{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T22:55:24Z","timestamp":1781564124516,"version":"3.54.5"},"reference-count":18,"publisher":"Georg Thieme Verlag KG","issue":"06","license":[{"start":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T00:00:00Z","timestamp":1773619200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Horm Metab Res"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>This retrospective study aimed to evaluate hematological and inflammatory markers\n                    as predictors of thyroid cancer in patients with atypia of undetermined\n                    significance thyroid nodules. A total of 174 patients with atypia of\n                    undetermined significance who underwent thyroidectomy were included. Pre- and\n                    postoperative immature granulocyte counts, neutrophil-to-lymphocyte ratio, and\n                    platelet-to-lymphocyte ratio were analyzed after achieving euthyroid status.\n                    Propensity score matching for age and gender resulted in a final cohort of 128\n                    patients (64 benign and 64 malignant). Static preoperative and postoperative\n                    immature granulocyte values did not differ significantly between the benign and\n                    malignant groups; however, the delta immature granulocyte value, defined as the\n                    change between pre- and postoperative measurements, was significantly lower in\n                    malignant cases (p=0.007). Receiver operating characteristic analysis\n                    demonstrated an area under the curve of 0.651 at a cut-off value of\u2264\u2212\u20090.01, with\n                    a sensitivity of 46.2% and a specificity of 79.2%. Univariate logistic\n                    regression revealed that delta immature granulocytes independently predicted\n                    malignancy in the overall cohort (odds ratio=3.273 and p=0.007) and in\n                    patients younger than 55 years (odds ratio=5.082 and p=0.007), whereas\n                    this association was not observed in patients aged 55 years and older. The\n                    neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios were not significant\n                    predictors. These findings suggest that dynamic changes in immature granulocyte\n                    levels between the pre- and postoperative periods, rather than single-time-point\n                    measurements, may serve as a cost-effective and accessible complementary tool\n                    for malignancy prediction in atypia of undetermined significance thyroid\n                    nodules.<\/jats:p>","DOI":"10.1055\/a-2827-6793","type":"journal-article","created":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T23:46:31Z","timestamp":1773704791000},"page":"229-234","source":"Crossref","is-referenced-by-count":0,"title":["An Evaluation of Immature Granulocytes as Predictors of Malignancy in\n                    Patients with Atypia of Undetermined Significance Thyroid Nodules"],"prefix":"10.1055","volume":"58","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5928-873X","authenticated-orcid":false,"given":"Damla","family":"T\u00fcfek\u00e7i","sequence":"additional","affiliation":[{"name":"Endocrinology and Metabolism, Recep Tayyip Erdogan\n                    Universitesi, Rize, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9122-379X","authenticated-orcid":false,"given":"Hasan","family":"Gucer","sequence":"additional","affiliation":[{"name":"Pathology, Recep Tayyip Erdogan Universitesi, Rize,\n                    Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2026,3,16]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1530\/ETJ-23-0067","article-title":"European thyroid association clinical practice guidelines for thyroid nodule\n                    management","volume":"12","author":"C Durante","year":"2023","journal-title":"Eur Thyroid J"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"48","DOI":"10.4103\/abr.abr_158_23","article-title":"Prevalence of thyroid nodules and predictive factors for their malignancy: Is\n                    there any correlation between level of TSH and type of malignancy?: A cross\n                    sectional study","volume":"13","author":"L Moradi","year":"2024","journal-title":"Adv Biomed Res"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"1105","DOI":"10.1001\/jamasurg.2022.4989","article-title":"Diagnostic accuracy of fine-needle biopsy in the detection of thyroid\n                    malignancy: A systematic review and meta-analysis","volume":"157","author":"V Hsiao","year":"2022","journal-title":"JAMA Surgery"},{"key":"ref4","first-page":"333","article-title":"Malignancy risk with atypia of undetermined significance finding on thyroid\n                    nodule FNA: Clinical experience from a tertiary institution","volume":"58","author":"J Stani\u010di\u0107","year":"2019","journal-title":"Acta clin Croat"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"1167","DOI":"10.1089\/thy.2009.0110","article-title":"Revised American thyroid association management guidelines for patients with\n                    thyroid nodules and differentiated thyroid cancer","volume":"19","author":"C Ds","year":"2009","journal-title":"Thyroid"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"372","DOI":"10.1002\/cncr.30360","article-title":"2015 American Thyroid Association management guidelines for adult patients with\n                    thyroid nodules and differentiated thyroid cancer: What is new and what has\n                    changed?","volume":"123","author":"B R Haugen","year":"2017","journal-title":"Cancer"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1186\/s12967-018-1636-y","article-title":"Predictive values of the selected inflammatory index in elderly patients with\n                    papillary thyroid cancer","volume":"16","author":"W Wen","year":"2018","journal-title":"J Transl Med"},{"key":"ref8","doi-asserted-by":"crossref","first-page":"539","DOI":"10.1016\/S0140-6736(00)04046-0","article-title":"Inflammation and cancer: Back to Virchow?","volume":"357","author":"F Balkwill","year":"2001","journal-title":"The Lancet"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"507","DOI":"10.1007\/s00268-020-05822-6","article-title":"Delta neutrophil index and neutrophil-to-lymphocyte ratio in the differentiation\n                    of thyroid malignancy and nodular goiter","volume":"45","author":"M B Bozan","year":"2021","journal-title":"World J Surg"},{"key":"ref10","doi-asserted-by":"crossref","first-page":"7769","DOI":"10.3390\/jcm13247769","article-title":"A machine learning-based model for preoperative assessment and malignancy\n                    prediction in patients with atypia of undetermined significance thyroid\n                    nodules","volume":"13","author":"G Moon","year":"2024","journal-title":"J Clin Med"},{"key":"ref11","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1186\/s12902-019-0435-7","article-title":"Medullary thyroid carcinoma with double negative calcitonin and CEA: A case\n                    report and update of literature review","volume":"19","author":"C Gambardella","year":"2019","journal-title":"BMC Endocr Disord"},{"key":"ref12","doi-asserted-by":"crossref","first-page":"433","DOI":"10.3390\/biomedicines13020433","article-title":"Thyroidectomy and its complications: A comprehensive analysis","volume":"13","author":"I Gerardi","year":"2025","journal-title":"Biomedicines"},{"key":"ref13","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1186\/s40463-021-00530-0","article-title":"Rate of malignancy for thyroid nodules with AUS\/FLUS cytopathology in a tertiary\n                    care center\u2013a retrospective cohort study","volume":"50","author":"K Hathi","year":"2021","journal-title":"J Otolaryngol-Head Neck Surg"},{"key":"ref14","doi-asserted-by":"crossref","first-page":"1263","DOI":"10.1089\/thy.2012.0453","article-title":"Follicular variant of papillary thyroid carcinoma is a unique clinical entity: A\n                    population-based study of 10,740 cases","volume":"23","author":"X-M Yu","year":"2013","journal-title":"Thyroid"},{"issue":"33","key":"ref15","first-page":"1039","article-title":"The 2023 Bethesda system for reporting thyroid cytopathology","volume":"2023","author":"S Z Ali","journal-title":"Thyroid"},{"key":"ref16","doi-asserted-by":"crossref","first-page":"6466","DOI":"10.3390\/ijms24076466","article-title":"Role of inflammatory biomarkers (NLR, LMR, PLR) in the prognostication of\n                    malignancy in indeterminate thyroid nodules","volume":"24","author":"C Gambardella","year":"2023","journal-title":"Int J Mol Sci"},{"key":"ref17","doi-asserted-by":"crossref","first-page":"e0322382","DOI":"10.1371\/journal.pone.0322382","article-title":"Diagnostic accuracy of neutrophil-to-lymphocyte and platelet-to-lymphocyte\n                    ratios in differentiating thyroid tumors: A systematic review and\n                    meta-analysis","volume":"20","author":"B B Teketelew","year":"2025","journal-title":"PLoS One"},{"key":"ref18","doi-asserted-by":"crossref","first-page":"S178","DOI":"10.1016\/j.ijsu.2014.05.015","article-title":"Efficacy of combined treatment for anaplastic thyroid carcinoma: Results of a\n                    multinstitutional retrospective analysis","volume":"12","author":"G Conzo","year":"2014","journal-title":"Int J Surg"}],"container-title":["Hormone and Metabolic Research"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2827-6793.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T22:35:28Z","timestamp":1781562928000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2827-6793"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,16]]},"references-count":18,"journal-issue":{"issue":"06","published-online":{"date-parts":[[2026,6,15]]},"published-print":{"date-parts":[[2026,6]]}},"URL":"https:\/\/doi.org\/10.1055\/a-2827-6793","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0018-5043","1439-4286"],"issn-type":[{"value":"0018-5043","type":"print"},{"value":"1439-4286","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,16]]}}}