are themselves significant markers of cardiovascular disease. NLR is reported as an independent predictor of outcome in stable coronary artery disease, as well as a predictor of short- and long-term mortality in patients with acute coronary syndromes. It is linked with increased risk of ventricular arrhythmias during percutaneous coronary intervention (PCI) and higher long-term mortality in patients undergoing PCI irrespective of indications of PCI. In patients admitted with advanced heart failure, high NLR was reported with higher inpatient mortality. Recently, NLR has been reported as a prognostic marker for outcome from coronary artery bypass grafting and postcoronary artery bypass grafting atrial fibrillation.
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              Analysis of the rising incidence of thyroid cancer using the Surveillance, Epidemiology and End Results national cancer data registry.

              Richard D. Cramer, Pingfu Fu, M Wilhelm … (2010)
              The incidence of thyroid cancer has more than doubled in recent decades. Debate continues on whether the increasing incidence is a result of an increased detection of small neoplasms or other factors. Using the Surveillance, Epidemiology and End Results database, we examined the overall incidence of thyroid cancer with variations based on tumor pathology, size, and stage, as well as the current surgical and adjuvant therapy of thyroid carcinoma. Thyroid cancer incidence increased 2.6-fold from 1973 to 2006. This change can be attributed primarily to an increase in papillary thyroid carcinoma, which increased 3.2-fold (P 5-cm tumors (all P 1 cm) well-differentiated thyroid carcinomas should be explored. Copyright © 2010 Mosby, Inc. All rights reserved.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Endocr Metab Immune Disord Drug Targets
                Journal ID (iso-abbrev): Endocr Metab Immune Disord Drug Targets
                Journal ID (publisher-id): EMIDDT
                Title: Endocrine, Metabolic & Immune Disorders Drug Targets
                Publisher: Bentham Science Publishers
                ISSN (Print): 1871-5303
                ISSN (Electronic): 2212-3873
                Publication date (Electronic): September 2019
                Publication date (Print): September 2019
                Volume: 19
                Issue: 6
                Pages: 859-865
                Affiliations
                Department of Endocrinology and Metabolism, Gaziosmanpasa University Faculty of Medicine , Tokat, , Turkey; Department of Nuclear Medicine, Gaziosmanpasa University Faculty of Medicine , Tokat, , Turkey; Department of Internal Medicine, Gaziosmanpasa University Faculty of Medicine , Tokat, , Turkey
                Author notes
                [* ]Address correspondence to this author at the Department of Endocrinology and Metabolism, Gaziosmanpasa University, School of Medicine, 60100 Tokat, Turkey; Tel: +90 (507) 247 73 98; Fax: +90 (356) 212 21 42; E-mail: fkutluturk@ 123456yahoo.com
                Article
                Publisher ID: EMIDDT-19-859
                DOI: 10.2174/1871530319666190206125545
                PMC ID: 7040522
                PubMed ID: 30727930
                SO-VID: cc0f61c0-36d0-49ce-8f27-d8ae58cf6d88
                Copyright © © 2019 Bentham Science Publishers
                License:

                This is an open access article licensed under the terms of the Creative Commons Attribution-Non-Commercial 4.0 International Public License (CC BY-NC 4.0) ( https://creativecommons.org/licenses/by-nc/4.0/legalcode), which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

                History
                Date received : 01 October 2018
                Date revision received : 10 January 2019
                Date accepted : 19 January 2019
                Categories
                Subject: Article

                ScienceOpen disciplines: Endocrinology & Diabetes
                Keywords: hypothyroidism,hyperthyroidism,mean platelet volume,neutrophil/lymphocyte ratio,platelet/lymphocyte ratio,platelet count
                Data availability:
                ScienceOpen disciplines: Endocrinology & Diabetes
                Keywords: hypothyroidism, hyperthyroidism, mean platelet volume, neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, platelet count

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