갑상선 유두암 환자에서 혈중 호중구-림프구 비율과 임상병리학적 특징 및 식이섭취의 연관성

Abstract

Papillary thyroid cancer (PTC) is the most common endocrine malignancy. Its occurrence is association with chronic inflammation. Neutrophil-to-lymphocyte ratio (NLR) has emerged as an easy and simple marker of systemic inflammatory response. NLR have been reported to be associated with prognostic factors of papillary thyroid cancer but conflicting results have also been reported, which is controversial. Diet has been suggested to play a role in thyroid cancer, but the association between the NLR and diet has not been studied. The purpose of this study was to investigate the association between NLR and previously known prognostic factors of PTC and evaluate the association between NLR and dietary intake of PTC patients. In this study, total of 401 patients who underwent thyroidectomy for papillary thyroid cancer between March 2011 to September 2017 Hanyang University Hospital were selected. We collected white blood cell count (WBC), neutrophil and lymphocyte from blood tests performed within one month preoperatively. In univariable linear regression analysis, NLR were significantly associated with current consumption of alcohol (β = -0.135, p = 0.011). In addition, dietary intake showed that protein (β = 0.112, p = 0.025), animal protein (β = 0.103, p = 0.038), niacin (β = 0.132, p = 0.008), magnesium (β = 0.106, p = 0.035), iodine (β = 0.210, p <0.001), selenium (β = 0.101, p = 0.042) and seaweed (β = 0.111, p = 0.027) were significantly associated with NLR. Multivariable linear regression analysis of adjusted energy intake showed that preoperative NLR was significantly negative association with current consumption of alcohol (β = -0.142, p = 0.007) and iodine intake (β = 0.171, p = 0.002) was significantly positive association. However, no association was found between preoperative NLR and the previously known prognostic factors of PTC. In addition, the risk for lymph node metastasis was positively association with excessive iodine intake. In conclusion, preoperative NLR did not show association with prognostic factors of papillary thyroid cancer. But preoperative NLR was negative association with current consumption of alcohol and iodine intake was positive association with preoperative NLR. In additional, excessive iodine intake was positively associated with negative prognostic factors such as lymph node metastasis in papillary thyroid cancer.