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

Abstract

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.