{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T01:47:32Z","timestamp":1783475252779,"version":"3.55.0"},"reference-count":36,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,10,16]],"date-time":"2025-10-16T00:00:00Z","timestamp":1760572800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,10,16]],"date-time":"2025-10-16T00:00:00Z","timestamp":1760572800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Endocrinology"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Patients with medium and high\u2010risk papillary thyroid carcinoma (PTC) demonstrate significantly poorer clinical outcomes compared to their low\u2010risk counterparts. However, current prognostic stratification for this patient population remains suboptimal due to the absence of reliable biomarkers. This investigation aims to evaluate the clinical utility and prognostic potential of three hematological inflammatory indices: the platelet\u2010lymphocyte ratio (PLR), neutrophil\u2010lymphocyte ratio (NLR), and systemic immune\u2010inflammation index (SII) in medium and high\u2010risk PTC cases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This study analyzed 1070 PTC patients from the \u201cDTCC study\u201d (2014\u20132016), a multicenter prospective cohort investigating the initial management of differentiated thyroid cancer (DTC) in China. Preoperative hematological parameters (including PLR, NLR, and SII) and baseline clinical characteristics were evaluated to assess their prognostic significance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In medium and high\u2010risk PTC patients, PLR\u2009\u2264\u2009115.6 predicted increased recurrence risk (OR\u2009=\u20094.579, 95% CI: 1.863\u201311.255,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001) and worse disease\u2010free survival (DFS;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001). Multivariate Cox regression confirmed PLR\u2009\u2264\u2009115.6 as an independent prognostic factor for reduced DFS (HR\u2009=\u20093.080, 95% CI: 1.115\u20138.507,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.030). Notably, this association persisted in intermediate\u2010risk patients. Among high\u2010risk PTC patients, however, SII\u2009\u2264\u2009360.9 (rather than PLR) demonstrated stronger predictive value for recurrence (OR\u2009=\u200915.154, 95% CI: 1.873\u2013122.640,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.011). Consistently, multivariate analysis identified SII\u2009\u2264\u2009360.9 as an independent risk factor for shorter DFS (HR\u2009=\u200914.399, 95% CI: 1.823\u2013113.730,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.011).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Our findings demonstrate that PLR and SII emerged as risk stratification\u2010specific prognostic biomarkers: PLR independently predicted prognosis in intermediate\u2010risk cases, while SII showed superior predictive value for prognosis in high\u2010risk patients. The differential utility of these indices\u2014PLR for intermediate\u2010risk stratification patients and SII for high\u2010risk stratification patients\u2014highlights their complementary roles in clinical decision\u2010making. As routinely available, cost\u2010effective inflammatory markers, PLR and SII may enhance risk\u2010adapted surveillance strategies, though further validation is warranted to standardize cutoff values and integrate them into existing clinical management systems.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>The trial was registered at ClinicalTrials. gov under the identifier NCT02638077.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/cen.70046","type":"journal-article","created":{"date-parts":[[2025,10,17]],"date-time":"2025-10-17T03:35:56Z","timestamp":1760672156000},"page":"255-269","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Prognostic Value of Hematological Inflammatory Indices (PLR, NLR, SII) in Medium and High\u2010Risk Papillary Thyroid Carcinoma: A Multicenter Cohort Study"],"prefix":"10.1111","volume":"104","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8229-4334","authenticated-orcid":false,"given":"Canxiao","family":"Li","sequence":"first","affiliation":[{"name":"Division of Thyroid Surgery, The China\u2010Japan Union Hospital of Jilin University, Jilin Provincial Key Laboratory of Surgical Translational Medicine Jilin Provincial Precision Medicine Laboratory of Molecular Biology and Translational Medicine on Differentiated Thyroid Carcinoma Changchun City Jilin Province China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shijie","family":"Li","sequence":"additional","affiliation":[{"name":"Division of Thyroid Surgery, The China\u2010Japan Union Hospital of Jilin University, Jilin Provincial Key Laboratory of Surgical Translational Medicine Jilin Provincial Precision Medicine Laboratory of Molecular Biology and Translational Medicine on Differentiated Thyroid Carcinoma Changchun City Jilin Province 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