Cancer Management and Research (Dec 2022)
Fibrinogen-to-Neutrophil Ratio as a New Predictor of Central Lymph Node Metastasis in Patients with Papillary Thyroid Cancer and Type 2 Diabetes Mellitus
Abstract
Danni Zheng,1 Jiawen Yang,2 Jiali Qian,2 Lingli Jin,1 Guanli Huang3,4 1Department of Breast Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, People’s Republic of China; 2Wenzhou Medical University, Wenzhou, Zhejiang, People’s Republic of China; 3Department of Breast and Thyroid Surgery Department, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People’s Hospital, Quzhou, Zhejiang, People’s Republic of China; 4Department of Thyroid Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, People’s Republic of ChinaCorrespondence: Lingli Jin, Department of Breast Surgery, The First Affiliated Hospital of Wenzhou Medical University, Shangcai Village, Nanbaixiang Street, Ouhai District, Wenzhou, Zhejiang, People’s Republic of China, Tel +86 577 5557 8527, Email [email protected] Guanli Huang, Department of Breast and Thyroid Surgery Department, The Quzhou Affiliated Hospital of Wenzhou Medical University Quzhou People’s Hospital, Kecheng District, Minjiang Avenue No. 100, Quzhou, Zhejiang, People’s Republic of China, Tel +86 570 8895 120, Email [email protected]: Many patients have a higher risk of thyroid cancer if they have both papillary thyroid carcinoma (PTC) and Type 2 diabetes mellitus (T2DM). Meanwhile, the primary reason for local PTC recurrence is cervical lymph node metastasis. Therefore, the prognosis of patients affects how cervical lymph nodes are managed during surgery. Due to surgical complications such as laryngeal nerve palsy and hypocalcemia, it is still debatable whether to prevent central lymph node dissection (CLND). Predicting central lymph node metastasis (CLNM) is crucial to direct CLND. It is unclear how important the fibrinogen-to-neutrophil ratio (FNR) is in thyroid cancer, so we looked into how it might help patients with PTC and T2DM predict CLNM.Patients and methods: Wenzhou Medical University’s First Affiliated Hospital provided us with 413 patients with PTC and T2DM, randomly divided into a training set (N = 292) and a validation set (N = 121). Univariate and multivariate logistic regression analyses were used to identify independent risk factors. After constructing a nomogram, the validity of the model was evaluated.Results: The maximum tumor diameter, high-density lipoprotein, thyroxine, triglyceride, lymphocyte, and FNR were all identified as independent risk factors by multivariate logistic regression analysis. The C index of the training set was 0.775, and the validation set was 0.654.Conclusion: In patients with PTC and T2DM, preoperative FNR was an independent risk factor for CLNM.Keywords: FNR, PTC, nomogram, CLNM, predictor
