Association between blood inflammatory indicators and prognosis of papillary thyroid carcinoma: a narrative review.

ABSTRACT

Background and Objective: Papillary thyroid carcinoma (PTC) is the most common subtype of thyroid cancer, accounting for up to 85-90% of cases, with the best overall prognosis and mostly inert tumors. However, some tumors are aggressive, causing metastasis, recurrence, and other bad outcomes. Preoperative inflammation indices, such as lymphocyte-to-monocyte ratio (LMR), neutrophil-to-lymphocyte ratio (NLR), and systemic immune inflammation index (SII) in peripheral blood, have recently gained attention as nonspecific markers of inflammatory response in thyroid. In this study, we reviewed the interactions between preoperative inflammatory factors and outcomes in patients with PTC. Methods: This is a narrative review. We searched for English articles published between January 2014 and December 2023 on PubMed and Web of Science to identify how do these blood indicators affect the prognosis of patients with papillary thyroid cancer. Key Content and Findings: All retrievable indicators that have predictive significance for the prognosis of PTC were included, and the prognosis mainly included tumor-node-metastasis (TNM) staging, survival rate, recurrence, clinical and pathological risk factors such as lymph node metastasis (LNM), etc. From the general evidence, the prognostic predictive value of cell count alone was unknown, and low LMR was usually associated with poor prognosis, high NLR and high platelet-to-lymphocyte ratio (PLR) usually indicated poor prognosis. Conclusions: These minimally invasive, low-cost, and easily obtainable blood indicators provide convenience for precise prognosis management of PTC patients, but many of the findings are conflicting and need to be validated by prospective studies that are more multi-sample, multi-centre and incorporate factors such as age that affect the immune response.