NPRI and its relationship with the differentiation degree and lymph node metastasis of differentiated thyroid carcinoma

Dong Jianjian; Qin Peng; Zhang Boyang; Sun Dongying; He Yang; Ma Zhongfeng; Wu Jialong; Li Dong

doi:10.11986/j.issn.1673-873X.2025.08.07

Abstract：Objective To investigate the relationship between the neutrophil/prealbumin ratio(NPRI)and the differentiation degree and lymph node metastasis of differentiated thyroid carcinoma(DTC),with the aim of providing a reference for clini-cal decision-making.Methods From May 2022 to August 2024,186 DTC patients treated at our hospital were enrolled as the DTC group;concurrently,180 patients with postoperative pathologically confirmed benign thyroid nodules were selected as the control group.Clinical data of all patients were collected.Neutrophil count,prealbumin level,and NPRI were com-pared between the DTC group and the control group,and among subgroups of the DTC group with different differentiation degrees and different lymph node metastasis status.Receiver operating characteristic(ROC)curves were plotted to evaluate the predictive value of neutrophil count,prealbumin,and NPRI for lymph node metastasis in DTC patients.Stepwise binary logistic regression analysis was used to explore factors influencing lymph node metastasis in DTC patients.Results Neutro-phil count and NPRI in the DTC group were higher than those in the control group,while prealbumin levels were lower than those in the control group;the differences were statistically significant(P＜0.05).Compared with the middle-and high-dif-ferentiation subgroups,the low-differentiation subgroup had higher neutrophil count and NPRI and lower prealbumin level;the middle-differentiation group had higher neutrophil count and NPRI and lower prealbumin level than the high-differentia-tion group;these differences were statistically significant(P＜0.05).Patients with lymph node metastasis had higher neu-trophil count and NPRI and lower prealbumin level than those without metastasis(P＜0.05).ROC analysis showed the ar-eas under the curve(AUC)for neutrophil count,prealbumin,and NPRI in predicting lymph node metastasis in DTC pa-tients were 0.727(0.682-0.772),0.801(0.756-0.851),and 0.904(0.854-0.946),respectively.Univariate analysis indicated that the proportions of patients with tumor diameter ≥2 cm,multiple lesions,and capsular invasion were signifi-cantly higher in the metastasis group than in the non-metastasis group(P＜0.05).Multivariate analysis showed that multi-ple lesions(OR=2.307,95％CI:1.252-4.253),capsular invasion(OR=2.052,95％CI:1.310-3.215),and NPRI 2.68(OR=2.807,95％CI:1.736-4.537)were independent risk factors for lymph node metastasis in DTC patients(P＜0.05).Conclusion Elevated NPRI is closely associated with lower differentiation and lymph node metastasis in DTC pa-tients.NPRI has good clinical value for predicting lymph node metastasis and may serve as a biological marker for anticipa-ting lymph node metastasis in DTC patients.