The effects of preoperative inflammatory index and immune function on the prognosis of thyroid cancer

Objective This study aimed to investigate the clinical value of preoperative peripheral blood inflammatory indices and immune function in evaluating clinicopathological characteristics and prognosis in thyroid cancer patients. Methods A total of 430 thyroid cancer patients who underwent radical surgery at Shanxi Provincial Cancer Hospital between January 2017 and June 2019 were enrolled as the thyroid cancer group. Additionally, 50 healthy individuals from the hospital’s health examination center during the same period were included as the healthy control group, and 100 patients with thyroid nodules were selected as the thyroid nodule group. Data collected for all participants included routine blood parameters (e.g., neutrophil, lymphocyte, and platelet counts), immune function indicators (e.g., CD3+, CD4+, CD8+, CD19+, and CD56+ cell percentages), and clinicopathological characteristics (e.g., gender, age, pathological type, number of lesions, and metastasis status). Retrospective analysis of clinical data was performed. Survival curves and Cox regression analysis were utilized to identify factors influencing thyroid cancer prognosis. Results Patients in the thyroid cancer group had higher levels of SII and Tg and TgAb than those in the healthy control group ( P = 0.018, P < 0.001, P = 0.007). The levels of SII and Tg and TgAb were higher in patients in the thyroid cancer group than in the thyroid nodule group ( P = 0.022, P = 0.043, P = 0.038). Clinicopathologic results showed that follicular carcinoma ( P = 0.008), occurrence of lymph node metastasis ( P = 0.016), and distant metastasis ( P < 0.001) of thyroid cancer patients had higher SII than those with papillary carcinoma, no lymph node metastasis and distant metastasis. Serum Tg and TgAb levels were higher in patients with thyroid cancer who also had lymph node metastasis ( P _Tg < 0.001, P _TgAb = 0.011) and distant metastasis ( P _Tg < 0.001, P _TgAb < 0.001) than in those who did not. The results of OS survival curves for immune-related factors showed that patients with thyroid cancer had the highest prognostic survival rates when the percentage expression of CD3+ cells, CD4+ cells, CD8+ cells, CD19+ cells, and CD56+ cells were between ≥62.5%, > 37.6%, ≤ 39.6%, ≥ 5.8%, and < 16.8%, respectively. The results of multifactorial analysis showed that age ( P = 0.019), pathologic type ( P < 0.001), presence of lymph node metastasis ( P < 0.001), presence of distant metastasis ( P < 0.001), preoperative SII ( P = 0.001), Tg ( P = 0.008), TgAb ( P = 0.027) levels, and CD8+ cells (%) ( P = 0.013) were independent influences on the prognosis of thyroid cancer patients. Conclusion Preoperative assessment of peripheral blood inflammatory indices and immune function aids in evaluating disease progression and prognosis in thyroid cancer patients. Optimal prognosis is achieved when peripheral immune cells are maintained in a dynamic equilibrium.