Analysis of the Relationship between Pan-immune-inflammation Value and the Clinical Pathological Characteristics and Surgical Prognosis of Thyroid Cancer.

Abstract

This study aimed to explore the relationship between the preoperative pan-immune-inflammation value (PIV) and the clinicopathological characteristics and surgical prognosis of thyroid cancer. This retrospective cohort study included 165 patients with thyroid cancer who underwent surgery. The value and clinical applicability of PIV and other immune-inflammatory biomarkers in assessing disease-free survival (DFS) were compared based on the area under the receiver operating characteristic (ROC) curve (AUC) and decision curve analysis (DCA). Patients were divided into high and low PIV groups according to the optimal cutoff value to assess the correlation between PIV and pathological characteristics. The Kaplan-Meier method was used for DFS analysis, and a Cox proportional hazards model was used to analyze the factors affecting DFS. The AUC of PIV for predicting DFS was higher than that of other immune-inflammatory biomarkers, and PIV demonstrated the highest clinical utility. Compared with the low PIV group, the high PIV group had a lower proportion of papillary thyroid carcinoma, a higher proportion of anaplastic thyroid carcinoma, and higher rates of stage III-IV disease, lymph node metastasis, maximum tumor diameter ≥2 cm, and multiple lesions. The DFS was significantly shorter in the high PIV group than in the low PIV group. After adjusting for confounding factors, a high PIV level was an independent risk factor for poor surgical outcomes. In conclusion, preoperative PIV is associated with the pathological type of thyroid cancer, TNM stage, lymph node metastasis status, and maximum tumor diameter. Furthermore, a high PIV level can increase the risk of poor surgical outcomes.