Neutrophil-to-lymphocyte ratio in benign and malignant thyroid nodules

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Aim This study aimed to investigate the association between the preoperative neutrophil-to-lymphocyte ratio (NLR) and benign versus malignant thyroid pathology among patients undergoing thyroidectomy. Methods A retrospective single-center analysis was conducted on 605 patients with thyroid pathology, including 493 with benign and 112 with malignant nodules. Demographic data, radiological and pathological nodule sizes, and preoperative NLR values were collected. Normality was assessed using the Kolmogorov-Smirnov test. Group comparisons were performed with independent samples t-test, Mann-Whitney U test, and chi-square test as appropriate. A P value < 0.05 was considered statistically significant. Results The groups did not differ significantly in age or sex (P > .05). Benign nodules exhibited larger radiological (32.62 ± 15.38 mm vs. 27.20 ± 16.49 mm) and pathological dimensions (28.80 ± 15.28 mm vs. 12.08 ± 14.45 mm) compared to malignant nodules (P < .01). Lymphocyte counts were higher in malignant cases (P = .03). The NLR was significantly elevated in the benign group (2.18 ± 0.94) compared with the malignant group (1.93 ± 0.63, P < .01). Among patients with nodules <40 mm, NLR distinguished benign from malignant lesions (P = .03), whereas this discriminatory capacity was lost in nodules >40 mm (P = .13). Conclusion The neutrophil-to-lymphocyte ratio may represent a simple, inexpensive, and readily available biomarker for the preoperative assessment of thyroid nodules, particularly in patients with nodules smaller than 40 mm. However, this association was not observed in larger nodules, highlighting the need for validation through prospective, multicenter studies.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.