Is the neutrophil-to-lymphocyte "ratio"nale from head and neck to thyroidology for thyroidologists?: promise or passé?

Dear Editor,

We read with a great deal the research article entitled "Is the neutrophil-to-lymphocyte ratio a marker for differentiating between benign and malignant submandibular gland masses?" by Bora¹. This research of high quality seems to demand portraying to evaluation of the effect of the neutrophil-to-lymphocyte ratio (N/L) on distinguishing benign from malignant masses in the submandibular triangle of the head and neck which has recently been published in the 69th volume of Rev Assoc Med Bras¹. The author stated that he retrospectively evaluated 48 cases who had undergone surgery for submandibular gland masses with the histopathology of sialolithiasis, sialadenitis, pleomorphic adenoma²–⁴, and malignant conditions. He deduced and emphasized that N/L, per se, can be used as a biomarker in submandibular gland masses and has prognostic significance in malignant masses. Moreover, he proposed that N/L can be utilized as a biomarker beyond fine needle aspiration cytology. Thereto, he highlighted N/L as being proven in distinguishing between benign and malignant nodules in patients¹ with suspicious thyroid nodules¹,⁵–¹⁷. Nevertheless, at least a minimal debate is still ongoing on an accurate decision on N/L whether it is a biomarker in discrimination of malignity or not. Exempligratia, we reported that N/L was not a convenient and favorable biomarker in forecasting thyroid malignancy¹⁸ in thyroidology¹⁹–²⁹. Of note, N/L, particularly in the thyroid with head and neck providers, the growing spectrum of clinical management for challenging conditions remains, especially for thyroidologists and thyroid health as different peas in a pod. Fide, sed cui vide. As a matter of fact, this issue merits further investigation. We thank Bora¹ for his valuable study.

• Funding: none.

ACKNOWLEDGMENTS

We thank all the study participants.

REFERENCES

• ¹
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• ²
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• ³
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• ⁴
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• ⁵
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• ⁶
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• ⁷
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• ¹³
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• ¹⁶
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• ¹⁸
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• ²¹
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• ²²
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Publication Dates

• Publication in this collection
  20 May 2024
• Date of issue
  2024

History

• Received
  24 Nov 2023
• Accepted
  27 Nov 2023