Mohammad Mahdi Jafari, Seyed Ziaeddin Rasihashemi, Ebrahim Farashi
Journal of Clinical Practice and Research - 2025;47(5):472-479
INTRODUCTION Thyroid nodules are among the most prevalent endocrine disorders, involving the abnormal growth of thyroid cells that form a lump in the thyroid gland. These typically asymptomatic lumps are often detected during physical examinations or incidentally on imaging studies. Fine-needle aspiration (FNA) is the primary diagnostic method for thyroid nodules; however, it has limitations in detecting thyroid follicular neoplasms, which account for 10-12% of thyroid malignancies.1,2 Ultrasonography and pathological features, such as vascular invasion, can help predict the likelihood of malignancy in thyroid nodules and their subsequent clinical outcomes.3-7 Various inflammatory markers may also have potential diagnostic value in indicating malignancy in neoplasms.8,9 The presence of tumor-infiltrating lymphocytes and neutrophils is associated with the enhancement of immune responses and cytokine production.10,11 In addition, malignant cells stimulate platelet production, which promotes tumor growth, tissue invasion, and cancer cell dissemination.12 This study investigated blood inflammatory markers associated with thyroid follicular neoplasms. Specifically, it evaluated the levels of inflammatory markers, including the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR), in follicular thyroid nodules and assessed their role in predicting the final pathological diagnosis of follicular thyroid neoplasms. MATERIALS AND METHODS Study Design and Participant Selection This cross-sectional descriptive study involved 150 patients aged 18 to 65 years with thyroid nodules who underwent thyroid surgery at Imam Reza Hospital, Tabriz University of Medical Sciences, Iran, between April 2019 and September 2022. After surgery, patients were classified as having benign (follicular adenoma) or malignant thyroid follicular neoplasms based on postoperative pathology results, which considered the presence of capsular and/or vascular invasion. Ethical Approval The study was approved by the local ethics committee of Tabriz University of Medical Sciences, Iran (Code: IR.TBZMED.REC.1402.054, Approval Date: April 17, 2023). Data Collection Demographic data, including sex, age, weight, and medical history, were extracted from patients' medical records. Patients were excluded if they did not have a final diagnosis of follicular adenoma or carcinoma, or if they had underlying infectious or hematological conditions, other associated malignancies, a history of head and neck radiation, coronary artery disease, autoimmune disorders, liver or kidney dysfunction, or long-term use of medications such as steroids. Radiological data were collected, including nodule echogenicity, ultrasound appearance (solid, cystic, or mixed solid-cystic), number of nodules (single or multiple), presence of microcalcifications, and nodule dimensions and location. These parameters were analyzed to assess features potentially associated with malignancy.
