{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T04:23:35Z","timestamp":1785558215448,"version":"3.56.0"},"reference-count":28,"publisher":"Public Library of Science (PLoS)","issue":"5","license":[{"start":{"date-parts":[[2021,5,11]],"date-time":"2021-05-11T00:00:00Z","timestamp":1620691200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100002636","name":"Inje University","doi-asserted-by":"publisher","award":["No.20190051"],"award-info":[{"award-number":["No.20190051"]}],"id":[{"id":"10.13039\/501100002636","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:p>The role of systemic inflammation has not been clearly defined in thyroid cancers. There have been conflicting reports on whether systemic inflammatory markers have predictive value for thyroid cancers. We aimed to evaluate the association between systemic inflammatory markers and clinicopathological factors in thyroid cancers and to assess their predictive value for thyroid cancers in detail. Five hundred thirty-one patients who underwent surgery for thyroid nodules were included. The patient population consisted of 99 individuals (18.6%) with benign thyroid nodules and 432 individuals (81.4%) with thyroid cancers. In 432 patients with thyroid cancers, neutrophil-to-lymphocyte ratio (NLR) was significantly higher in the cases with tumors greater than 2 cm than in those with tumors less than 2 cm. (<jats:italic>p<\/jats:italic>= 0.027). NLR and platelet-to-lymphocyte ratio (PLR) were significantly higher in cases with lateral lymph node metastasis (LNM) than in those without LNM (<jats:italic>p<\/jats:italic>= 0.007 and 0.090, respectively). The nodule size was significantly higher in benign thyroid nodules than in thyroid cancers (<jats:italic>p<\/jats:italic>&lt; 0.001). When the cases were stratified by tumor size, NLR was a significant predictor of thyroid cancers in cases with nodules greater than 2 cm (Exp(B) = 1.85, 95% CI = 1.15\u20132.97,<jats:italic>p<\/jats:italic>= 0.011), but not in those with nodules less than 2 cm. In thyroid cancers, preoperative NLR was associated with pathological prognosticators such as tumor size and lateral lymph node metastasis. When the size difference between thyroid cancers and benign thyroid nodules was adjusted, NLR could be a significant predictor of thyroid cancers.<\/jats:p>","DOI":"10.1371\/journal.pone.0251446","type":"journal-article","created":{"date-parts":[[2021,5,11]],"date-time":"2021-05-11T17:29:43Z","timestamp":1620754183000},"page":"e0251446","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":32,"title":["The diagnostic predictive value of neutrophil-to-lymphocyte ratio in thyroid cancer adjusted for tumor size"],"prefix":"10.1371","volume":"16","author":[{"given":"Taek Yoon","family":"Cheong","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sang Duk","family":"Hong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keun-Woo","family":"Jung","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9990-4293","authenticated-orcid":true,"given":"Yoon Kyoung","family":"So","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2021,5,11]]},"reference":[{"key":"pone.0251446.ref001","doi-asserted-by":"crossref","first-page":"1581","DOI":"10.1016\/j.ejca.2014.02.015","article-title":"Neutrophil\/lymphocyte ratio as a prognostic factor in biliary tract cancer","volume":"50","author":"MG McNamara","year":"2014","journal-title":"Eur J Cancer"},{"key":"pone.0251446.ref002","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1186\/1471-2407-14-117","article-title":"Prognostic significance of neutrophil-lymphocyte ratio in hepatocellular carcinoma: a meta-analysis","volume":"14","author":"WK Xiao","year":"2014","journal-title":"BMC Cancer"},{"key":"pone.0251446.ref003","doi-asserted-by":"crossref","first-page":"e92079","DOI":"10.1371\/journal.pone.0092079","article-title":"Prognostic role of NLR in urinary cancers: a meta-analysis","volume":"9","author":"Y Wei","year":"2014","journal-title":"PLoS One"},{"issue":"Suppl 1","key":"pone.0251446.ref004","doi-asserted-by":"crossref","first-page":"E1068","DOI":"10.1002\/hed.24159","article-title":"Neutrophil-to-lymphocyte ratio and overall survival in all sites of head and neck squamous cell carcinoma","volume":"38","author":"S Rachidi","year":"2016","journal-title":"Head Neck"},{"key":"pone.0251446.ref005","doi-asserted-by":"crossref","first-page":"662","DOI":"10.1002\/hed.24658","article-title":"Neutrophil-to-lymphocyte ratio: Prognostic indicator for head and neck squamous cell carcinoma","volume":"39","author":"N Rosculet","year":"2017","journal-title":"Head Neck"},{"key":"pone.0251446.ref006","doi-asserted-by":"crossref","first-page":"526","DOI":"10.1007\/s12020-013-0089-6","article-title":"Prognostic importance of baseline neutrophil to lymphocyte ratio in patients with advanced papillary thyroid carcinomas","volume":"46","author":"JY Kim","year":"2014","journal-title":"Endocrine"},{"key":"pone.0251446.ref007","doi-asserted-by":"crossref","first-page":"535","DOI":"10.1016\/j.jss.2019.09.034","article-title":"Lymphocyte-Monocyte Ratio Significantly Predicts Recurrence in Papillary Thyroid Cancer","volume":"246","author":"M Yokota","year":"2020","journal-title":"J Surg Res"},{"key":"pone.0251446.ref008","doi-asserted-by":"crossref","first-page":"8471235","DOI":"10.1155\/2017\/8471235","article-title":"Association of Baseline Neutrophil-to-Lymphocyte Ratio with Clinicopathological Characteristics of Papillary Thyroid Carcinoma","volume":"2017","author":"DK Manatakis","year":"2017","journal-title":"Int J Endocrinol"},{"key":"pone.0251446.ref009","doi-asserted-by":"crossref","first-page":"494","DOI":"10.3803\/EnM.2015.30.4.494","article-title":"Association of the Preoperative Neutrophil-to-ymphocyte Count Ratio and Platelet-to-Lymphocyte Count Ratio with Clinicopathological Characteristics in Patients with Papillary Thyroid Cancer","volume":"30","author":"SM Kim","year":"2015","journal-title":"Endocrinol Metab (Seoul)"},{"key":"pone.0251446.ref010","doi-asserted-by":"crossref","first-page":"38551","DOI":"10.1038\/srep38551","article-title":"Association between neutrophil-to-lymphocyte ratio and differentiated thyroid cancer: a meta-analysis","volume":"6","author":"JF Liu","year":"2016","journal-title":"Sci Rep"},{"key":"pone.0251446.ref011","doi-asserted-by":"crossref","first-page":"2321","DOI":"10.7314\/APJCP.2016.17.4.2321","article-title":"Lack of Variation in Inflammatory Hematological Parameters between Benign Nodular Goiter and Papillary Thyroid Cancer","volume":"17","author":"S Yaylaci","year":"2016","journal-title":"Asian Pac J Cancer Prev"},{"key":"pone.0251446.ref012","doi-asserted-by":"crossref","first-page":"2406","DOI":"10.4049\/jimmunol.139.7.2406","article-title":"Immunosuppression by activated human neutrophils. 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