Abstract This retrospective study aimed to evaluate hematological and inflammatory markers as predictors of thyroid cancer in patients with atypia of undetermined significance thyroid nodules. A total of 174 patients with atypia of undetermined significance who underwent thyroidectomy were included. Pre- and postoperative immature granulocyte counts, neutrophil-to-lymphocyte ratio, and platelet-to-lymphocyte ratio were analyzed after achieving euthyroid status. Propensity score matching for age and gender resulted in a final cohort of 128 patients (64 benign and 64 malignant). Static preoperative and postoperative immature granulocyte values did not differ significantly between the benign and malignant groups; however, the delta immature granulocyte value, defined as the change between pre- and postoperative measurements, was significantly lower in malignant cases (p=0.007). Receiver operating characteristic analysis demonstrated an area under the curve of 0.651 at a cut-off value of≤− 0.01, with a sensitivity of 46.2% and a specificity of 79.2%. Univariate logistic regression revealed that delta immature granulocytes independently predicted malignancy in the overall cohort (odds ratio=3.273 and p=0.007) and in patients younger than 55 years (odds ratio=5.082 and p=0.007), whereas this association was not observed in patients aged 55 years and older. The neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios were not significant predictors. These findings suggest that dynamic changes in immature granulocyte levels between the pre- and postoperative periods, rather than single-time-point measurements, may serve as a cost-effective and accessible complementary tool for malignancy prediction in atypia of undetermined significance thyroid nodules.
TÜFEKÇİ et al. (Mon,) studied this question.