<b>Prediction of the recurrence of differentiated thyroid carcinoma by post-operative neutrophil and platelet count</b>

Objective: The present study aimed to combine pre- and post-operative peripheral blood laboratory indicators with clinicopathological characteristics to predict differentiated thyroid carcinoma (DTC) recurrence. Study Design: Retrospective case-control analysis.Methods: From June 2013 to December 2020, 488 patients with DTC received treatment at The Second Affiliated Hospital of Guangxi University of Science and Technology. Pre- and post-operative inflammatory marker levels and clinicopathological features were obtained from the medical record system. Kaplan–Meier survival analysis and proportional hazards model were used to assess the DTC recurrence risk. The nomogram was developed to estimate the predictive power of the indicators by the C-index, area under the curve (AUC) and calibration curves. Results: 36 (7.38%) of 488 DTC patients suffered recurrence. Lymph node metastases (LNMs) (hazard ratio [HR]=12.07, 95%CI: 1.82–79.97, P=0.010), tumor diameter ≥2 cm (HR=3.78, 95%CI:1.55-9.25, P=0.004), post-operative neutrophil count (post-NEU)>4.78 109/L (HR=0.29, 95%CI:0.11-0.73, P=0.008), and post-operative platelets count (post-PLT)>316 109/L(HR=2.82, 95%CI:1.37-5.81, P=0.005) were independent risk factors for DTC recurrence. The median AUC values for predicting the recurrence of DTC at 2 years and 3 years were 0.86 (range: 0.75-0.97) and 0.84 (0.72-0.95), respectively. Patients with higher risk in nomogram had lower Recurrence-free survival (RFS) rate at both 2 years and 3 years (all P<0.001). Conclusion: In the present study, DTC patients with LNMs, tumor diameter ≥2 cm, higher post-NEU level, and higher post-PLT level exhibited an increased risk of DTC recurrence. The prediction model incorporating these characteristics robust thereby offering valuable insights into the prognostication of DTC patients in practical healthcare applications.</p