Linking MPV and NLR to TI-RADS: improved predictive accuracy for thyroid malignancy

The incidence of papillary thyroid cancer has fluctuated, partly due to advancements in neck ultrasonography and fine-needle aspiration (FNA). Identifying additional markers to differentiate benign from malignant thyroid nodules could optimize patient management and reduce unnecessary procedures. This retrospective study included 355 patients categorized into those without nodules (group 1) and those with nodules (group 2). FNA results classified nodules as benign (group A) or malignant (group B). The Pearson and Spearman correlations, Student t test, Mann-Whitney U test, and receiver operating characteristic curve analysis calculated and compared inflammatory markers across groups. The study cohort included 126 patients without nodules (group 1), and 229 patients with nodules (group 2) of whom 39 were diagnosed with papillary thyroid cancer. The median age was 56, with 54.4% females and 45.6% males. Receiver operating characteristic analysis revealed significant but poor diagnostic performance for mean platelet volume (MPV) and neutrophil-to-lymphocyte ratio (NLR), with optimal cutoff values of 10.1 and 1.60, respectively (P < .001; area under the curve: 0.30), and P < .001, area under the curve: 0.24, respectively). Patients with MPV ≥ 10.1 fL had a higher prevalence of thyroid cancer (17.1%) compared to those with MPV < 10.1 fL (5.4%). Patients with NLR ≥ 1.6 exhibited a higher prevalence of thyroid cancer (54.7%) compared to those with NLR < 1.6 (4.6%). Higher MPV and NLR values were also significantly associated with higher thyroid imaging reporting and data system classifications (P < .001 and P = .05, respectively). Elevated MPV and NLR are significantly associated with thyroid cancer and higher thyroid imaging reporting and data system classifications. These markers, combined with ultrasonography and FNA, may aid in differentiating benign from malignant thyroid nodules, potentially improving patient management and reducing unnecessary procedures.