Med Bull Sisli Etfal Hosp. 2022; 56(2): 270-275 | DOI: 10.14744/SEMB.2021.78871

Clinical Significance of Erythrocyte Sedimentation Rate, Leukocyte, Fibrinogen, C-Reactive Protein, and Pentraxin 3 Values in Thyroid Nodules

Sabahattin Destek¹, Beyza Benturk², Yunus Yapalak³, Omer Faruk Ozer^4
1Department of General Surgery, Sehit Prof. Dr. Ilhan Varank Sancaktepe Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
²Department of General Surgery, Bezmialem Vakif University, Faculty of Medicine Hospital, Ýstanbul, Turkey
³General Surgery Clinic, Patnos State Hospital, Agri, Turkey
⁴Department of Medical Biochemistry, Bezmialem Vakif University, Faculty of Medicine Hospital, Ýstanbul, Turkey

Objectives: Thyroid nodules (TN) are common. Genetic and environmental factors as well as chronic inflammation play a role in occurrence of these nodules. The key point in diagnostic assessment is to rule out malignancy. Biomarkers that can show the possibility of malignancy continue to be investigated. We evaluated the relationship between sedimentation rate, leukocyte, fibrinogen, C-reactive protein (CRP), and pentraxin 3 (PTX3) inflammatory markers and characteristics and cytology of TN.
Methods: This study included a nodular goiter group with 55 persons and control group with 58 persons. Participants’ gender, age, family history, thyroid function tests, sedimentation, leukocyte, fibrinogen, CRP, and PTX3 serum levels were recorded. The number of nodules, the largest nodule diameter, nodular echogenicity, and nodule structures were examined on ultrasonography (US) and thyroid biopsy was performed.
Results: The number of TN in patients was between 1 and 4. The number of patients with two TN was higher (47.3%, n=26). Nodule diameters differed between 3 and 62 (mean 21) mm. In thyroid biopsy, papillary thyroid cancer was detected in 25.5% (n=14) of the patients. The number of nodules on US increased as CRP values increased (p=0.013). In addition, the number of nodules on US decreased as fibrinogen values increased (p=0.003). No significant difference was found between the groups in terms of sedimentation, leukocyte, and PTX3 values.
Conclusion: The number of TN was positively correlated with CRP and negatively correlated with fibrinogen levels. However, there was no difference between benign and malignant differentiation and biomarkers. CRP values that correlate with the increase in the number of nodules can be used in prognosis and clinical follow-up.

Keywords: C-reactive protein, erythrocyte sedimentation rate, fibrinogen, leukocyte, pentraxin 3, thyroid nodule

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Tiroid Nodüllerinde Eritrosit Sedimantasyon Hýzý, Lökosit, Fibrinojen, C Reaktif Protein ve Pentraxin-3 Deðerlerinin Klinik Önemi

Sabahattin Destek¹, Beyza Benturk², Yunus Yapalak³, Omer Faruk Ozer^4
1Genel Cerrahi Anabilim Dalý, Þehit Prof. Dr. Ýlhan Varank Sancaktepe Eðitim ve Araþtýrma Hastanesi, Saðlýk Bilimleri Üniversitesi, Ýstanbul
²Bezmialem Vakýf Üniversitesi Týp Fakültesi Hastanesi, Genel Cerrahi Anabilim Dalý, Ýstanbul
³Genel Cerrahi Kliniði, Patnos Devlet Hastanesi, Aðrý
⁴Bezmialem Vakýf Üniversitesi Týp Fakültesi Hastanesi, Týbbi Biyokimya Anabilim Dalý, Ýstanbul

Amaç: Tiroid nodülleri yaygýn görülür. Bu nodüllerin oluþumunda, genetik ve çevresel faktörlerin yaný sýra kronik inflamasyon da rol oynamaktadýr. Tanýsal deðerlendirmede anahtar nokta, maligniteyi dýþlamaktýr. Malignite olasýlýðýný gösterebilecek biyobelirteçler araþtýrýlmaya devam etmektedir. Çalýþmamýzda eritrosit sedimentasyon hýzý, lökosit, fibrinojen, C reaktif protein ve pentraxin-3 enflamatuvar biyobelirteçleriyle tiroid nodül özellikleri ve sitolojileri arasýndaki iliþkiyi deðerlendirdik.
Yöntemler: Bu çalýþmada 55 hastadan oluþan nodüler guatr grubu ve 58 saðlýklý bireylerden oluþan kontrol grubu oluþturuldu. Katýlýmcýlarýn cinsiyeti, yaþý, aile öyküsü, tiroid fonksiyon testleri, sedimentasyon, lökosit, fibrinojen, CRP ve pentraksin-3 serum düzeyleri kaydedildi. Ultrasonografide nodül sayýsý, en büyük nodül çapý, nodüllerin yapýlarý incelendi ve tiroid biyopsisi yapýldý.
Bulgular: Hastalarda tiroid nodülü sayýsý 1 ile 4 arasýnda idi. Ýki tiroid nodülü olan hasta sayýsý daha fazlaydý (%47,3, n: 26). Nodül çaplarý 3-62 (ortalama 21) mm arasýnda deðiþmekteydi. Tiroid biyopsisinde hastalarýn %25.5'inde (n: 14) papiller tiroid kanseri saptandý. CRP deðerleri arttýkça ultrasonografide nodül sayýsý arttý (p=0.013). Ayrýca fibrinojen deðerleri arttýkça ultrasonografide nodül sayýsý azaldý (p=0,003). Sedimantasyon, lökosit ve pentraksin-3 deðerleri açýsýndan gruplar arasýnda anlamlý fark bulunmadý.
Sonuç: Nodül sayýsý CRP ile pozitif, fibrinojen seviyeleri ile negatif korelasyon gösterdi. Bu klinik takipte önemli olabilir. Ancak benign ve malign ayrýmý ile biyobelirteçler arasýnda fark yoktu. Nodül sayýsýnýn artýþýyla korelasyon gösteren CRP deðerleri, prognozda ve klinik takipte kullanýlabilir. (SETB-2021-03-063)

Anahtar Kelimeler: Eritrosit sedimantasyon hýzý, lökosit; fibrinojen; C-reaktif protein; pentraksin-3; tiroid nodule

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