{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T00:07:58Z","timestamp":1785197278596,"version":"3.55.0"},"reference-count":42,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,2,23]],"date-time":"2026-02-23T00:00:00Z","timestamp":1771804800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,2,23]],"date-time":"2026-02-23T00:00:00Z","timestamp":1771804800000},"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":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Differentiated thyroid carcinoma (DTC) has an excellent prognosis, but recurrence remains a clinical concern, especially in intermediate\u2010risk patients. Current stratification systems focus primarily on tumor characteristics, overlooking the host's biological capacity to counteract tumor progression. To investigate this aspect, we assessed systemic inflammatory and nutritional status using hematological indices. The study aimed to evaluate the prognostic value of these markers in predicting recurrence risk in patients with intermediate\u2010risk DTC.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively analyzed consecutive patients with intermediate\u2010risk DTC who met the following criteria: (1) were classified as intermediate risk according to ATA guidelines; (2) showed an excellent or indeterminate response 12 months after initial treatment; and (3) had at least three consecutive years of follow\u2010up at our center after thyroidectomy. Nine hematological indices were calculated from blood samples collected on the day of RAI administration. Statistical analyses included ROC curve analysis, logistic regression, and Kaplan\u2013Meier analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 282 patients were included, with a median follow\u2010up of 91 months. Among the indices tested, the monocyte\u2010to\u2010lymphocyte ratio (MLR) predicted recurrence better than the others. A cut\u2010off of 0.188 yielded 82.9% sensitivity and 54.7% specificity (AUC: 0.70). In multivariate analysis, high MLR (OR\u202f\u2009=\u2009\u202f4.94,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f\u2009&lt;\u2009\u202f0.001), tumor size, vascular invasion, and lymph node metastases were independently associated with recurrence. Cox regression confirmed MLR as an independent predictor of shorter recurrence\u2010free survival (HR\u202f\u2009=\u2009\u202f3.01,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009\u202f0.001). Nutritional indices showed no prognostic value.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Pre\u2010RAI MLR may serve as a simple marker to refine recurrence risk stratification and personalize follow\u2010up in intermediate\u2010risk DTC.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/cen.70113","type":"journal-article","created":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T23:36:25Z","timestamp":1773012985000},"page":"670-681","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Pre\u2010RAI Monocyte\u2010to\u2010Lymphocyte Ratio Predicts Early and Higher Recurrence Risk in Intermediate\u2010Risk DTC, While PNI and NRI Show No Prognostic Value"],"prefix":"10.1111","volume":"104","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0567-6494","authenticated-orcid":false,"given":"Tommaso","family":"Piticchio","sequence":"first","affiliation":[{"name":"Department of Medicine and Surgery University Kore of Enna Enna Italy"},{"name":"Department of Clinical and Experimental Medicine, Endocrinology Section Garibaldi\u2010Nesima Hospital, University of Catania Catania Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-4104-1105","authenticated-orcid":false,"given":"Francesco","family":"Galeano","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Medicine, Endocrinology Section Garibaldi\u2010Nesima Hospital, University of Catania Catania Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salvatore","family":"Volpe","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Medicine, Endocrinology Section Garibaldi\u2010Nesima Hospital, University of Catania Catania Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-7021-9860","authenticated-orcid":false,"given":"Antonio","family":"Prinzi","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Medicine, Endocrinology Section Garibaldi\u2010Nesima Hospital, University of Catania Catania Italy"},{"name":"Department of Precision Medicine in Medical, Surgical and Critical Care (Me.Pre.C.C.) University of Palermo  Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ignazio","family":"Barca","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Medicine, Endocrinology Section Garibaldi\u2010Nesima Hospital, University of Catania Catania Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Scuto","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Medicine, Endocrinology Section Garibaldi\u2010Nesima Hospital, University of Catania Catania Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosario","family":"Le Moli","sequence":"additional","affiliation":[{"name":"Department of Medicine and Surgery University Kore of Enna Enna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulio","family":"Geraci","sequence":"additional","affiliation":[{"name":"Department of Medicine and Surgery University Kore of Enna Enna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Tumminia","sequence":"additional","affiliation":[{"name":"Endocrine Unit, A.R.N.A.S Garibaldi\u2010Nesima Hospital Catania Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sium","family":"Wolde Sellasie","sequence":"additional","affiliation":[{"name":"Division of Endocrinology and Diabetes, CTO Andrea Alesini Hospital, Department of Surgical Sciences University of Rome Tor Vergata Rome Italy"},{"name":"PhD School of Applied Medical\u2010Surgical Sciences University of Rome Tor Vergata Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Pallotti","sequence":"additional","affiliation":[{"name":"Department of Medicine and Surgery University Kore of Enna Enna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Frasca","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Medicine, Endocrinology Section Garibaldi\u2010Nesima Hospital, University of Catania Catania Italy"},{"name":"Endocrine Unit, A.R.N.A.S Garibaldi\u2010Nesima Hospital Catania Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,2,23]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-8587(22)00035-3"},{"key":"e_1_2_11_3_1","unstructured":"SEER*Explorer: An interactive website for SEER Cancer Statistics. Surveillance Research Program National Cancer Institute accessed May 27 2025 https:\/\/seer.cancer.gov\/statistics-network\/explorer\/."},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/pon.3903"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12020-024-04027-4"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdz400"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2015.0020"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijms20184413"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.3892\/mco.2013.170"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1080\/10408398.2020.1714542"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.3390\/nu14061298"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.3390\/biomedicines12010239"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/ncp.11336"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.3390\/medicina61050785"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1515\/med-2025-1214"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.3389\/fnut.2025.1577563"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1177\/10732748241309048"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000019686"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2023.1253394"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/jso.27363"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12885-024-12801-w"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(07)61602-X"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40618-024-02480-6"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1159\/000354537"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.21037\/gs-24-72"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2016-2555"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.envpol.2022.120478"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12957-020-01962-0"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.3390\/diagnostics12112655"},{"key":"e_1_2_11_30_1","doi-asserted-by":"publisher","DOI":"10.1620\/tjem.2023.J074"},{"key":"e_1_2_11_31_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12020-020-02328-y"},{"key":"e_1_2_11_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jss.2019.09.034"},{"key":"e_1_2_11_33_1","doi-asserted-by":"publisher","DOI":"10.1177\/15330338211027910"},{"key":"e_1_2_11_34_1","doi-asserted-by":"publisher","DOI":"10.1177\/10732748221115236"},{"key":"e_1_2_11_35_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11154-023-09845-x"},{"key":"e_1_2_11_36_1","first-page":"399","volume-title":"Nat Rev Clin Oncol","author":"Mantovani A.","year":"2017"},{"key":"e_1_2_11_37_1","doi-asserted-by":"publisher","DOI":"10.3390\/cancers17050794"},{"key":"e_1_2_11_38_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40425-019-0656-3"},{"key":"e_1_2_11_39_1","doi-asserted-by":"publisher","DOI":"10.1038\/nri3399"},{"key":"e_1_2_11_40_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9610(80)90246-9"},{"key":"e_1_2_11_41_1","doi-asserted-by":"publisher","DOI":"10.1093\/ajcn\/47.2.366"},{"key":"e_1_2_11_42_1","doi-asserted-by":"publisher","DOI":"10.1093\/ajcn\/47.2.357"},{"key":"e_1_2_11_43_1","doi-asserted-by":"publisher","DOI":"10.2147\/CMAR.S239296"}],"container-title":["Clinical Endocrinology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/cen.70113","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/cen.70113","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/cen.70113","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T02:59:15Z","timestamp":1777431555000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/cen.70113"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,23]]},"references-count":42,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2026,6]]}},"alternative-id":["10.1111\/cen.70113"],"URL":"https:\/\/doi.org\/10.1111\/cen.70113","archive":["Portico"],"relation":{},"ISSN":["0300-0664","1365-2265"],"issn-type":[{"value":"0300-0664","type":"print"},{"value":"1365-2265","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,23]]},"assertion":[{"value":"2025-07-21","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-02-18","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-02-23","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}