Prognostic significance of the pan-immune-inflammation value (PIV) in patients with differentiated thyroid carcinoma

Objective: The pan-immune-inflammation value (PIV) is a novel inflammatory biomarker for evaluating inflammatory status in patients with cancer. The aim of this study was to evaluate the prognostic value of PIV in patients with differentiated thyroid cancers (DTCs). Subjects and methods: The study included 376 patients with DTC who underwent curative resection. The PIV was calculated using the formula (neutrophils x monocytes x platelets)/lymphocytes. The TNM stages 3-4 were considered advanced. Patients were also categorized into low-, intermediate-, and high-risk groups according to the American Thyroid Association (ATA) risk classification system. Demographic, laboratory, and clinicopathological data were obtained from the patients' files. The predictive value of PIV on TNM advanced stage, ATA high-risk category, and distant metastases was evaluated using receiver operating characteristic (ROC) curve analysis. Results: The optimal PIV values for predicting TNM advanced stage, ATA high-risk category, and distant metastases were, respectively, 331.62 (area under the curve [AUC] 0.730, sensitivity 66.7%, specificity 64.8%), 365.52 (AUC 0.822, sensitivity 79.5%, specificity 76.9%), and 357.65 (AUC 0.774, sensitivity 75.2%, specificity 72%). On regression and PIV >= 357.65 (OR 7.224, 95% CI 1.70 0-30.693, p = 0.007) emerged as independent risk factors for ATA high-risk category and distant metastases, respectively. Conclusion: Among patients with DTC, PIV is an independent risk factor for distant metastases and ATA high-risk category. While this finding must be supported by more comprehensive studies, PIV has the potential to be used as a prognostic biomarker in these patients.