Researchers discovered that platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), platelet distribution width (PDW), and mean platelet volume (MPV) may be useful biomarkers in medullary thyroid carcinoma (MTC), as published in Frontiers in Endocrinology

Studies have demonstrated the importance of host systemic responses in determining clinical outcomes and the prognosis of certain cancers. Inflammatory indices, such as PLR and LMR, are widely considered potential biomarkers for predicting cancer outcomes.

MTC accounts for only 1% to 2% of thyroid cancers. There has been scarce research into biomarkers that can be used to evaluate MTC clinical outcomes and prognosis. Given that the inflammatory indices mentioned are already well-established biomarkers for other types of cancers, Li and colleagues set out to determine whether they can likewise be used as biomarkers for MTC.

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Read more about MTC epidemiology 

To carry out their study, the research team retrospectively analyzed 68 patients who were diagnosed with MTC and underwent surgery at their institution between 2009 and 2020. They calculated various inflammatory indices based on the preoperative complete blood count.

Based on postoperative serum calcitonin levels, patients were divided into 3 categories: remission (calcitonin levels returned to normal and remained constant), stable (calcitonin levels were stable but did not decrease to normal values), and progression (calcitonin levels increased to 150 pg/mL or doubling time was less than 12 months). 

“The [receiver operating characteristic] analysis showed that PDW was significantly associated with lateral [lymph node] metastasis, preoperative PLR, PDW, and MPV were predictive of invasion, and MPV and LMR were predictive of postoperative [calcitonin] progression,” the researchers said.

This shows that inflammatory indices could be linked to cancer progression and postoperative calcitonin levels in MTC. “Overall, this suggests that inflammatory indices are potential biomarkers for predicting the clinicopathological features and prognosis of medullary thyroid carcinoma,” Li et al concluded.


Li C, Zhang H, Li S, et al. Prognostic impact of inflammatory markers PLR, LMR, PDW, MPV in medullary thyroid carcinomaFront Endocrinol. 2022;13:861869. doi:10.3389/fendo.2022.861869